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Objective/background: This retrospective non-randomized controlled cohort study aimed to evaluate the efficiency of simultaneous maxillary expansion and mandibular advancement for the management of pediatric OSAS., Patients/methods: The sample was composed of 94 children treated with an innovative orthopedic device to correct a Class II malocclusion associated with an OSAS. Polysomnographic recordings were performed before and after the treatment. We also included a group of 113 age-matched control patients who had the same pathologies, but who did not receive the orthopedic treatment at the time they undergone polysomnographic exams. Statistical tests evaluated the significance of the evolution of these data, both in treated and untreated control patients., Results: After nine months (±3 months) of treatment, respiratory OSAS symptoms significantly improved: the AHI significantly decreased as it became inferior to the pathological threshold (<1) for 53% of the treated patients' sample, with a greater proportion within the youngest age group (63%). Only two patients still presented a moderate OSAS after treatment, with an AHI slightly superior to 5. This positive evolution of OSAS respiratory symptoms was not observed within the control group, highlighting the real impact of the orthopedic treatment over the children's natural growth. However, sleep remained fragmented following the treatment., Conclusions: This study confirmed that simultaneous maxillary expansion and mandibular advancement induced a modification of the maxilla-mandibular anatomy, helping in the significant improvement of the respiratory OSAS symptoms. Then, considering these preliminary results, pediatric OSAS can be managed with this new orthopedic strategy, especially if it is performed early., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Membrane proteins (MPs) comprise about one-third of the human proteome, playing critical roles in many physiological processes and associated disorders. Consistently, they represent one of the largest classes of targets for the pharmaceutical industry. Their study at the molecular level is however particularly challenging, resulting in a severe lack of structural and dynamic information that is hindering their detailed functional characterization and the identification of novel potent drug candidates.Magic Angle Spinning (MAS) NMR is a reliable and efficient method for the determination of protein structures and dynamics and for the identification of ligand binding sites and equilibria. MAS-NMR is particularly well suited for MPs since they can be directly analysed in a native-like lipid bilayer environment but used to require aggravating large amounts of isotope enriched material. The frequent toxicity of human MP overexpression in bacterial cultures poses an additional hurdle, resulting in the need for alternative (and often more costly) expression systems. The recent development of very fast (up to 150 kHz) MAS probes has revolutionized the field of biomolecular solid-state NMR enabling higher spectral resolution with significant reduction of the required sample, rendering eukaryotic expression systems cost-effective.Here is presented a set of accessible procedures validated for the production and preparation of eukaryotic MPs for Fast-MAS 1 H-detected NMR analysis. The methodology is illustrated with the human copper uptake protein hCTR1 recombinantly produced and 13 C- 15 N uniformly labeled with the versatile and affordable Pichia pastoris system. Subsequent purification procedures allow the recovery of mg amounts that are then reconstituted into liposome formulations compatible with solid-state NMR handling and analysis., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

The frequency of midface and frontobasal fractures has increased over the past 40 years despite the improvement and stringent regulation implemented on modern safety equipment (belts, helmets…). This observation might be correlated with the progress of radiodiagnosis tools. Literature was reviewed according to Prisma guidelines. We searched for reviewed articles, published between January 2000 and December 2017, through Medline (Pubmed) online databases and ScienceDirect, using the following MeSH Keywords: "Le Fort classification", "Le Fort fracture", "Frontobasal fracture", "skull base fracture", "Midface Fractures". Among 652 patients with frontobasal fractures, 125 (19.1%) were associated with a Le Fort fracture. 59 (9%) were associated with Le Fort III fracture, 51 (7.8%) with Le Fort II fracture and 15 (2.3%) with Le Fort I fracture. When frontobasal fractures were associated with midfacial fractures, we found 18 cerebrospinal fluid leaks (11.8 %) and 19 cases of meningitis (12.5 %). When only the frontobasal area was involved, there were 6 cerebrospinal fluid leaks (4.3 %) and 6 meningitis (4.3 %). Our results highlight a regular association between Le Fort fractures and frontobasal fractures for stages II and stage III of Le Fort fractures and also found a higher rate of neuro-septic complication. Further research shall investigate treatment and monitoring recommendations fitting modern epidemiology of craniofacial traumatology., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Objective: This study aimed to analyze the morphology of the hypoplasic mandible and its evolution during the growth period to better understand how it differs from the pediatric healthy mandible., Method: Three-dimensional mandibular models of hypoplasic and healthy children aged from 39 gestational weeks to 7 years old were analyzed with a morphometric method including data clustering. Morphological distinctions between pathological and healthy mandibles were highlighted. Bilateral and unilateral mandibular hypoplasia were distinguished., Results: The study sample was composed of 31 hypoplasic children and as many sex- and age-matched healthy children. Morphological distinctions between pathological and healthy mandibles were highlighted only from the first year of life. In bilateral hypoplasia, the overall mandibular dimensions were reduced while there was only a ramus asymmetry in unilateral mandibular hypoplasia (mean ± SD of the difference between the Grp03c and Grp03b subgroups: 6.80 ± 6.37 - P value = 1.64e -3 for the height of the left ramus versus 0.18 ± 4.18 - P value = .82 for the height of the right ramus). Supervised classification trees were built to identify the pathology and discriminate unilateral from bilateral mandibular hypoplasia (prediction rates = 81% and 84%, respectively)., Conclusions: Based on a morphometric analysis, we demonstrated that mandibular hypoplasia significantly impacts the mandibular morphology only from the first year of life, with a distinction between bilateral and unilateral hypoplasia.

Whether to conserve or remove miniplates, widely used in oral and maxillofacial surgery, has not been agreed on in the literature. Complications such as pain, infection, and screw exposure or loosening have already been largely described. We present the consequences of a trauma recurrence on a mandible with miniplates. The data of 13 patients who had a mandibular fracture previously surgically treated with miniplates (ten mandibular fractures and three mandibular osteotomies) were analysed. All the patients were male; the average age was 32 years (range, 20-64 years). The mechanism of the second trauma was assault in most of the cases. The average time between the first osteosynthesis and the new fracture was 35 months (range, 6-128 months). The fractures occurred at a distance from the miniplates in all the cases except two. No plate fracture was reported. We hypothesised that miniplates reinforced the underlying bone, protecting it from fractures, and transmitted the forces to areas anterior or posterior to the miniplates or to the condyle. Thus, the risk of mandible trauma recurrence should be taken into account in the indication of plate removal, and the biomechanical consequences of the conservation of the miniplates should be studied., (Copyright © 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Introduction: The study aimed to evaluate the evolution of the respiratory status during sleep of OSAS children treated with a custom-made device combining maxillary expansion and mandibular advancement., Material and Methods: Sleep studies were performed before and after the treatment for 103 children presenting an initial OSAS and Class II malocclusion. Sleep questionnaires were also addressed to parents several years after the end of the treatment to evaluate its long-term effects., Results: After nine months of treatment, the sleep breathing quality significantly improved: the Apnea/Hypopnea Index systematically decreased ≤5. According to the sleep questionnaires results, 84% of the patients did not show any loud or troubled breathing several years after the end of the treatment., Discussion: Simultaneous maxillary expansion and mandibular advancement induced an increase of the oral space in the three spatial dimensions, helping in the significant improvement of the OSAS symptoms, with long-terms effects on the sleep breathing quality., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

