[Prosthetic rehabilitation with dental implant in cleft lip and palate: a ten-year retrospective study]. / Réhabilitation implantaire des fentes labiopalatines: étude rétrospective sur dix ans.

INTRODUCTION: Two problems need to be faced during cleft lip and palate surgical treatment to gain a functional and esthetic result: restoration of the maxillary bone defect and the missing lateral incisor tooth, which may be replaced by an implant. The aim of our study was to demonstrate that it is possible to successfully place a dental implant after obtaining adequate bone graft volume. PATIENTS AND METHOD: 12 consecutively treated patients were studied, 7 with unilateral and 5 with bilateral clefts, mean age 21.5 years, with an average follow-up of 5.5 years (range: 1-10 years). Various types of autogenous or alogenous bone grafts were performed to provide adequate bone volume for immediate or secondary implant placement. We studied the number of bone grafts needed to reach this target, and the number of implants placed, focusing on lateral incisor tooth replacement. RESULTS: Enough cleft bone volume for the implant was obtained in 9 out of 12 cases (75%). All endosseous implants placed in bone graft were successfully restored, 8 out of them for lateral incisor. Some surgical cases are described. DISCUSSION: Global improving of cleft lip and palate surgical treatment by implantology is now feasible. Maxillary defect bone grafting, often in several stages, is strictly necessary to place an implant but also to obtain a good cosmetic result in cleft repair. Length, direction, and cervical implant position have to be considered too. Reconstruction of mucosal anatomy also contributes to the end result.

[Pseudo-tumoral osteomyelitis. Immunologic study and etiopathogenic approach. Apropos of 2 cases]. / L'ostéomyélite pseudo-tumorale. Etude immunologique et approche étiopathogénique. A propos de 2 cas.

Two cases of pseudo-tumoral osteomyelitis are reported. The first concerns a 12 year-old boy who presented with pain of the left knee during 8 months and, later on, with swelling of the upper extremity of the left leg, without fever or local inflammatory signs. The radiological aspect of condensation with a filling defect and "chimney" crossing the cartilage led to osteotomy. Local bacteriological samplings were normal. The second case concerns a 11 year-old boy who, after having complained from pain of the right wrist during 2 weeks, presented with swelling and on X-ray films a picture of metaphyso-epiphyseal lysis and an aspect of sequestrum in its center. There was no biological sign of inflammation. Evolution was favorable after antibiotic treatment and immobilization. In both cases, an immunological study showed an activation syndrome of the immune system with increased serum IL-1, IL-2 receptors and class II antigen receptors on the surface of T cells, suggesting a previous immunization of both children towards staphylococcus and, thereby, the subacute nature of evolution.

[Recurrent multifocal periostosis in children. Report of a familial form]. / La périostose multifocale récurrente de l'enfant. A propos d'une forme familiale.

Recurrent multifocal periostosis of childhood is an infrequent disease. All cases reported to date have been sporadic. A familial form affecting three siblings is reported herein. Clinical and biologic features were similar to those described in the previously reported cases. This case is of particular interest for two reasons: 1) the pattern of familial clustering suggests autosomal recessive transmission; 2) repeated CT scans were performed in these patients (but not in previously reported cases) and demonstrated early involvement of the three bone layers, suggesting panostosis rather than periostosis.

[Contribution of echography in the course and treatment of acute osteomyelitis]. / Apport de l'échographie dans l'évolution et le traitement de l'ostéomyélite aiguë.

In a series of 43 cases of acute hematogenous osteomyelitis, the ultra sound (US) allowed the diagnosis and the accurate localisation of the sub periosteal abscess. The early surgical treatment of the sub periosteal abscess since its nascent or, at least, before its rupture into the soft parts, changes completely the development of the illness and reduces considerably the chronicity forms. This early surgical treatment allows also to isolate rapidly the germ and to test its sensitiveness to antibiotics, which insures a better effectiveness to the medical treatment.

[Long-term results of the treatment of fractures of the patella]. / Résultats lointains du traitement des fractures de la rotule.

A series of 400 patellar fractures has been reviewed with a follow-up of three to 12 years. The continuity of the extensor apparatus had been interrupted in 73 per cent of cases and in 21 per cent the fracture was compound. The best results were obtained by conservative treatment with plaster, patellar suture or partial patellectomy. Total patellectomy, in contrast, only gave satisfactory results in one case out of two.