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The occurrence of pneumomediastinum and subcutaneous emphysema following oral treatment is the result of the inappropriate use of dental equipment using pressurised air. However, their use in oral surgery, including dental extractions, continues nowadays. In addition to being a source of subcutaneous and pneumomediastinum emphysema at risk of infection, pneumatic instrumentation can also be a source of potentially serious gas embolisms. A thorough knowledge of this type of complication by the practitioners and the proper use of the instrumentation will enable a significant reduction of the incidence of theses complications.

The history of transgenderism is reaching a new turning point. From the medical beginnings of the 1940's to the real innovations of the last decade, surgery can, more than ever, contribute to the gender reassignment process. This article will firstly describe the evolution of the transgender demand, and will then review the specificities of male and female facial anatomy. We will conclude by defining the maxillofacial surgical field and the new role of the reference center at the University Hospital of Liège in this promise of treatment, that is both intimate and innovative.

The use of new technologies in medicine becomes more and more frequent because they allow us to raise therapeutic quality. This is the case in maxillofacial surgery. 3D planning for oncological resection and reconstruction brings many benefits. In this article, we will present the first case operated with this technology at CHU Liege and discuss the advantages and disadvantages of this technique.

In our society, the number of gender affirming surgeries is increasing. Mastectomy is usually the initial surgical procedure performed for the treatment of gender dysphoria in transgender men. It has been shown to improve quality of life and to promote assimilation into the new genre. Creating an aesthetic male chest requires adjustment of the breast tissue volume, proper placement of nipple areola complex, and removal of the inframammary fold. Although many papers have been published on this topic, there is still no consensus as to which surgical technique should be preferred. This article deals with the procedures performed in our plastic surgery department at CHU in Liège and reviews the literature relating to the various surgical techniques, postoperative complications as well as patient satisfaction.

In recent years, 3D design and printing technology has been successfully used in maxillofacial bone reconstruction procedures. We had the opportunity to observe its benefits in the manufacture of custom facial implants. The production is so precise that perfect anatomical congruence and biocompatibility are possible. Within the plastic and maxillofacial surgery department of the University Hospital of Liège, we had the opportunity to perform two operations requiring facial skeleton redefinition implants. The purpose of this article is to highlight the current possibilities of facial prostheses via new 3D techno¬logies, but also the advantages and possible complications of this type of surgery.

As the leading cause of blindness in the world, corneal diseases are second only to cataracts. However, the epidemiology of corneal disease is complex and includes a wide variety of infectious and inflammatory eye diseases (trachoma), immune sequelae (cicatricial pemphigoid on Lyell's disease) of after trauma (chemical burn). The general treatment for severe corneal disease is the corneal transplantation with penetrating keratoplasty. However, the failure of this treatment is virtually certain when the ocular surface is severely compromised. Keratoprosthesis is therefore the only viable option to restore vision in these patients. Only practiced by less than a dozen teams in the world, the osteo-odonto-keratoprosthesis (OOKP) is regularly practiced at the University Hospital of Liège, thanks to a close collaboration between the ophthalmology and maxillofacial surgery teams. Thanks to removal of a tooth and his bone support, patients suffering from bilateral dry eye following pathologies such as burns or cicatricial pemphigoid can benefit from this technique in order to recover an optimal visual acuity in a sustainable way.

Although well studied since the 50's, bruxism remains a largely unknown pathology. Its origin is complex, mixing psychological as well as neurological, odontological and hypnic aspects. However, the few analyzes performed on this topic have allowed to set convincing etiopathological hypotheses, including central dysregulation of the dopaminergic system as well as of the neuro-masticatory system. To avoid harmful consequences as headaches, temporomandibular disorders and premature dental scuffs / fractures, it is mandatory to diagnose bruxism as early as possible. For this purpose, and in addition to anamnestic and clinical data, the practitioner can confirm diagnosis with polysomnography, including electromyographic study of masticatory muscles and audiovisual recording. Some orthodontic, pharmacological and psychological solutions have already proved efficient. Nevertheless, a better knowledge of causative neurobiological mechanisms would allow to foresee etiology-based treatments.

Dento-maxillofacial dysmorphoses represent a considerable area of maxillofacial surgery. Their incidence has constantly been on the rise since the beginning of the century. This can be explained by variations in the food and society habits.We will first discuss the various causes (congenital and environnemental) and the pathophysiology of these disorders. Then, we will separate them according to the skeletal and Angle's classifications. We will examine the predictive criteria of these dysmorphoses from the youngest age and consider their clinical and cephalometrical diagnosis. We will envisage their functional and aesthetic consequences and expose the preventive options. Finally, we will describe the orthodontic and surgical treatment available today and conclude that surgery remains the gold standard by restoring the conventional axis.

Anterior dislocation of the temporomandibular joint is not uncommon and requires prompt management. A defect of dislocation reduction can lead to severe functional impairment of a complex, and often active joint. The diagnosis is clinical and relatively obvious. It is made by the frontline medical team, general practitioner or emergency doctor. Recurrent cases are a matter for maxillofacial surgeons. This article describes a conventional technique for anterior dislocation reduction, to achieve urgently. The second part of the article deals with the specialized surgical treatment of relapsing forms.

Vascular anomalies can be classified as hemangiomas or vascular malformations. Hemangiomas are benign neoplasms, frequently diagnosed in infancy. The vast majority of these anomalies are totally harmless and spontaneously regress, although they often worry the parents because of esthetic reasons. Only a few (1/4), however, are endangering and will require therapy. Vascular malformations are rather vessel abnormalities which, unlike hemangiomas, persist. They require a thorough evaluation and most will benefit from an intervention. The recent development of informative imaging techniques (ultrasonography, Dopplerflow imaging and magnetic resonance) has permitted significant advances in the etiology and therapy of these vascular anomalies. All too often, these patients shuffle from physician-to-physician seeking help. Thus the authors recommend a multidisciplinary approach. This team should include a plastic surgeon, a radiologist and a paediatrician.