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Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Despite a high incidence of oestrogen receptor-positive (ER+) HER2-negative (HER2-) breast carcinoma (BC) in elderly women, rationale and modalities of adjuvant chemotherapy (CT) vary greatly and remain heterogeneous after 70 years, precluding evaluation of its benefit and impact on functional status and outcome. As for trials investigating innovative treatments, elderly patients are often excluded from programs evaluating new modern prognosis classifiers. Trial design: ASTER 70s is a prospective multicentre trial that investigates the impact on overall survival (OS) of adjuvant CT in elderly ER+ HER2- BC patients selected with a modern prognosis classifier while taking into account competing risks for mortality (EudraCT 2011-004744-22). After surgery, 2,000 patients over 70 years will have genomic grade (GG) assessed centrally by qRT-PCR on formalin-fixed paraffin-embedded samples (Ipsogen). Only those with a high GG or Equivocal (estimation ~700, group I) will be randomized between endocrine treatment alone and CT followed by endocrine treatment. CT regimen is left to the choice of investigators amongst 3 regimen of same duration [4 q3w cycles, docetaxel+cyclophosphamide (TC), doxorubicin or non pegylated liposomal doxorubicin (Myocet®)+cyclophosphamide (AC or MC), all with G-CSF], as well as endocrine treatment (aromatase inhibitor±tamoxifen). Radiotherapy will follow standard guidelines. Patients with low GG or not randomized for any reason (estimation ~1,300, group II) will be followed up as an observational cohort, with endocrine treatment only. Eligibility criteria: Any ER+ HER2- BC after complete surgery, M0, any pT or pN. Normal organ functions. No specific BC treatment before surgery. No exclusion for underlying medical condition unless potential contra-indication to study drugs. Specific aims: OS is the primary endpoint. Secondary endpoints address competing risks for mortality, include cost-effectiveness and QTWiST analysis, geriatric questions, acceptability and quality of life (QLQ C30 and specific elderly scale ELD15). The Lee's 4-year mortality score is calculated. The G8 screening tool is also assessed and used for stratification. Translational research will focus on ageing and prognostic biomarkers, and pharmacogenetic. Statistical methods: Sample size based on 4-year OS (87.5 vs 80%), bilateral test, a=0.05, ß=0.20 and HR= 0.60. Present accrual and target accrual: The trial has been opened to inclusion in April 2012. 14 centres have been activated with 14 patients included: 7 randomized in group I, 2 included in the cohort (group II) and 4 with GG determination ongoing. [ABSTRACT FROM AUTHOR]

Introduction: Apposition grafting is a method of choice for reconstruction of the anterior maxillary. The purpose of this work was to evaluate the success rate, the degree of bone resorption and the osteointegration of these grafts., Material and Methods: We reviewed retrospectively 36 cases of pre-maxillary bone apposition in patients operated from 1998 to 2002. Autografts were used for all patients. The harvesting site was parietal for 24 patients, intraoral for 8 and iliac for 4., Results: There was two graft failures. The success rate was 94.5%. Partial resorption with effect on implantation was noted in 3 patients. Eighty implants were inserted successfully in 234 grafted sites with on average 2.4 implants per graft. Three implants were removed. Implant survival was 96.2%., Discussion: This study demonstrated that the premaxillary apposition technique using autologous grafts provides sufficient bone volume to enable optimal implant insertion and stability.

The purpose of this article is to report the clinical course and follow-up of a child with ectodermal dysplasia who was treated with implants surgery very early. Different possibilities for prosthetic restoration in the anodontic child are reviewed. Tolerance was excellent. Good cover of the implant was achieved at four years. We propose early implantation reconstruction surgery for these exceptional cases. A prospective multicentric study of this condition would be useful.

Material and Methods: This series included 60 patients operated on between 1996 and 1998. Preoperative work-up included a x-ray study bone quality, preparation of the buccal cavity and assessment of the rhinosinus. We used the surgical technique described by Boynes and Tatum with modifications. The bone graft, mean 16 cm2 was fixed with a stud and clamp assemble or a long screw through the gingival crest, or with a microscrew on the lateral wall of the maxillary sinus. Minimal follow-up was two years., Results: Mean age was 54 years (range 20-80). There were only two minor (hematoma) donor site problems. At the receiver site, there were 30 perforations of the mucosa that had no effect on the graft vitality. During the postoperative period, there were 2 hematomas that resolved spontaneously and 20 cases of dysesthesia in the V2 territory. Mid-term outcome (15 days to 6 months postoperatively) showed: 4 graft infections requiring removal in 3 cases and 6 partial resorptions requiring a new parietal bone graft in 3 cases., Discussion: The iliac bone graft provided abundant cancellous tissue. The mid-term outcome was satisfactory although the postoperative problems resolved more slowly and were more painful than when harvesting a parietal graft. Mucosal perforations were frequent but reparable and did not increase postoperative morbidity. Infection was the most severe complication. Our incidence (3%) was slightly higher than reported in the literature. A possible explanation would be the mean height of the graft (18-20 mm) and the severity of the atrophies treated.

Objective: We conducted a prospective study to determine the types of bone anomalies observed in different types of dental agenesia., Patients and Method: This prospective series included 30 patients who attended our pluridisciplinary clinic since 1988. There were 22 cases of non syndromal agenesia and 8 cases of syndromal agenesia. Patients consulted for a variety of reasons, no specific sign was found. The diagnosis was based on the panoramic x-ray and confirmed at the genetic consultation., Results: Results were systemized by localization of the agenesia. In all cases, the height of the bone crest was preserved compared with the adjacent teeth. In the anterior part of the maxillary, the bone crest was thin showing a water drop aspect. In the posterior maxillary, there was a decrease in the subsinusal height due to invagination of the floor of the sinus. In the anterior part of the mandible, the crest had a knife blade aspect but no loss of height and in the posterior part, a preserved distance between the residual crest rim and the dental canal., Discussion: In 60% of the solitary agenesias in the anterior part of the maxillary, augmentation was not required. A sinus graft was required in all cases involving the posterior maxillary. Multiple anterior or lateral agenesias were treated with a parietal graft.

The objective of this study was to determine the long term stability of implants on mandibles reconstructed by microvascular bone transfer. We present two cases of mandible reconstruction, the first one was performed after tumor resection and the second one after gunshot injury. The reconstructions were performed by iliac crest osseous and osteocutaneous free flaps and the mean follow-up period was 8 years. The implant was an IMZ Titanium and a classic prosthetic system was used. No complication was observed (mucous ulceration, infiltration around the implant), and the feared friction phenomenon between the neo mucosa and the reconstructed bone has not been a problem for long term follow-up.

Between April 1988 and February 1990, 3,007 cases of female breast cancer were recorded among people insured by CANAM*; 118 cancers were bilateral from the start and 2,889 were unilateral. At the time of diagnosis the patients' age ranged from 24 to 101 years (median: 60 years), and 35.6 percent of the tumours were virtually subclinical. Lymph node involvement was clinically absent in 75 percent of the cases and histologically absent in 57 percent. In women under 50 the proportion of small TO-T1 tumours was greater than 40 percent, which pleaded for detection before the age of 50 years. Conversely, in economically weak populations and in women who were followed up for cancerous disease, breast cancer was diagnosed at a later stage. In older (retired) women (median age: 74), who accounted for 44 percent of the whole population, the proportion of advanced tumours was practically doubled (T4: 11 percent versus 6 percent), and the probability of metastases at the time of diagnosis had risen from 4.2 to 6.1 percent. In these patients, clinical examination once a year should contribute to an earlier diagnosis.