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Atrophy of the alveolar crest, meant as a syndrome due to a certain variety of pathogenetic episodes developing in a more or less marked framework of resorption of the alveolar to the maxillary processes, represents an issue of debated and uncertain solution, especially in a view of the extreme degrees of the phenomenon. Various kinds of surgical approach have been suggested over time: among them mention should be made of the onlay graft technique, the osteotomy intervention visor type, the osseous interposition sandwich type, and other methods, which were often the result of a pontered mediation of the above mentioned, and which should have therefore enjoyed their single advantages. In consideration of the different techniques, the results were more or less noteworthy and it was clear, however, that a certain "gap" was still existing between the results aimed to and the results reached. Today, thanks to the tissue-expander technique, combined with the use of alloplasty materials (hydroxylapatite), we can give a new contribution to the solution of this invalidating pathology, thus reaching more complete and lasting results in the plastic reconstruction of the alveolar crest, and avoiding at the same time the disadvantages, even of iatrogenic kind, of an osteotomy intervention.

This study describes the infectious complications in 68 heart-lung transplant patients. We focused interest on early post-transplant infections so called nosocomial pulmonary infections, their exacerbating cofactors their clinical expression, and elements of diagnosis and treatment. Furthermore we describe the principal infections seen during long-term followup, which are opportunist infections caused most often by immunosuppression: Cytomegalovirus infections have a high incidence with serious clinical consequences in heart-lung transplant patients. As well as pneumocystis carinii infections and fungal infections, such as aspergillosis.

The authors illustrate the advantage of vascularised as opposed to conventional edges in the reconstruction of the jaw, focusing in particular on the use of a fibular autologous transplant. After a rapid description of the surgical technique used to remove the graft, they report a case of mandibular reconstruction in a young patient who had been involved in a shooting accident which had led to the loss of the left of this jaw.

There are various methods used in maxillofacial surgery for the control of superficial hemorrhage. The purpose is to achieve a better identification of the anatomical structures and reduce operating times without side effects. Ornipressin has no arrhythmogenic effects in presence of inhalational anesthetics and should therefore be considered safer then adrenalin. The authors examined the cardiocirculatory effects of this drug by means of an invasive hemodynamic study on five patients. The results showed that ornipressin causes worrying increases in blood pressure and peripheral vascular resistances, with reduction in the cardiac output.

Baseline selenium (Se) levels in serum samples were collected from 22 patients with precancerous and 19 with malignant oral cavity lesions as well as from 13 healthy controls of the same geographic areas. Mean serum Se levels were 105, 101, and 77.03 ng/ml in the precancerous, controls, and malignancy groups, respectively. A statistically significant difference (p less than 0.005) was found between the neoplastic and both the precancerous and control groups. After careful clinical evaluation, precancerous patients received three 4-week cycles of Se, in either inorganic or organic form. Of the 22 precancerous patients entering the study, 18 were available for evaluation of clinical response. The analysis of serum Se variations revealed that serum Se levels tended to increase after the first and second cycles and then gradually returned to baseline values. At the end of the therapy, there were two complete responses (CR), five partial responses (PR), six minor responses (MR), and five stable diseases (SD) with an objective response (CR + PR) of 38.8%. Progression after suspension of therapy occurred in 7 of 18 patients; this may indicate the need of a longer treatment period with this essential trace element.

After defining chemoprevention a description is given of the phases of differentiation in normal epithelial cells and the features of proliferation in neoplasias developing in this epithelium. The latest studies on carcinogenesis indicate various types of prevention with which one can alter this transformation process. Epidemiological studies have shown that subjects with low serum levels of Vit-A or Beta carotenoids are at high risk of developing epithelial cancer. Three main categories of agents inducing cell transformation are described: a) physiological induction agents; b) non physiological induction agents; c) cytotoxic drugs. In regard to clinical use, some studies have focussed on the importance of Vit-A in chemoprevention of risk conditions (pre-cancerous lesions) and in prevention of cancer recurrence. The authors point out the increasing interest in the use of retinoids in the chemoprevention of head and neck cancer and report some personal clinical experience.

Whenever we need to study visual-vestibular interactions, our method of choice among the ones based on thermal stimulation is the visual suppression test. In the vestibular laboratory of the II E.N.T. Clinic of the University of Parma the V.S.T. has been employed since 6 years systematically in all patients undergoing Electronystagmography. Our study was based on 10 normal patients and on 30 patients suffering from different pathologies. These patients were divided into groups according to the site of the lesion. The results we obtained are interesting: this test gives us important clinic data that we cannot obtain using other methods and allows us to discriminate the central or the peripheral site of the vestibular system lesion.

The authors studied the behaviour of the porite type coral which has been previously implanted in man in order to get a reparation of osseous and parodontal defects. The histomorfological exam (at the optical microscope, SEM and X-Ray microscope) of a non decalcified bioptic piece, which had been obtained with an appropriate instrument, shows a deposition of neoformed bone around the coral. Six months after the implantation the tissue was stable without any osteoclasts in activity; even the implanted coral grains had not been attached by them. The Authors agree with most of the statements made by Souyris et Al., but they do not believe in the total substitution of the coral with the bone, at least not in short terms: therefore further scientific works will be necessary to clear this point.

Results with althesin as anaesthetic in out-patient dental surgery are reported. A personal technique is described and reference is made to a large series in an account of the way althesin proved suitable for this form of anaesthesia. Stress is laid on the rarity of intra- and postoperative complications, and the rapid, complete return to consciousness observed after althesin.