Search

Nowadays, tooth extraction has become a frequently performed surgical procedure whose most common postoperative outcome is alveolar bone atrophy. To reduce the bone dimensional changes, localized alveolar ridge augmentation or socket preservation with bone grafting is required. The socket may be filled with synthetic grafts, xenografts, autografts, allografts, autologous platelet concentrate. The use of platelet concentrates for healing improvement and regeneration of the soft and hard tissues in oral cavity is one of the latest achievements in dentistry. One of the newest practices in bone augmentation is the use of platelet rich fibrin, derived from the patient’s own blood and can be very easily accepted by patients due to cost effectiveness, low donor morbidity and low rate of postoperative complications or infection. This biomaterial might be a solution for patients that have strong beliefs regarding the use of allografts or xenografts, or which are afraid of complications during or after autografting procedure. One cannot say that there is an ideal grafting material and must consider a person’s religious affiliation or beliefs when performing bone augmentation.

This study proposes a new approach to a borderline pathology between Otorhinolaryngology (E.N.T.) and Oral and Maxillofacial Surgery (O.M.F.), the malignant tumors of the oropharyngeal and retromolar trigone junction.52 cases of retromolar trigone and oropharynx malign tumors were solved in the ENT department of "St. Spiridon" Universitary Hospital Iasi between 2012 and 2014. All patients were males, 35-64 years old, in different TNM stages. The novelty stands in the multidisciplinary approach, with an operating team consisting of both E.N.T. and O.M.F. surgeons, which joined their knowledge and expertise in order to offer a better treatment for the patient. Human Papilloma Virus (HPV) infection has been known as a trigger factor in head and neck cancers. The connection between HPV infection and malignant tumors of the oropharyngeal--retromolar trigone junction, together with the other traditional risk factors (smoking, alcohol, stress and sexual behavior) are involved in the therapeutic protocols, improving the life quality, the survival rate and reducing the treatment costs.Excision of the malignant tumors at the level of the junction between the oropharynx and retromolar trigone often requires repairing the tissular defects that remain using different flaps. Postsurgical mecanotherapy (physiotherapy) under the surveillance of an experienced physiotherapist is also needed for a complete recovery.This therapeutical protocol aims to assure a better life quality for the patients, with a faster postsurgical recovery and social reinsertion by reducing the healing time of the areas affected by inflammation and necrosis generated by the neoplastic process.

Penetrating orbitocranial injuries caused by intraorbital foreign body are a rare cause of morbidity being most common among young people. The term intraorbital foreign body refers to a foreign body that occurs within the orbit but outside the ocular globe. We report the case of a 12-year-old male child who sustained a right cranial facial trauma due to accidental fall on a piece of wood, which penetrated intraorbitally. Native cranial magnetic resonance imaging (MRI -1.5 T) revealed the presence of an intraorbital foreign body, 6 cm long and 1.5 cm wide, near the orbital apex. In our patient, early surgical extraction of the foreign body had a decisive role on his full recovery. In this case, although a large foreign body penetrated the entire length of the orbit, it did not cause damage to any intraorbital structure. Vision and right ocular globe function had an excellent prognosis.

To retrospectively analyze the epidemiological, clinical and pathological data of parotid tumors.Reassessment of the histologic diagnosis of parotid tumor in the patients admitted to the Oral and Maxillofacial Surgery Unit of the Iasi "Sf. Spiridon" University Emergency Hospital during 2009-2013. Data on gender, age, place of residence, location, size, surgical procedure type and histopatological type were recorded.The risk of developing pleomorphic adenonma is 7.40 times higher in women and 4.08 times higher before the age of 50 years. The risk of Warthin tumor is 16.47 times higher in male patients and 3.58 times higher in urban patients. People older than 50 years have a 7.14 times higher risk of developing malignancy and rural people have a 2.41 times higher risk of developing cancer. Diabetes, obesity and systemic hypertension were not important risk factors in our study.According to this study age and the place of residence could be important predictors for parotid gland tumors. Since in Romania there are few epidemiological data regarding the parotid gland pathology, further cohort studies are needed for a better understanding of their clinical and pathological behavior.

Partial discharges measurements have been performed on 3.3 kV IGBT power modules. Results using both the normalized and a new proposed test are compared. The new test, allowing the detection of partial discharges in all the insulating materials, is detailed. Elementary defect patterns are used to distinguish the main cause (dies or insulating materials) of the observed partial discharges in IGBT modules

Biphosphonates are used in the treatment of bone metastases of some cancer forms, such as multiple myeloma, Paget disease, osteoporosis, fibrous displasia, etc. A significant consequence of the utilization of such drugs is osteonecrosis of the maxillary bones. The aim of the study was to evaluate the risk factors provoking osteonecrosis of the maxillary bones after the treatment with biphosphonates, in the patients who addressed the Clinics of Oral and Maxillo-Facial Surgery between 2006-2011. Materials and method: 33 patients suffering from this pathology were registered, their files including information on age, sex, social background, the disease for which the drug had been recommended and the prescribed dose, the manner of its administration and the duration, the cause of the maxillary lesion, the symptomatology demonstrated during the first consultation, additional examinations, treatment and evolution. Results: most cases of osteo-necrosis had been caused by dental extractions, especially at the mandible. The higher risk was faced by women who were administered the drug intravenously. Conclusions: Post-surgical evolution was favourably influenced when the surgery had in view the value of the carboxy-terminal group from the structure of serum colagen.