The blood-brain barrier (BBB) is a highly selective membrane composed predominantly of brain capillary endothelial cells expressing drug efflux transporters that prevent substrates from accessing the brain. Inflammation is associated with central nervous system diseases and can impair BBB permeability via several mechanisms, including altered transporter and cell junction expression. This can modify the brain's exposure to drugs. However, comprehensive genomic analysis of the impact of interleukin (IL)-6, which plays a key role in the inflammatory response, on the BBB is lacking. In the present study, we analyzed the effects of exposure of hCMEC/D3 cells to 20 ng/mL IL-6 for 72 h. We performed RNA sequencing and ABC transporter efflux assays. Physiologically based pharmacokinetics (PBPK) simulations were conducted to evaluate the potential impact of IL-6 on the digoxin pharmacokinetics profile and brain exposure by decreasing BBB ABCB1 efflux activity. Exposure of hCMEC/D3 cells to IL-6 triggered the deregulation of numerous genes involved in barrier permeability, such as cell junctions, focal adherens complex, and cell adhesion molecules. We observed mild modification of the mRNA expression and efflux activities of ABC transporters. PBPK simulation showed that, if we only consider the impact of IL-6 on ABCB1 transporter, the modification of the digoxin pharmacokinetics profile and brain exposure is slight. IL-6 slightly affected the gene expression levels and activities of ABC transporters on BBB cells, exhibiting a weaker effect than on hepatic cells. However, inflammation may cause other modifications, such as altered BBB permeability, that could modify drug pharmacokinetics., (© 2020 Société Française de Pharmacologie et de Thérapeutique.)

5-Fluorouracil (5-FU) is an anticancer drug extensively used for different cancers. Intracellular metabolic activation leads to several nucleoside and nucleotide metabolites essential to exert its cytotoxic activity on multiple cellular targets such as enzymes, DNA and RNA. In this paper, we describe the development of a method based on liquid chromatography coupled with high resolution mass spectrometry suitable for the simultaneous determination of the ten anabolic metabolites (nucleoside, nucleotide and sugar nucleotide) of 5-FU. The chromatographic separation was optimized on a porous graphitic carbon column allowing the analysis of the metabolites of 5-FU as well as endogenous nucleotides. The detection was performed on an Orbitrap® tandem mass spectrometer. Linearity of the method was verified in intracellular content and in RNA extracts. The limit of detection was equal to 12 pg injected on column for nucleoside metabolites of 5-FU and 150 pg injected on column for mono- and tri-phosphate nucleotide metabolites. Matrix effect was evaluated in cellular contents, DNA and RNA extracts for nucleoside and nucleotides metabolites. The method was successfully applied to i) measure the proportion of each anabolic metabolite of 5-FU in cellular contents, ii) follow the consequence of inhibition of enzymes on the endogenous nucleotide pools, iii) study the incorporation of metabolites of 5-FU into RNA and DNA, and iv) to determine the incorporation rate of 5-FUrd into 18 S and 28 S sub-units of rRNA., Competing Interests: The authors declare that there are no conflicts of interest., (© 2020 Xi'an Jiaotong University. Production and hosting by Elsevier B.V.)

Background: Although many studies focus on short-term side effects of radioiodine therapy, almost none studied long-term side effects. We assessed radioiodine long-term salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma and compared it to short-term morbidity within the same population., Methods: A standardized self-administrated questionnaire was submitted in 2019 by patients treated with radioiodine between January 2011 and December 2012. These patients had already answered the same questionnaire 6 years before., Results: Our study showed a significant reduction for salivary side effects: discomfort in submandibular or parotid area, swelling, pain, a bad or salty taste in the mouth, allowing to get back to a "normal" diet., Conclusions: Our study suggests that a significant rate of patients will recover from I 131 therapy salivary side effects. As almost 30% of these remissions happened during our late stage follow-up, we highlight the necessity of a long-term follow-up in these patients., (© 2020 Wiley Periodicals LLC.)

Immunotoxins are emerging candidates for cancer therapeutics. These biomolecules consist of a cell-targeting protein combined to a polypeptide toxin. Associations of both entities can be achieved either chemically by covalent bonds or genetically creating fusion proteins. However, chemical agents can affect the activity and/or stability of the conjugate proteins, and additional purification steps are often required to isolate the final conjugate from unwanted byproducts. As for fusion proteins, they often suffer from low solubility and yield. In this report, we describe a straightforward conjugation process to generate an immunotoxin using coassociating peptides (named K3 and E3), originating from the tetramerization domain of p53. To that end, a nanobody targeting the human epidermal growth factor receptor 2 (nano-HER2) and a protein toxin fragment from Pseudomonas aeruginosa exotoxin A (TOX) were genetically fused to the E3 and K3 peptides. Entities were produced separately in Escherichia coli in soluble forms and at high yields. The nano-HER2 fused to the E3 or K3 helixes (nano-HER2-E3 and nano-HER2-K3) and the coassembled immunotoxins (nano-HER2-K3E3-TOX and nano-HER2-E3K3-TOX) presented binding specificity on HER2-overexpressing cells with relative binding constants in the low nanomolar to picomolar range. Both toxin modules (E3-TOX and K3-TOX) and the combined immunotoxins exhibited similar cytotoxicity levels compared to the toxin alone (TOX). Finally, nano-HER2-K3E3-TOX and nano-HER2-E3K3-TOX evaluated on various breast cancer cells were highly potent and specific to killing HER2-overexpressing breast cancer cells with IC 50 values in the picomolar range. Altogether, we demonstrate that this noncovalent conjugation method using two coassembling peptides can be easily implemented for the modular engineering of immunotoxins targeting different types of cancers.

