Esthetic and functional reconstruction of the posttumoral interrupted mandible with double-barrel fibular free flap graft: rationale for a microsurgical and prosthodontic approach.

Reconstruction after substantial osseous, cutaneous, and muscular tissue loss following a mandibular resection is a challenge. The use of a fibular free flap is an outstanding, but delicate, treatment option. These grafts, using the double-barrel technique, can achieve an almost complete reconstruction of the mandibular defect.

[Cranial-bone grafting under local anesthesia].

Autogenous bone remains the gold standard for preimplant bone-grafting procedure. When important volumes must be grafted with cancellous bone, the calvarial-harvesting site must still be considered, due to the quality of this membranous bone and the safety of the procedure if the surgeon is experimented. To simplify the procedure, the author proposes calvarial-bone harvesting under local anesthesia with a mini-bone plane.

[First treatment of distal loss of tissue on lower limbs. About 15 cases].

Distal extremity of lower limb sustains the complications of loss of tissue: problem of coverage (cutaneous and tendon necrosis, osteoarticular infection. The whole point of the surgery is to fight against the infection by repeated debridments, against the deformations or their correction by early osteosynthesis (pins and external fixation). The coverage is very important in this treatment: either with Vacuum-Assisted Closure (VAC) and skin graft or fasciocutaneous flap.

[Vascularized bone grafts in the treatment of hemifacial microsomia].

A systematic and theoretic review is performed on the vascularised bone donor sites that may be useful in the case of hemifacial microsomia. A review of the literature reveals that the iliac crest and the scapula are the most commonly used vascularised bone grafts. A case study is included in the paper, showing an hemifacial microsomia reconstruction using a composite fibular vascularised bone graft.

[Vertical alveolar distraction osteogenesis of the posterior edentulous mandible: a case report].

When it is necessary to increase the vertical height of the residual alveolar ridge, alveolar distraction osteogenesis has numerous advantages compared to other preprosthetic surgical procedures. It is frequently used for this purpose in the anterior region because of the obvious accessibility. The authors present a clinical case of edentulous posterior mandible, with insufficient vertical alveolar bone height, treated by alveolar distraction osteogenesis leading to three titanium fixtures.

[Postoperative monitoring of free fibular grafts by dynamic magnetic resonance imaging. Preliminary results in three cases of mandibular reconstruction].

The vascularized free fibular graft has been used in mandibular reconstructive surgery since 1975. This technique has been progressively developed, and it is now the procedure of choice for mandibular reconstruction although in certain postoperative circumstances it can be difficult if not impossible to monitor bone vitality. However, bone vascularization can be detected by dynamic magnetic resonance imaging (MRI), as this technique has been experimentally and clinically validated in the early diagnosis of osteonecrosis.

[The craniofacial architectural factors predisposing to a skeletal Class II identified by Jean Delaire's architectural analysis].

The current state-of-the-art medical practice involves considering treatment both in terms of symptomatology and etiology. In the case of dento-facial deformities, treatment and prognosis must deal both with constitutional and functional anomalies. Most accurate diagnosis can be achieved using Jean Delaire's architectural cephalometric analysis.

[Parietal grafts in maxillofacial and pre-implant surgery].

Due to the recent regulations generated by the diversity of infectious risks, autologous bone is the standard graft material in maxillofacial surgery. Although synthetic biomaterials can be useful, they remain insufficient in many situations. Among the many sites offering graft material, monocortical parietal bone which is accessible within the craniocephalic operative field has distinguishing characteristics due to its membranous embryological origin and its mode of direct ossification which does not include a cartilaginous stage.