To carry out performance demonstrations of the Eddy-Current NDE processes applied on French nuclear power plants, EDF studies the possibility of using simulation tools as an alternative to measurements on steam generator tube mocks-up. This paper focuses on the strategy led by EDF to assess and use code_Carmel3D and Civa, on the case of Eddy-Current NDE on wears problem which may appear in the U-shape region of steam generator tubes due to the rubbing of anti-vibration bars.

Maxillary canines have the longest period of development, the deepest area of formation and the most difficult path of all teeth. The maxillary canines are the most likely to remain unerupted or impacted. The maxillary permanent canine is considered important by virtue of its place in the scheme of functional occlusion and its contribution to facial appearance. We successfully orthodontically treated two cases with palatally impacted canines. Although both cases had palatally impacted canines, they were different due to canine position and angulation.

The use of autogenous bone graft in the reconstruction of mandibular defects following tumor extirpation is a reliable method for further functional rehabilitation. The exact amount of bone needed for harvesting is usually achieved by estimation of the gap and direct measuring. We present the case of a 51-years old patient referred to our clinic for a recurrent mandibular keratocyst. Besides clinical examination, the diagnosis work-up consisted of ortopantomography and computertomography (CT). Based on CT images, a graphic reconstruction of the mandible was realized and a 3D negative template of the scheduled mandibular defect was printed. The tumor was removed by a segmental resection of the mandible, while a fragment of bone tissue similar to the 3D model was harvested from the iliac crest. This bone fragment replaced the mandible defect and was fixed by means of four plates and titanium screws. No postoperative complications occurred. The pathology result confirmed the diagnosis of keratocyst. In conclusion, this method proved to be useful for precise planning of the shape and size of the graft in addition to exact placement of the graft in an acceptable prosthodontically position for future dental implant rehabilitation.

To achieve performance demonstration, which is a legal requirement for the qualification of NDE processes applied on French nuclear power plants, the use of modeling tools is a valuable support, provided that the employed models have been previously validated. To achieve this, in particular for eddy current modeling, a validation methodology based on the use of specific benchmarks close to the actual industrial issue has to be defined. Nonetheless, considering the high variability in code origin and complexity, the feedback from experience on actual cases has shown that it was critical to define simpler generic and public benchmarks in order to perform a preliminary selection. A specific Working Group has been launched in the frame of COFREND, the French Association for NDE, resulting in the definition of several benchmark problems. This action is now ready for mutualization with similar international approaches.

This study presents the CT imaging of a group of maxillofacial tumors that include benign tumors and primary and secondary malignant processes.All patients were CT explored with and without intravenous contrast, using specific head and neck protocols.We studied the topography of the tumors, their impact on neighborhood regions and post-treatment results. The diagnostic of all patients had histological confirmation. In maxillofacial tumors and tumor-like diseases, 3D imaging was significantly superior to 2D axial imaging in showing the tumor shape and spatial relationships between tumors and surrounding structures. Two dimensional imaging and MPR imaging were excellent to reveal internal structure and pathological changes of tumors. 2D imaging and MPR imaging also achieved better results in showing tumors extended to soft tissues.

The authors propose the temporoparietal fasciocutaneous flaps for covering the surface skin defects from oro-maxillo-facial region.Between 2000 and 2006 we performed 8 of this kind of flaps: 5 insular temporoparietal fasciocutaneous flaps, 2 fasciocutaneous flaps and one rotated flap. These flaps were used for reconstruction of the defects of the mouth's commissures, genian region in 1/2 superior, parotid region, upper lip and nasogenian sulcus.We recorded a singular case with necrosis of the insular fasciocutaneous flap; the rest of 7 were entirely survived. The cosmetic appearance was acceptable for all patients and the symmetry of the reconstructed area versus contralateral area was satisfactory. One case has cicatriceal alopecia at the donor site and in two cases, alopecia because of use of the skin graft for covering the donor defect.The fasciocutaneous temporoparietal flap is a value technique for repairing the facial skin defect.

The treatment of extended oro-maxillofacial lesions is a difficult task. Free flaps are the optimal reconstruction method in well defined situations. Though not improving survival, they have lead to a lower morbidity and to the improvement of the patient's life quality. A great step forward was represented by the radial forearm flap. This paper reflects the experience of a team approach (oro-maxillofacial and plastic surgery). The radial forearm free flap was considered as the optimal solution for 22 patients with defects concerning the tongue and/or mouth floor (8), the lower lip (7), or other facial regions (5). The defects were due to the resection of malignant tumors spinocellular (18) or basocellular carcinoma (2), benign tumors (1) or posttraumatic (1). Flap's characteristics allow wide area coverage and high plasticity. Thus, in case of malignant tumors, surgeons may perform resections within the oncological limits, while post-resectional defects can be covered with very good functional and aesthetic results. The morbidity of the donor region is within acceptable limits. Team approach in head and neck reconstruction (oromaxillofacial surgeon-plastic surgeon) leads to superior quality results, allowing each specialist to focus on the aspects he/she is most familiar.

