Repair of bony defect with combination biomaterials.

BACKGROUND: Numerous possibilities are available for the reconstruction of facial bone defects. The materials used to fill such defects must satisfy various requirements. One of the most important is that they must undergo transformation into autologous bone tissue in the process of remodeling. AIM: A report is given of the long-term results of augmentations of large bone defects performed with different bone-substitute materials in two patients. PATIENTS AND METHODS: In one case, augmentation was carried out with beta-tricalcium phosphate after the removal of a fibromyxoma. In the second case, three large cystic lesions in the mandible of a patient with Gorlin-Goltz syndrome were filled with beta-tricalcium phosphate, with a mixture of beta-tricalcium phosphate and platelet concentrate, or with hydroxyapatite of algal origin. The process of ossification was checked at 6-month intervals by means of clinical, radiologic (orthopantomograms and two-dimensional and three-dimensional computer tomograms), and histologic methods. RESULTS: At 1 year after the intervention, the site of the augmentation was in all cases occupied by hard tissue of good quality. With the given imaging procedures, it was difficult to distinguish between the original bone and the region filled with bone-substitute material. The three-dimensional computer tomogram images indicated that the contours and quality of the new bone corresponded with the physiologic and anatomical conditions. The histologic examinations show the remodeling of the bone-substitute materials. DISCUSSION: The bone-substitute materials applied in these cases fully satisfied the demands of transformation into bone (remodeling). The speed of remodeling seemed to be the fastest when the mixture of beta-tricalcium phosphate and platelet concentrate was used.

Sternocleidomastoid tumor of infancy: two cases of an interesting entity.

Sternocleidomastoid tumor of infancy (SCMTI), also known as fibromatosis colli or muscular torticollis, is the most common cause of congenital torticollis. It is present in approximately 0.4% of live births, and usually 90% of patients will have a good prognosis if therapy is initiated and continued for the appropriate period of time. This paper presents two cases of SCMTI and explains the diagnostic modalities and treatment options for this entity. SCMTI should be diagnosed early in the infant's life, since early detection and initiation of conservative treatment leads to resolution of the disease in the majority of patients.

[Osteomas of the jaws. A clinical and rehabilitative problem]. / Osteomi dei mascellari. Un problema clinico e riabilitativo.

The authors study, based on three cases of maxillary osteoma brought to their attention, evaluates the most suitable type of operation to perform, and the method with which to attention which to approach the problem of postoperative functional rehabilitation. This pathological condition is characterized by slow developments and the late appearance of symptoms deriving from the invasion of surrounding tissues. The chosen technique is surgery, involving the removal of the neoplasm. The benign nature of the neoplasm makes conservative surgery possible, including the partial removal of the neoplasm, in order to preserve the bone tissue indispensable for prosthetic rehabilitation. In cases in which the neoplasm spreads to surrounding tissues, in which more destructive surgery is required with an attendant loss of considerable portions of bone, we have used osteo-muscular pedicle flaps in combination with implantation techniques to obtain adequate functional and prosthetic rehabilitation.

[Resection and reconstruction of mandible for treatment of two rare benign tumors]. / Résection et reconstruction de la mandibule pour le traitement de deux tumeurs bénignes rares.

Odontogenic myxoma and particularly juvenile fibromatosis are rare benign tumors in the maxillo-facial region. The aggressive local and sometimes voluminous development of these tumors may necessitate partial mandibulectomy. Autologous bone graft from the iliac crest is the best material for mandibular reconstruction because of its functional and esthetic results. If osteosynthesis of the graft is achieved by means of internal wiring, several weeks of intermaxillary fixation are required, whereas internal rigid fixation with plate and screws allows the patient to open the mouth more rapidly.