First face composite-tissue transplant recipient successfully treated for cytomegalovirus infection with preemptive valganciclovir treatment.

Little is known about cytomegalovirus (CMV) infection after face transplantation, since only two of the 11 cases of face transplantation reported worldwide have documented a CMV infection after transplantation. Herein, we present the first report of a composite-tissue face allotransplant recipient at high risk for CMV infection (D(+)/R(-) [CMV serpositive donor positive/CMV seronegative receptor]) undergoing preemptive treatment. Preemptive treatment was safe and effective for controlling CMV infection and thus promoting early acquisition of a CMV-specific immune response that protected the patient from late-onset CMV disease.

Reconstruction of a severe facial defect by allotransplantation in neurofibromatosis type 1: a case report.

BACKGROUND: On January 26, 2010, our team performed a facial transplant for a patient with neurofibromatosis type 1. We detail the perioperative surgical strategies for the composite tissue allograft (CTA) of the lower parts of the face to restore a severe defect after excision of bilateral massive plexiform neurofibromas. The main distinctive feature included an innovative provisional heterotopic transplantation (PHT) technique of the facial allograft to the femoral vessels before its final orthotopic transplantation. CASE REPORT: A 35-year-old Caucasian man received a CTA of the lower two-thirds of the face, including a chin osseous segment. The face was obtained from a non-heart-beating donor. The sequence of microsurgical procedures began by performing a PHT of the CTA to the recipient's femoral vessels in the right thigh. Intraoperatively, he experienced considerable blood loss that required transfusion of 24 units of packed cells. Surgical revision was required at day 7 to remove an extensive hematoma in the right side of the CTA. The maintenance immunosuppressive regimen included steroids, mycophenolate mofetil, and tacrolimus. CONCLUSION: We have reported a case of successful provisional transplantation of a human facial allograft onto the thigh as an alternative technique in human face transplantation. PHT was a reliable alternative procedure to obtain the facial allograft from a cadaveric donor.

Cementoblastoma involving the maxillary sinus.

A cementoblastoma is rare, benign, and of odontogenic ectomesenchymal origin, usually associated with the roots of the first mandibular tooth. We present an unusual case of one that involved the roots of the first and second maxillary molars, extended into the maxillary sinus, and was associated with a displaced unerupted third molar. The initial presentation was misleading and resulted in inadequate management. The definitive diagnosis had not been established until 2 years later.

[Frontal sinus obliteration using tibial bone graft and platelet-rich plasma for the treatment of chronic osteomyelitis]. / Obliteración del seno frontal mediante injerto de tibia y plasma reco en plaquetas para el tratamiento de la osteomielitis crónica.

OBJECTIVES: The more successfully surgical treatment for the treatment of chronic frontal sinusitis complicated with chronic osteomielitis, is the cleaning and curettage of the sinus with obliteration of the sinus cavity and nasofrontal duct. Several autologous and alloplastics materials are used for this obliteration. MATERIAL AND METHODS: We report the case of a patient previously operated on because of frontal sinus plasmocytoma who developed frontal sinusitis with chronic osteomielitis and cutaneous suppuration. He received surgical treatment with frontal sinus curettage and obliteration with tibial bone graft and platelet-rich plasma (PRP). Symptoms disappeared and there were no complications or recurrence. CONCLUSIONS: Obliteration of the frontal sinus with tibial bone graft and PRP after sinus cleaning and curettage can be a good alternative in the treatment of chronic frontal sinus osteomielitis.

Dental gemination: report of case.

Dental anomalies can be classified in different groups: anomalies of volume, anomalies of number, anomalies of form, anomalies of position and anomalies by union. Of the latter, we distinguish between fusion, alveolus-dental gemination, concrescence, coalescence and anchylosis. Gemination is more frequent in the anterior teeth, although it can also affect the bicuspids and molars, being an anomaly of infrequent union (prevalence 0.5%). We present the case of a young male patient age 19, without medical antecedents of interest, that goes to consultation for repeated inflammatory accidents at level of the inferior left retromolar area. These episodes are caused by a semi-impacted inferior third molar that is fused to a supernumerary fourth molar, sharing its roots, crown, pulp chambers and canals. After the appropriate radiologic study and suitable planning, the semi-impacted third molar was extracted under local anaesthesia and without any other complications during or after the operation.

Ameloblastic carcinoma of the maxilla: a report of 3 cases.

Odontogenic carcinomas of the maxilla are classified as malignant ameloblastoma, ameloblastic carcinoma or primary intraosseous carcinoma. The term 'ameloblastic carcinoma' is used to describe those ameloblastomas in which there is histological evidence of malignancy in the primary, recurrent or metastatic tumour. Three cases of ameloblastic carcinoma with an unusual location in the maxilla are presented here. Histologically, the lesions were characterized by typical zones of ameloblastoma as well as zones with anaplastic transformation. The authors review the literature describing the clinical and histological presentation and the treatment of this rare tumour.

Mandibular fractures in children. A retrospective study of 99 fractures in 59 patients.

Fifty-nine children younger than 16 years with mandibular fractures were studied by age, sex, type of fracture, cause, methods of treatment, and complications. The cases were divided into three age groups. The male-to-female ratio was 2.9:1. Motor vehicle accidents were the most common cause of mandibular fractures. Associated injuries were more common in young children. The condyle was involved in 43.3% of fractures. Intermaxillary fixation was the most common treatment used. Complications appeared to be rare.