Pichia pastoris is a eukaryotic microorganism reputed for its ability to mass-produce recombinant proteins, including integral membrane proteins, for various applications. This article details a series of protocols that progress towards the production of integral membrane proteins, their extraction and purification in the presence of detergents, and their eventual reconstitution in lipid nanoparticles. These basic procedures can be further optimized to provide integral membrane protein samples that are compatible with a number of structural and/or functional investigations at the molecular level. Each protocol provides general guidelines, technical hints, and specific recommendations, and is illustrated with case studies corresponding to several representative mammalian proteins. © 2020 by John Wiley & Sons, Inc. Basic Protocol 1: Production of membrane proteins in a P. pastoris recombinant clone using methanol induction Basic Protocol 2: Preparation of whole-membrane fractions Alternate Protocol 1: Preparation of yeast protoplasts Basic Protocol 3: Extraction of membrane proteins from whole-membrane fractions Basic Protocol 4: Purification of membrane proteins Alternate Protocol 2: Purification of membrane proteins from yeast protoplasts Alternate Protocol 3: Simultaneous protoplast preparation and membrane solubilization for purification of membrane proteins Basic Protocol 5: Reconstitution of detergent-purified membrane proteins in lipid nanoparticles., (© 2020 John Wiley & Sons, Inc.)

Purpose: Since prehistory, changes of the facial skeleton have been related to the modification of diet. More recent studies have shown changes in the morphology of the mandible and maxilla due to variations of strain during mastication. The temporal muscle (TM) is a strong masticatory muscle, with its insertions extending through the temporal fossa. Our objective is to observe the relations between the TM and the lateral orbital wall (LOW) which could indicate an influence of mastication on the shape of the LOW., Methods: We conducted a retrospective study using 100 CT scans. The length of the lateral orbital wall (LLOW), the angle between LOW and the medial orbital wall (MOW), the cross-sectional areas of LOW and of the TMs were measured on both sides of each CT scan. The correlation between TMs and other three parameters was studied by Pearson correlations., Results: A correlation was found between TMs and LOWs, a lower with LLOW, and a very weak and negative correlation between LOW/MOW angle., Conclusions: Anatomical knowledge about TM and investigation of masticatory strains lead us to think that mastication have minimal effect on the morphology of the LOW, only on the frontal process of zygomatic. This may explain, in part, why the LOW is the strongest wall of the orbit.

Inflammatory response is characterized by an increase of several cytokines. Some are known to modify drugs pharmacokinetic by reducing the expression levels of drug-metabolizing enzymes (DMEs) and transporters. This impact of inflammatory signaling is well established in hepatic cells, but not in intestinal cells. EpiIntestinal is a 3D human small intestinal tissue model with epithelial polarity, allowing good evaluation of metabolism and drug transport. This study aimed to analyze the effect of IL-6 on this tissue model. RNA sequencing was performed in cells incubated with 5, 10, or 20 ng/mL IL-6 for 8 h to 72 h to study the impact of IL-6 on drug metabolism and pharmacokinetics gene expression. The influence of IL-6 on the activity of cytochromes P450 (CYPs) was studied by measuring metabolite formation of specific substrates with LC-HRMS. Its impact on ATP-binding cassette (ABC) transport was evaluated by measuring intra- and extracellular substrates using spectrofluorometry. Exposure of EpiIntestinal cells to IL-6 resulted in reduction of some CYP mRNAs, such as CYP2C19, CYP2C9, and CYP3A4, by 40% to 50%. Activities of these CYPs were also decreased in EpiIntestinal cells by 20% to > 75%. IL-6 exposure did not modify ABCB1 and ABCCs transporter activities in this model. This study shows that gene expression levels and activities of drug-metabolizing enzymes and ABC transporters may be altered by the pro-inflammatory cytokine IL-6 in intestinal cells. If these results are confirmed in vivo, it may result in pharmacokinetic modifications, such as pre-systemic metabolism, with clinical effects, and require dosage adaptation.

Objectives: Numerous tools have been developed to characterize the morphometry of 3D models. The aim of this study was to apply these techniques to better understand the morphometric growth pattern of healthy children's mandibles., Material and Methods: The study sample was composed of 480 very young children aged from 36 gestational weeks to 7 years old. The sample was divided into three subsamples according to the development stages of their deciduous dentition. Several biometric data were collected on 3D mandibular models., Results: There was homothetic growth during the first years of life. Once all deciduous teeth were fully erupted, the mandibular corpus warped more independently of the ramus, and the inter-individual variability was more pronounced. Throughout the growth period, several subgroups could be identified, highlighting the morphological growth pattern of the mandible., Conclusions: A particular morphogenesis of the mandible during the growth period was observed, which was correlated with deciduous dentition development. In younger individuals, this morphological pattern was mainly characterized by the progressive closure of the chin symphysis and ramus growth. The tongue movements in the oral space, depending on whether the child was bottle- or breast-fed, may explain this result. As the children grew older, the mandible widened to create sufficient space for the developing teeth buds. During the eruption of deciduous dentition, the mandible took on various morphologies, which was likely based on the child's sex and diet. Therefore, we assume that this mandibular morphogenesis is induced by the functional strains affecting the mandible during deciduous teeth development., (© 2019 Wiley Periodicals, Inc.)

Stringent toxicological tests have to be performed prior to the industrial development of alternative chemicals particularly high energy dense materials (HEDMs) such as explosives. The properties (e.g., power, stability) of these compounds are constantly being improved, the current axis of research being the nitration of nitrogen heterocycles leading to HEDMs such as nitropyrazole-derived molecules. However, except for 3,4,5-trinitropyrazole (3,4,5-TNP), which was shown to be highly toxic in mice, the toxicological impact of these HEDMs has so far not been investigated. Furthermore, as industrials are strongly advised to develop alternative safety testing assays to in vivo experiments, we herein focused on determining the cytotoxic and genotoxic effects of seven Nitropyrazole-derived HEDMs on three rodent cell lines (mouse embryonic BALB/3T3 clone A31 cells, Chinese hamster ovary cells CHO-K1 and mouse lymphoma L5178Y TK +/- clone (3.7.2C) cells), two human fibroblast lines (CRC05, PFS04062) and on the human hepatic HepaRG model (both in proliferative and differentiated cells). A stronger cytotoxic effect was observed for 1,3-dinitropyrazole (1, 3-DNP) and 3,4,5-TNP in all cell lines, though differentiated HepaRG cells clearly displayed fewer likely due to the metabolism and elimination of these molecules by their functional biotransformation pathways. At the mechanistic level, the sub-chronic cytotoxic and genotoxic effects were linked to ROS/RNS production (experimental assays), HA2.X and to transcriptomic data highlighting the increase in DNA repair mechanisms., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Introduction: The authors' main purpose was to simulate the behavior of a titanium mesh implant (TMI) used to reconstruct the orbital floor under the stress of a blunt trauma., Materials and Methods: The orbital floor of a previously validated finite element model (FEM) of the human orbit was numerically fractured and reconstructed by a simplified TMI. Data from a CT scan of the head were computed with MICMICS (Materialise, Louvain, Belgium) software to re-create the skull's geometry. The meshing production, the model's properties management and the simulations of blunt traumas of the orbit were conducted on HYPERWORKS ® software (Altair Engineering, Detroit, MI, USA). Some of the elements of the orbital floor were selected and removed to model the fracture; these elements were duplicated, their characteristics being changed by those of titanium to create a TMI covering this fracture. A 3D FEM composed of 640,000 elements was used to perform 21 blunt trauma simulations on the reconstructed orbit., Results: In 90.4% (19/21) of the tests conducted, the TMI, whether free from any bony attachment or screwed to the orbital rim, has tended to move in the orbit and/or to deform., Discussion: In the event of traumatic recurrence, which is not rare, TMIs may deform in a "blow-in" motion and threaten intra-orbital structures., (Copyright © 2018. Published by Elsevier Masson SAS.)

