Clinical Evaluation of Unsintered Hydroxyapatite Particles/Poly L-Lactide Composite Device in Craniofacial Surgery.

ABSTRACT: A total of 47 patients who underwent the craniofacial implantation of unsintered hydroxyapatite particles and a poly-L-lactide device were evaluated for clinical local findings and computed tomography (CT) images after about 6 months. Long-term follow-up of 3 patients was done from 5 to 11 years. The patients underwent CT imaging pre- and postoperatively, while local clinical examination was done upon follow-up. For the 3 patients who were followed up for more than 5 years, implant changes were evaluated by using CT. Computed tomography revealed 3 patients of dislocation, 2 patients of insufficient bone union, and 3 patients of implant breakage. All patients healed well with no complications requiring a secondary operation. The CT findings of the long-term cases revealed the following: a plate and screw were still present 5 years postsurgery (patient 1), mesh implants were completely resorbed after 9 years and 6 months (patient 2), and plates were almost resorbed after 11 years but some of their shapes remained (patient 3).The unsintered hydroxyapatite/poly-L-lactide device is useful in the maxillofacial region in terms of strength and radiographic contrast. However, since the absorption rate is slow, it is necessary to keep in mind its long-term radiographic detectability and the possibility of late-onset granuloma.

Use of dermal fat grafts for treating anetoderma with lipoatrophy following involution of hemangiomas.

Infantile hemangioma (IH) is a benign vascular tumor that gradually involutes over several years. Rapidly involuting congenital hemangioma (RICH) is the relatively rare congenital vascular tumor that is fully grown at birth and does not undergo postnatal growth and involutes during the first year. However, after involution of both IH and RICH, some have severe sequelae, such as redundant skin or conspicuous scarring, requiring additional treatment. We present the case of a 6-year-old girl with a concave deformity due to subcutaneous atrophy, skin darkening, and altered skin texture of her left zygomatic region following involution of a hemangioma. We successfully treated this patient by transferring a dermal fat graft. This technique can be beneficial for atrophic sequelae after regression of a hemangioma and is easy to perform and cosmetically effective.

Deprotonative Silylation of Aromatic C-H Bonds Mediated by a Combination of Trifluoromethyltrialkylsilane and Fluoride.

A method for the deprotonative silylation of aromatic C-H bonds has been developed using trifluoromethyltrimethylsilane (CF3SiMe3, Ruppert-Prakash reagent) and a catalytic amount of fluoride. In this reaction, CF3SiMe3 is considered to act as a base and a silicon electrophile. This process is highly tolerant to various functional groups on heteroarenes and benzenes. Furthermore, this method can be applied to the synthesis of trimethylsilyl group-containing analogs of TAC-101, which is a bioactive synthetic retinoid with selective affinity for retinoic acid receptor α (RAR-α) binding. We also report further transformations of the silylated products into useful derivatives.