[Prosthetic and surgical options in the rehabilitation of the after-effects of alveolar clefts]. / Choix chirurgico-prothétiques dans la gestion alvéolaire des séquelles de fentes labio-maxillo-palatines.

The question of final-phase treatment and prosthetic rehabilitation is posed for the young adult patient who has followed a program of surgical, orthopedic, and orthodontic work aimed at achieving a functional, aesthetic balance. When a toothless space has been maintained or recreated between the proximal teeth of each fragment, two solutions are at hand for the expert odontologist: implantology, or traditional joint prosthesis. Four problems are evoked here to describe the difficulties related to this therapeutic decision: confrontation of the banks, residual osseous defect, teeth bordering the cleft, and the odontologist's role in the overall responsibility for the patient. The choice of the final surgical and prosthetic context induces a multifactor analysis, and must be integrated early on, as part of a multidisciplinary therapeutic strategy. Psychological acceptance is thereby favored, along with the rational search for a durable, aesthetic result.

Obstructive congenital gingival granular cell tumor.

Congenital gingival granular cell tumors (also known as congenital epulis or Neumann's tumor) are rare and always benign intraoral tumors originating from the alveolar ridge. They are typically seen as a mass protruding out of a newborn child's mouth. We report a case of a large obstructive congenital gingival granular cell tumor of the mandibular ridge. The intraoral mass was first detected on a 38-week prenatal ultrasound scan and resulted in neonatal airway obstruction. Complete surgical removal was performed with an uneventful postoperative course. Histologic and immunohistochemical assessments with antibodies against S-100 protein confirmed the diagnosis. The clinical and morphological aspects, differential diagnosis, histogenesis, and treatment are discussed.

Unicoronal suture autotransplantation in the rabbit.

INTRODUCTION: Our hypothesis was that a neurocranial suture autograft will, when shielded from dura, grow and be incorporated into the calvarium. METHODS: Growth was monitored by marker separation in three isohistogenic groups of rabbits, between postnatal days 9 and 90. In order to simulate increased neurocapsular expansion force, the left-sided coronal suture of a group of 20 rabbits was immobilised with a resorbable suture on gestational day 25. The other group of 10 rabbits was sham-operated. On postnatal day 9, 10 of the experimental rabbits underwent transplantation of the suture contralateral to the defect resulting from extirpation of the immobilised suture. The transplant was shielded from dural influence by a platinum foil. RESULTS: The growth of the immobilised coronal sutures was severely impaired, and also that of the contralateral unicoronal sutures to a lesser extent. A significant catch-up of growth occurred in the transplanted unicoronal sutures. Overgrowth occurred at the donor sites. CONCLUSION: The results allow us to consider suture transplantation combined with endosteal dura stripping in craniosynostosis surgery.

[Evolution of the craniofacial surgery in Nancy]. / Evolution de la chirugie crânio-faciale.

The fantastic promotion of the craniofacial surgery during the last three decades and the success raised up from it, comes from the neuro-sensorial concentration in this region, from the severe psychological affect of the ugliness resulting from a trauma or a malformation, finally from the repair by the way of rigorous protocols, fulfilled by a multidisciplinary team all along the evolution and growth.