Introduction: With more than 270 million spectators, football - or soccer - is the most popular sport in the world. International football events generate many risky situations, including hooliganism and are an opportunity to analyze the incidence and the particularities of associated trauma. We sought to underline the potential rapid and brutal increase in maxillofacial trauma during a world-class competition., Material and Methods: A retrospective multicenter study of the epidemiology of maxillofacial traumas during the UEFA 2016 Cup was conducted. All the medical data from each UEFA 2016 World Cup matches from 10 June 2016 to 10 July 2016 were collected. Only the maxillofacial traumas requiring a surgery under general anesthesia and a hospitalization were included., Results: 11 patients from 3 different cities were included. The main etiology was interpersonal violence (7/11), followed by road accidents (3/11). Open reduction with internal fixation of a mandibular fracture was the most performed surgery (9/11). Patients were 18 to 50 year-old, with an average age of 30.6 years., Discussion: This study underlines the violence of riots between "ultra" supporters during the 2016 UEFA cup. We noticed an upsurge of maxillofacial trauma severe enough to require a surgery under general anesthesia. Hooligan behaviors should be known by every practitioner dealing with trauma care, and may requires transitional adjustment of public health policy., (Copyright © 2019. Published by Elsevier Masson SAS.)

Objectives: Facial surgery for cosmetic purposes aims to improve the physical appearance and self-image of normal individuals. The aim of the guidelines is to answer questions related to legislation, patient evaluation and motivations, relevance and risk assessment, patient information and patient follow-up., Methodology: Analysis and synthesis of the medical literature through research of bibliographic databases in French and English from 2000 to 2017. Research and use of guidelines from evaluation agencies and academic societies. Drafting of guidelines with indications on levels of evidence., Results: 24 guidelines with levels of evidence B (scientific presumption), C (low level of evidence) or EO (expert opinion) were selected to answer the questions. Cosmetic facial surgery must be performed by certified, qualified professionals in authorized structures. It must follow certain specific rules as well as a charter and code of ethics so as to enforce the rules of practice., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Introduction: Parotidectomy for benign tumours is usually performed after facial nerve trunk discovery through an anterograde approach (AA) of the nerve. More recently, a retrograde approach (RA) toward the facial nerve, which begins on the facial nerve branches and ends on the nerve trunk, has been described. A literature review of the RA was conducted to evaluate the RA and to compare it with AA., Methods: A literature review was conducted for the years 1980 through 2016. Nine studies out of 216 were included, including 558 parotidectomies and 370 RA. We studied the operative time (OT), the postoperative complications including facial paralysis (FP), tumour recurrences, and possibilities for reoperation., Results: Operative time was shorter in RA than in AA. Transitory FP significantly less frequent in RA than in AA in only one studies and not significantly in four studies. Incidence of Frey syndrome was similar in RA and AA. Tumour relapses were reported in 1.8% of cases with RA, comparable to AA., Conclusion: Retrograde parotidectomy is recommendable. OT was significantly shorter for the RA. The FP rate was lower for RA than for AA, but the difference was not significant. The recurrence rate appeared to be similar between RA and AA. Possibilities of reoperation were better after RA., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: The authors' main purpose was to develop a detailed finite element model (FEM) of the human orbit and to validate it by analyzing its behavior under the stress of blunt traumas., Materials and Methods: A pre-existing 3D FEM of a human head was modified and used in this study. Modifications took into account preliminary research carried out on PubMed database. Data from a CT scan of the head were computed with Mimics ® software to re-create the skull geometry. The mesh production, the model's properties and the simulations of blunt orbital traumas were conducted on Hyperworks ® software., Results: The resulting 3D FEM was composed of 640 000 elements and was used to perform blunt trauma simulations on an intact orbit. A total of 27 tests were simulated. Fifteen tests were realized with a metallic cylinder impactor; 12 tests simulated a hit by a closed fist. In all the tests conducted (27/27), the orbital floor was fractured. Fracture patterns were similar to those found in real clinical situations according to the buckling and hydraulic theories of orbital floor fractures., Discussion: The similitude between the fracture patterns produced on the model and those observed in vivo allows for a validation of the model. This model constitutes, at the authors knowledge, the most sophisticated one ever developed., (Copyright © 2018. Published by Elsevier Masson SAS.)