In the past 15 years (1991-2005) we used the muscular-mucosal lingual flap with posterior pedicle for 82 patients.The main indication has been the reconstruction of the residual defects after resection of the mucosal mouth floor carcinomas (especially those located in the anterior third of the mouth or with gingival and alveolar invasion) or after resection of the gingival-alveolar mandible carcinomas with invasion of the mouth floor. Deglutition and phonation have been fully recovered at 14 to 20 days post-surgery, with temporary alterations during radiotherapy, due to radiation-induced mucositis. Mobility of the remaining of the tongue was acceptable and physiotherapy had a significant impact in recovering an intelligible phonation and for better mastication and deglutition due to compensatory hypertrophy of the lingual musculature.The muscular-mucosal lingual flap remains a good technical alternative for surgical reconstruction especially for advanced-age patients, heavy smokers or alcohol-consumers, patients with prior radiation therapy or patients with precarious co-operation for more advanced reconstructive techniques.

The treatment of temporomandibular ankylosis, indifferently by anatomoclinical type or etiologic factor (trauma, infection, rheumatism), is exclusively surgical. The frequent indication in the temporomandibular ankylosis of types I and II Topazian remains the neo-articular modeling osteotomy with or without interposition. A clinical and retrospective study of 25 patients diagnosed with temporomandibular ankylosis (unilateral or bilateral) was performed. The patients were operated between 1993- 2005 by interpositional arthroplasty after resection of the joint osseous block. From 32 surgical procedures in temporomandibular ankylosis, the Dacron was used for 29 interventions. The qualities of this material were confirmed by good results obtained after 1-12 years of following. The mobility of the mandible and postoperative mouth opening were in normal limits with lack of complications or recurrences. The technique is simple and the interposition material is well tolerated by the body. The Dacron texture is soft, elastic, resistant with physically and chemically stable. It is easy to be modeled, perfectly adaptable on resting osseous mass, and it is integrates intra new joint by penetration of the connective fibrous in itself. Given these facts, the interposition material of Dacron plays the role of the fibrocartilage in the temporomandibular joint.

International audience; Interleaved power converters are now used in many different conversion systems involving various topologies (series or parallel) and related to different fields or loads. This paper deals with interleaved parallel commutation cells using coupling transformers with a possibly high number of cells. The first part of the paper is a reminder of the basics of magnetic couplers addressing monolithic as well as distributed implementations. The limits associated with the conventional supply of such couplers (supply voltages forming a direct polyphase system) are described. In the second part of the paper, an optimized voltage supply improving the performances of the system is introduced. Experimental results obtained on a seven-cells test bench validate the approach

In interleaved converters, the commutation cells can be interconnected by intercell transformers. In this paper we show how a modified sequence of the voltages applied to windings reduces the flux density in the magnetic core branches. Experimental measurements confirm the flux reduction obtained with the modified supply. Thermal measurements were made in order to evaluate the reduction of total core losses when the modified supply is used.

Benign symmetric lipomatosis (BSL) is a rare proliferative disorder of the adipose tissue, characterized by symmetrical fat deposits, predominantly in the neck and shoulder area, upper back and arms. This study contains the analyse of a lot of ten patients with BSL, which were surgical treated in our department between 1994-2004. The followed parameters were: sex, age, heredo-collateral antecedents, associated organic diseases, the motivation of medical addressability, the sites of first lesions, the length of evolution before the admission, methods for diagnosis, number of surgical sessions necessary to extirpation of fat deposits, the results of the periodic follow-up examination. The followed patients with BSL were treated by surgery (extirpation of the cervical fat masses): one surgical session (8 cases) or two sessions (2 cases). The morphological, functional and psychic results were good. Recurrence at the site of surgery was not detected in any follow-up subjects. The elective treatment in BSL is surgical, by extirpation of the lipomatous masses; a satisfactory, lasting result can be expected only after the most radical possible extirpation (not only for cosmetic intentions).

The quickly and exactly method of location of the hinge-axis is based on the moiré effect, produced between two superposed optical nets, one of it being moved. A face bow is fixed on the mandible to the occlusion rim. Two optical devices are mounted on the bottoms of the face bow. Two other optical nets are applied on the skin, corresponding to the TMJ. During the opening movements of the mandible when a pure rotation of the mandibular condiles take place on the TMJ, the optical nets are displaced and me exactly register the place corresponding to the rotation axe and we can note on the skin the hinge axis. The checkout was done using a phanthom achieved in our department, consisting of a skull made up of polyestheric resins and an elastic element made up of PVC.