Introduction: Orbital haematomas threaten the visual prognosis, but no treatment guidelines have been proposed. Antithrombotics could affect their prognosis and treatment. This study aimed to evaluate the effect of antithrombotics in the management of orbital haematomas and to suggest a standardised protocol., Material and Methods: We conducted a retrospective study by sending a standardised questionnaire to 20 French maxillofacial surgery university departments to collect all the cases of orbital haematoma., Results: Twenty-five cases from 10 centres were collected, including five patients treated with anticoagulant and one patient treated with dual antiplatelet. Antithrombotics increased the risk of amaurosis and ocular disorders significantly. Surgery was performed for 66.7% of patients treated with antithrombotic and for 89.5% of other patients. Surgical delay was longer in patients treated with antithrombotic. Surgical drainage was used in most of the cases, whereas canthotomy with inferior cantholysis was the least-used technique., Conclusion: Antithrombotics appear to worsen the functional prognosis of orbital haematomas. A surgical management of orbital haematoma in patients treated with antithrombotics is not contraindicated. Surgical delay must be shortened as much as possible. A lateral canthotomy with inferior cantholysis seems to be an appropriate solution., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Introduction: Inferior alveolar nerve (IAN) lesions related to endodontic treatments can be explained by the anatomical proximity between the apices of the mandibular posterior teeth and the mandibular canal. The aim of this article is to review the management of inferior alveolar nerve lesions due to endodontic treatments and to establish a therapeutic flow chart., Methods: A review of publications reporting IAN damage related to endodontic treatment over the past 20 years has been conducted, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combines an electronic search of the Pubmed ® and Google Scholar ® databasis. Forty-two full-text articles corresponding to 115 clinical cases have been selected. Two personal clinical cases were additionally reported., Results: IAN lesions due to endodontic treatments require urgent management. Early surgical removal of the excess of endodontic material, in contact with the nerve allows the best recovery prognosis (72h). Beyond this delay, irreversible nervous lesions prevail and a medical symptomatic treatment, most of the time with pregabalin, must be/can be carried out. A delayed surgical procedure shows some good benefits for patients. However, the healing prognosis remains poorly predictable., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Hydrazine-based liquid propellants are routinely used for space rocket propulsion, in particular monomethylhydrazine (MMH), although such compounds are highly hazardous. For several years, great efforts were devoted to developing a less hazardous molecule. To explore the toxicological effects of an alternative compound, namely (E)-1,1,4,4-tetramethyl-2-tetrazene (TMTZ), we exposed various cellular animal and human models to this compound and to the reference compound MMH. We observed no cytotoxic effects following exposure to TMTZ in animal, as well as human models. However, although the three animal models were unaffected by MMH, exposure of the human hepatic HepaRG cell model revealed that apoptotic cytotoxic effects were only detectable in proliferative human hepatic HepaRG cells and not in differentiated cells, although major biochemical modifications were uncovered in the latter. The present findings indicate that the metabolic mechanisms of MMH toxicity is close to those described for hydrazine with numerous biochemical alterations induced by mitochondrial disruption, production of radical species, and aminotransferase inhibition. The alternative TMTZ molecule had little impact on cellular viability and proliferation of rodent and human dermic and hepatic cell models. TMTZ did not produce any metabolomic effects and appears to be a promising putative industrial alternative to MMH., (Copyright © 2018. Published by Elsevier Ltd.)

The high-energy compound 3,4,5-trinitropyrazole (TNP) was developed as an alternative to other less energetic and more sensitive explosive materials, in particular 1-methyl-2,4,6-trinitrobenzene (TNT). However, the level of toxicity of TNP remains understudied. Here using an in vivo CD1 mouse model, we mimicked an acute exposure (24 h) to TNP, given either orally or intravenously, and determined the maximum administrable doses (190 mg/kg and 11 mg/kg, respectively), as well as the lethal dose for 50% (LD 50 ) of female or male mice (390 mg/kg for both) treated intravenously with TNP alone. Several metabolites including nitroso-dinitro-pyrazole, hydroxylamino-dinitro-pyrazole, hydroxyl-dinitro-pyrazole and amino-dinitro-pyrazole were identified in urine. TNP is quickly metabolized and eliminated via urine as two main amino-dinitro-pyrazole metabolites. A comparison of the transcriptomic effects of TNP and TNT after 10 days exposure enabled us to demonstrate no major induction of transcripts involved both in cell death mechanisms (apoptosis, necrosis, autophagy) and physiological pathways (glycolysis, ATP production). Finally, subchronic exposure to TNP was replicated in female mice, fed 16.8-52.8 mg/kg/day of TNP for one month, to study the impact on cellular functions. Although blood TNP levels remained high, a lower rate of TNP accumulation in the liver and lungs were observed than during an acute exposure. Conversely, cellular stress functions explored using the RT 2 Profiler™ PCR Array Mouse Molecular Toxicology PathwayFinder remained unaltered after this chronic exposure. These findings demonstrate that TNP can be rapidly eliminated in vivo without accumulating in vital organs., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The chin may be concerned by morphological abnormalities in its various dimensions. Classical genioplasty techniques can be used to correct these but have some disadvantages. The "chin wing", described by Triaca, is a technique of genioplasty extended to the mandibular angles, considering the mandibular basilar border as an anatomical unit, thus achieving a better harmonious functional and aesthetic result. The preoperative assessment included a mandibular Cone Beam to evaluate the position of the inferior alveolar nerve. The procedure was performed under general anesthesia. The periosteal dissection was limited to the osteotomy area and mental nerves were protected. The osteotomy observed a modification of its orientation in front of the mental foramen to become parallel to the basilar border, which was interrupted at the level of the mandibular angle. The spaces created were filled with bone grafts and maintained by a symphysary plate. Chin wing genioplasty both improves the function and aesthetic of the face because it considers the mandibular basilar border as an entire anatomical unit. It can be performed independently of any procedure to modify the bone bases. Nowadays, chin wing remains a challenging technique hardly performed., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Mandibular dental anterior crowding is a common multi-factorial phenomenon. The involvement of the lower third molar remains unclear. These pending questions led us to conduct a literature review to evaluate the impact of the lower third molar on mandibular dental anterior crowding. Twelve articles were selected, published from 1974 to 2014. Four studies were prospective. Sample size ranged from 30 to 9044. The average age was 20.56 years old. Seven studies considered patient with orthodontic treatment. The studies compared two to four groups. Studying tools were radiographs, casts and clinical examinations. Little's irregularity index, TSALD and Ganss ratio were used. In total, 83% of articles (n=10/12) did not find any significant relationship between lower third molar and mandibular dental anterior crowding. However, methods and designs of these studies being questionable, a definite conclusion on the impact of mandibular third molar on mandibular dental anterior crowding cannot be set., (Copyright © 2018. Published by Elsevier Masson SAS.)

Purpose: The fetal development of the mandible is nowadays quite understood, and it is already known that craniofacial growth reaches its highest rate during the first 5 years of postnatal life. However, there are very few data focusing on the perinatal period. Thus, the present article is addressing this concern by studying the mandible morphology and its evolution around the birth with a morphometric method., Methods: Thirty-one mandibles modelled in three dimensions from post-mortem CT-scans were analyzed. This sample was divided into two subgroups composed of, respectively, 15 fetuses (aged from 36 gestational weeks), and 16 infants (aged to 12 postnatal weeks). 17 distances, 3 angles, and 8 thicknesses were measured via the prior set of 14 landmarks, illustrating the whole mandible morphology., Results: Although this methodology may depend on the image reconstruction quality, its reliability was demonstrated with low variability in the results. It highlighted two distinct growth patterns around birth: fetuses mandibles do not significantly evolve during the perinatal period, whereas, from the second postnatal weeks, most of the measurements increased in a homogeneous tendency and in correlation with age., Conclusions: The protocol developed in this study highlighted the morphologic evolution of the mandible around birth, identifying a different growth pattern from 2 postnatal weeks, probably because of the progressive activation of masticatory muscles and tongue. However, considering the small sample size, these results should be thorough, so identification and management of anatomic abnormalities could eventually be achieved.

Introduction: The management of oral fistula to the nose depends on its etiology, its size and its location. Here, we describe a simple technique, inspired by the ones initially developed by Bardach for cleft palates repair. The surgical alternatives are discussed., Technical Note: The double palatal flap is a simple technique, allowing closure in a single session of a central or centro-lateral palate fistula. The key of this technique is the dissection between nasal and palate mucous layers, providing a sufficient amount of laxity to close the defect without tension., Discussion: The double palatal flap can cover centro-lateral palate mucosal fistulae. It provides both aesthetic and functional results in a single stage. Reliability, simplicity and quickness are its main advantages. Outcomes are usually simple; Velar insufficiency may occur, that can be corrected by speech therapy., (Copyright © 2017. Published by Elsevier Masson SAS.)

Purpose: To suggest a decision tree for the choice of the best minimally invasive technique to treat submandibular and parotid calculi, according to the diameter of the calculi and their position in the excretory duct., Materials and Methods: Submandibular and parotid ducts can both be divided into thirds, delineated by easily recognizable landmarks. The diameter of calculi is schematically classified into 1 of these 3 categories: floating, slightly impacted, or largely impacted., Results: Using 3 criteria, the type of gland involved (G), the topography (T) of the calculus and its diameter (D), a 3-stage GTD classification of calculi was established. Next, the best indication for each available minimally invasive technique (sialendoscopy, transmucosal approach, a combined approach, intra- or extracorporeal stone fragmentation) was determined for each calculus stage., Conclusions: The minimally invasive treatment options are numerous and have replaced invasive resection surgical approaches (submandibulectomy and parotidectomy) in the management of salivary calculi, significantly improving the prognosis of these diseases. We emphasize the need for flexibility in the surgical indications and challenge the dogma of "all endoscopic" management of salivary calculi., (Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Introduction: Salivary duct stenosis is the second most common cause of obstructive pathology after lithiases, and it primarily affects the parotid gland. Salivary duct stenosis is treated with drug therapy and/or sialendoscopy. If unsuccessful, surgical removal of the gland is indicated, but it is associated with a high risk of facial morbidity. The aim of this study is to evaluate the clinical efficacy of an alternate treatment, botulinum toxin, in salivary duct stenosis., Material and Methods: In a preliminary retrospective study from January 2011 to December 2014, six patients with parotid duct stenosis received 50IU of botulinum toxin in three injections in the parotid gland. The frequency of relapses and the intensity of pain and swelling were recorded before and after treatment. The onset of action and duration of efficacy were also assessed., Results: Four of six patients showed a decrease in the frequency of swelling episodes and greater pain relief during the first year of treatment, but to a lesser extent after 2years. The mean duration of efficacy was 3.5months with an interval between two injections of 5.7months. Only one parotidectomy had to be performed. No major side effects were observed, with only one case of local infection at the injection site., Conclusion: Botulinum toxin appears to be a viable alternative in treating salivary duct stenosis before resorting to surgical gland removal., (Copyright © 2017. Published by Elsevier Masson SAS.)

Purpose: To evaluate the use of cartilage as a potential graft material toward osteo-odontal tissue replacement in keratoprosthesis surgery., Methods: We describe a modification of the osteo-odonto-keratoprosthesis surgery that involves the use of autologous auricular conchal cartilage graft (ACCG). In stage 1a, a full-thickness cheek mucosa graft was performed over the ocular surface. In stage 1b, ACCG was harvested via a retroauricular approach. An optical polymethyl-methacrylate cylinder was embedded into a double-layered fragment of cartilage and secured by cyanoacrylate glue. The graft is then placed in a infraorbital pocket. Stage 2, performed after 3 months, involved retrieval of the complex and implantation after reflection of the mucosal flap, corneal trephination, iris and lens removal and anterior vitrectomy., Results: We report two cases of chondro-keratoprosthesis (CKPRO) who underwent surgery with up to 15 months of follow-up. Preoperatively, vision was limited to light perception (LP) in both cases. On patient 1, CKPRO was performed in the right eye and the postoperative visual acuity stay limited to LP related to preoperative retinal lesions. On patient 2, CKPRO was performed in the left eye and the vision was improved to 20/100 J6. No postoperative complications such as extrusion, epithelial downgrowth, retrocorneal membrane or endophtalmia were observed., Conclusions: ACCG could be an interesting alternative to replace osteo-odontal graft in keratoprosthesis surgery. However, further comprehensive studies with larger sample size and longer follow-up are required. However longer follow-up and a higher number of patient are required to report postoperative complications incidence, survival and functional outcomes.

Introduction: Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space., Material and Methods: We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded., Results: Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases., Discussion: Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Introduction: Malignant cutaneous adnexal neoplasms are rare and have been characterized only recently. They can occur at any age but preferentially in elderly. There are 3 of them: trichoblastic carcinoma, trichilemmal carcinoma and malignant pilomatricoma. The aim of our study was to make a diagnostic and therapeutic update about these tumors when located at the face or at the scalp., Materials and Methods: A bibliographic research was made on PubMed using following keywords: appendage skin carcinoma AND pathology AND/OR therapeutic. Articles published before 2000 were considered outdated and were excluded., Results: Twenty-five articles met the inclusion criteria. Clinical presentation was non-specific. Histological examination only allowed for diagnosis. Lesions were locally or loco-regionally aggressive. Lymphatic or hematogenous metastasis were reported. No consensus about treatment was found. When surgery was used, it consisted in resection with safety margins ranging from 0.5 to 3cm depending on the teams. In case of metastasis, treatment consisted in chemo- and/or radiotherapy. A quarterly medical monitoring was recommended., Discussion: Malignant cutaneous adnexal tumors are rare. There is nowadays no treatment consensus. An initial staging by mean of a head and neck, chest, abdominal and pelvic CT-scan is mandatory. Treatment has to be decided in a multidisciplinary cancer committee. In the absence of metastasis, the reference treatment is surgical resection, possibly by Mohs micrographic technique, with large safety margins. In case of metastasis or if the loco-regional extension does not allow for a complete excision, chemotherapy and/or radiotherapy may be proposed. A close monitoring is essential., (Copyright © 2017. Published by Elsevier Masson SAS.)

Introduction: Surrounded by a variety of structures including the facial sinuses and the brain, the human orbit displays unique anatomical features. It is known that orbital volume correlates with age and sex. The aim of this study was to evaluate sexual dimorphism of orbital volume relative to the size of the skull, and to establish criteria for gender determination., Methods: Orbital volume was measured from 3D models of the orbits. The volumes were expressed in relation to the centroid size of the skull, to ensure that any sexual dimorphism in orbital volume was not simply due to a difference in skull size. Thirty-three male and 42 female subjects were included in the study., Results: The volume of both orbits were significantly higher in men than in women (P=0.0001). The right, left and total orbital volumes relative to the centroid skull size were also significantly higher in men than women (P<0.05). The method was repeatable and reproducible. A test of gender determination was developed, with a precision of 77.3%., Discussion: This is the first study showing a sexual dimorphism in orbital volume relative to skull size. This difference in volume could explain the greater predisposition to myopia in women and their more frequent need for orbital decompression in thyroid orbitopathies., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Minimally invasive techniques (MIT), including sialendoscopy, extracorporeal lithotripsy and intraoral approach, have to be preferred in parotid stones removal. In case of MIT failure, a combined intra- and extra-oral approach can be achieved. The aim of our study was to evaluate the efficacy and the complications of these combined approaches., Materials and Methods: A retrospective study has been conducted on patients treated between 2006 and 2015. All adult patients presenting with one or more parotid stones and in whom TMI failed have been included. Age and sex of the patients, number, size and location of the stones, result of the procedure, occurrence of pain, swelling, or infection have been recorded., Results: Nine patients were included (mean age: 56). Mean follow-up was 48 months. Eighty-eight percent of patients had an unique stone. Nine stones were extracted by combined approach. Mean diameter of the stones was 8.5mm and 33% of them were located at the junction between middle and posterior third of parotid duct. All the patients suffered preoperatively from daily retention symptoms, such as pain (55%) and swelling (100%). Two patients had an infectious complication (duct and/or gland infection). Seventy-five percent (9/12) of stones were removed. Complications consisted of 1 fistula, 1 facial paresis, 3 recurrences. Seven of 9 patients (77%) had a total relieve after surgery., Discussion: Surgical combined approaches for parotid stones removals are indicated after failure of MIT when symptoms affect quality of life., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Combined efforts in the fields of neuroscience, computer science, and biology allowed to design biologically realistic models of the brain based on spiking neural networks. For a proper validation of these models, an embodiment in a dynamic and rich sensory environment, where the model is exposed to a realistic sensory-motor task, is needed. Due to the complexity of these brain models that, at the current stage, cannot deal with real-time constraints, it is not possible to embed them into a real-world task. Rather, the embodiment has to be simulated as well. While adequate tools exist to simulate either complex neural networks or robots and their environments, there is so far no tool that allows to easily establish a communication between brain and body models. The Neurorobotics Platform is a new web-based environment that aims to fill this gap by offering scientists and technology developers a software infrastructure allowing them to connect brain models to detailed simulations of robot bodies and environments and to use the resulting neurorobotic systems for in silico experimentation. In order to simplify the workflow and reduce the level of the required programming skills, the platform provides editors for the specification of experimental sequences and conditions, environments, robots, and brain-body connectors. In addition to that, a variety of existing robots and environments are provided. This work presents the architecture of the first release of the Neurorobotics Platform developed in subproject 10 "Neurorobotics" of the Human Brain Project (HBP). At the current state, the Neurorobotics Platform allows researchers to design and run basic experiments in neurorobotics using simulated robots and simulated environments linked to simplified versions of brain models. We illustrate the capabilities of the platform with three example experiments: a Braitenberg task implemented on a mobile robot, a sensory-motor learning task based on a robotic controller, and a visual tracking embedding a retina model on the iCub humanoid robot. These use-cases allow to assess the applicability of the Neurorobotics Platform for robotic tasks as well as in neuroscientific experiments.

Introduction: Primary intraosseous carcinoma (PIOC) of the jaws is a rare epidermoid carcinoma from epithelial origin and initially strictly localized within the bone. Histologically, type 3 PIOC (PIOC3) is a de novo primary intraosseous carcinoma. Because of the rarity of this illness, we propose an analysis of a personal case and a revue of the literature., Material and Methods: Two search engines (Pubmed ® , Sciencedirect ® ) were questioned over the period 1976-February 2016 by using following keywords carcinoma, intraosseous, jaws, squamous cell carcinoma. Articles reporting proven PIOC3 and mentioning a precise treatment were selected., Results: Thirty articles concerning 54 patients (sex ratio: 2.4; mean age: 56.8; extreme: 24-78) met the inclusion criterions. The most common symptoms were swelling (53%), pain (44.9%) and infra-alveolar nerve paresthesia (30.6%). The time to diagnosis was 13 weeks. Classification of Zwetyenga et al. showed more than 80% of T2 and T3 stages. The lesions were predominantly mandibular (85.2%) and posterior. Less than a third of patients had lymph node and 10% had distant metastasis. Treatment consisted mostly in a combination of surgery and radiotherapy. With a mean follow-up of 74.8 months, 70.8% were in remission with no evidence of recurrence. We report the case of a 58-year-old patient, with no medical history, complaining since several months about periodontitis with teeth mobility in the right mandibular area. The panoramic X-ray showed a bone lysis at the place of tooth No. 46. In the absence of alveolar healing after extraction and antibiotherapy, a biopsy was made that diagnosed a differentiated keratinizing squamous cell carcinoma. CT scan and MRI showed a mandibular cortical bone loss with involvement of adjacent structures and lymphadenopathy in the ipsilateral IB area. The patient was treated with a combination of chemotherapy and surgery. Postoperative chemo- and radiotherapy is still going on., Discussion: The PIOC3 is a rare tumor, mainly arising in males around 50. Diagnosis should be evoked in the presence of painful swelling and nervous symptoms. The time to diagnosis is long. Tumors are usually seen at late stages. Treatment classically combines surgery and radiotherapy., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Basal cell carcinoma (BCC) is the most common skin cancer in France. It is commonly diagnosed in front of a papule or nodule of the face. The surgeon should be able to question the diagnosis of BCC when nodular lesions are untypical, keeping in mind that some differential diagnoses require only medical treatment., Observations: The authors successively describe three non infectious entities mimicking BCC of the face, requiring purely medical treatment: facial granuloma described by Lever, cutaneous pseudolymphoma, sarcoidosis., Discussion: In front of a non-typical skin nodule CBC, a dermatological expert advice may be quite helpful. The value of this collaboration is to guide or otherwise to suspend surgical excision., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Parotid gland duct lithiasis is preferentially managed using minimally-invasive techniques such as sialendoscopy and lithotripsy. However, these 2 techniques cannot remedy all obstructions and other techniques such as the Transoral Stensen's Duct Approach (TSDA) may sometimes be helpful., Material and Methods: A retrospective study of patients treated with TSDA was conducted to evaluate this procedure between 2006 and 2013. Criteria for inclusion were: failures for lithiases (22 patients and 28 lithiases) treated with sialendoscopy and/or lithotripsy for parotid gland duct obstruction. Mean follow-up was 47.4 months. Pain intensity, swelling and occurrence of infectious episodes were evaluated immediately and after middle-term and long-term follow-up (up to 36 months)., Results: The best results were obtained for anterior lithiasis, with an 87.5% immediate success rate. Morbidity was low with 2 transient facial nerve upper buccal branch palsies and 2 post-operative stenoses., Discussion: TSDA is an easy-to-perform and safe technique that can be recommended in cases of sialendoscopy or lithotripsy failure for anterior-third parotid duct lithiasis. Even if this technique has shown limitations for more posterior lithiases, or other causes of obstruction (stenosis, megaduct), it requires no specific material and may be useful. It may avoid an external combined approach or a parotidectomy., (Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Introduction: Scleroderma is a rare disease of the connective tissue (50 to 200 patients/1 million people; 60,000 patients in France). We conducted a literature review about the orofacial manifestations of scleroderma that have been little studied., Material and Methods: The 45 articles found in 6 different databases by using the keywords "scleroderma", "systemic sclerosis", "oral medicine", "face" and published between 1944 and 2016 were selected, for a total of 328 patients., Results: A total of 1187 orofacial manifestations of scleroderma were identified, occurring mainly in women (84.5%) with a mean age of 40.2 years, 10 years on average after the first manifestation of the disease. The main ones were limitation of mouth opening (69.8%), widening of the periodontal ligament (67.3%), xerostomia (63.4%), telangiectasia (36.2%) and bone lesions (34.5%). Dental root resorptions, pulp and nose calcifications were also reported but with no evident link with scleroderma., Discussion: Orofacial manifestations of scleroderma are probably more common than reported. They mostly affect women with a mean age of 40. The most common oral manifestations are limitation of mouth opening, widening of the periodontal ligament and xerostomia. Because of the handicap they may be responsible for, these manifestations must be detected early in order to prevent from functional impairments and from dental and periodontal lesions., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Temporomandibular joint (TMJ) dysfunction associates pain, limited mouth opening and joint noise. Failures of conservative treatments may lead to arthroscopy. The aim of our study was to evaluate the current interest of arthroscopy in the treatment of TMJ dysfunction., Material and Methods: Using the keywords "TMJ" and "Arthroscopy", 1668 articles were found in the Sciencedirect database. We selected 17 papers published between September 2012 and May 2016. Six questions were asked: (1) what treatment should be given to patients suffering from TMJ dysfunction? (2) What treatment should be performed for TMJ disorders when conservative treatments failed? (3) Does Wilkes staging change the surgical indication? (4) What has to be done in case of arthroscopy failure? (5) Can disc position be improved after surgery? (6) Should the disc position be improved?, Results and Discussion: (1) Conservative treatment should always be considered in first intention (2) In case of conservative treatment failures, surgery can be proposed, beginning with the less invasive one (3) Whatever the Wilkes stage, treatment should begin by the less invasive one (4) In case of arthroscopy failure, TMJ arthrotomy can be indicated (5) Disc position may be improved in the long term but it is complex to obtain (only one paper) (6) there is no evidence that disk has to be repositioned., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Management of zygomatic bone fractures is still debated. Method and delay for intervention has to be chosen considering respective issues of operative or conservative treatments, especially hemorrhagic complications. The maxillofacial surgeon must be able to determine life-threatening situations and to react appropriately., Cases Report: We report 2 cases of external carotid branches pseudoaneurysm leading to massive hemorrhage after early or delayed zygomatic fracture surgery. The first patient underwent open reduction of fracture by intraoral approach. An active bleeding occurred in the immediate postoperative time. In the second case, a zygomatic osteotomy was performed 1 year after fracture. Bleeding occurred 2 weeks after surgery. In both cases, angiography demonstrated a pseudoaneurysm developed from the external carotid branches. Embolisation led to rapid bleeding control., Discussion: Severe hemorrhage resulting from maxillofacial trauma may be life-threatening. Once the "damage control" principles applied, selective embolisation of external carotid branches is an efficient alternative to surgery for the control of bleeding resulting from ruptured pseudoaneurysm., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Ranula is a pseudocyst of the sublingual gland, often of unknown etiology. In few cases, it can extend to the neck when passing through the mylohyoid muscle. Diagnosis is not always easy as other cervical cystic lesions may have the same clinical aspect. Some ranulas recur after removal. The aim of our study was to conduct a review about plunging ranulas, with a focus on the most useful paraclinical exams and the most effective treatment., Material and Methods: A review of the literature has been conducted in the PubMed database between 2015 and 2010 using following keywords: plunging ranula, recurrent plunging ranula., Results: Thirteen articles reporting 37 cases of plunging ranulas have been selected. Among these cases, 3 recurred. Paraclinical exams consisted in US, CT scan and MRI. Main reported treatment was sublingual gland removal, sometime associated with marsupialization., Discussion: The most useful paraclinical exam is CT scan. Total sublingual gland removal is the most efficient treatment., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Orthognathic surgery procedures mark the endpoint of lengthy orthodontic-surgical preparations and herald the completion of treatment for patients and their families. The main types of procedure are full maxillary Le Fort I osteotomies, mandibular osteotomies and chin surgery. To ensure a successful outcome, all require a favorable environment and extreme technical skill. But, like all surgical operations, they are also subject to peri- and post-operative complications resulting from treatment hazards or errors. Whatever the cause, surgical complications can entail failures in the management of the malformation. By seeking to understand and analyzing these complications, we can already help to prevent and reduce the contingent risks of failure., (© EDP Sciences, SFODF, 2016.)