Zygomatic bone shape in intentional cranial deformations: a model for the study of the interactions between skull growth and facial morphology

Intentional cranial deformations (ICD) were obtained by exerting external mechanical constraints on the skull vault during the first years of life to permanently modify head shape. The repercussions of ICD on the face are not well described in the midfacial region. Here we assessed the shape of the zygomatic bone in different types of ICDs. We considered 14 non-deformed skulls, 19 skulls with antero-posterior deformation, nine skulls with circumferential deformation and seven skulls with Toulouse deformation. The shape of the zygomatic bone was assessed using a statistical shape model after mesh registration. Euclidian distances between mean models and Mahalanobis distances after canonical variate analysis were computed. Classification accuracy was computed using a cross-validation approach. Different ICDs cause specific zygomatic shape modifications corresponding to different degrees of retrusion but the shape of the zygomatic bone alone is not a sufficient parameter for classifying populations into ICD groups defined by deformation types. We illustrate the fact that external mechanical constraints on the skull vault influence midfacial growth. ICDs are a model for the study of the influence of epigenetic factors on craniofacial growth and can help to understand the facial effects of congenital skull malformations such as single or multi-suture synostoses, or of external orthopedic devices such as helmets used to correct deformational plagiocephaly.R.H.K. and S.K. were supported by the Union des Blessés de la Face et de la Tête, Fondation des ‘Gueules Cassées’. S.K. was supported by the Fédération Française d’Orthodontie (FFO)

Maxillary shape after primary cleft closure and before alveolar bone graft in two different management protocols: A comparative morphometric study

AIM AND SCOPE: Result assessment in cleft surgery is a technical challenge and requires the development of dedicated morphometric tools. Two cohorts of patients managed according to two different protocols were assessed at similar ages and their palatal shape was compared using geometric morphometrics. MATERIAL AND METHODS: Ten patients (protocol No. 1) benefited from early lip closure (1-3 months) and secondary combined soft and hard palate closure (6-9 months); 11 patients (protocol No. 2) benefited from later combined lip and soft palate closure (6 months) followed by hard palate closure (18 months). Cone-Beam Computed Tomography (CBCT) images were acquired at 5 years of age and palatal shapes were compared between protocols No. 1 and No. 2 using geometric morphometrics. RESULTS: Protocols No. 1 and No. 2 had a significantly different timing in their surgical steps but were assessed at a similar age (5 years). The inter-canine distance was significantly narrower in protocol No. 1. Geometric morphometrics showed that the premaxillary region was located more inferiorly in protocol No. 1. CONCLUSION: Functional approaches to cleft surgery (protocol No. 2) allow obtaining larger inter-canine distances and more anatomical premaxillary positions at 5 years of age when compared to protocols involving early lip closure (protocol No. 1). This is the first study comparing the intermediate results of two cleft management protocols using 3D CBCT data and geometric morphometrics. Similar assessments at the end of puberty are required in order to compare the long-term benefits of functional protocols

Tres depósitos de agua en Alençon – Francia

Local authorities from the beginning decided that the tank for this project had to be 35 meters above ground and 8 meters deep. But the decision to construct three reservoirs instead of one was made mainly for economic reasons and also to permit emptying by stages. A sliding formwork facilitated successive construction of all three. Each reservoir consists of a tubular stem 30 meters high, and the eight elements which support the cone-shaped water tank are each jointed at the bottom, so as to prevent differential settling movement. Each reservoir, full of water, weighs 5,000 tons. To calculate the work the lamina method was used.<br><br>Las autoridades locales impusieron para la realización de esta obra la condición de que el tanque tenía que estar colocado a 35 m de altura y debía tener una profundidad de 8 m. La decisión de hacer tres depósitos en lugar de uno, se tomó principalmente por razones de economía y escalonamiento de vaciado, ya que, por una parte, el encofrado deslizante podía utilizarse en los tres, y por otra, permitía hacerlos sucesivamente. Cada depósito consta de un fuste tubular, de 30 m de altura, del que arrancan los ocho soportes que sostienen el vaso troncocónico que contiene el agua. Cada uno de los soportes va articulado en su parte inferior con objeto de evitar momentos secundarios en el fuste. Del mismo modo, para prevenir asientos diferenciales, se han dispuesto placas de base independientes. El peso de cada depósito, lleno de agua, es de 5.000 toneladas. Para su cálculo se empleó el método de láminas

Complications dentaires de la préparation orthodontique et de la chirurgie orthognathique

Introduction : Le protocole orthodontico-chirurgical peut exposer à certains risques au niveau de l’organe dentaire et du parodonte. Malgré leur faible incidence, ces complications peuvent venir compromettre un plan de traitement. Ces complications potentielles doivent être connues et intégrées dans la prise en charge pour réduire leur incidence et, le cas échéant, y faire face dans le cadre de la collaboration orthodontico-chirurgicale. Matériels et méthodes : Les auteurs présentent dans cet article les différentes complications possibles au cours d’un traitement. Conclusion : L’information donnée au patient quant aux risques inhérents à la réalisation d’un protocole orthodontico-chirurgical doit absolument comprendre les risques de lésion de l’organe dentaire et du parodonte

Nouveaux moyens de communications en orthochirurgie - workflow numérique

L’essor des technologies, notamment la dématérialisation des informations propres au patient (courriers, imageries, empreintes) et les planifications numériques ont changé peu à peu la façon dont le trio orthodontiste-patient-chirurgien communique. La dématérialisation des données permet un échange plus rapide et efficient entre spécialistes. Par ailleurs, les simulations informatiques des projets orthodontiques et chirurgicaux et leurs présentations au patient s’intègre comme un nouvel outil éducatif. La maîtrise des moyens d’informations disponibles doit être utilisée pour l’éducation du patient en dehors des temps de consultation. Les différents moyens de communication et leurs intégrations au sein d’une prise en charge orthodontico-chirurgicale vont être ici détaillés point par point

Lower jaw reconstruction and dental rehabilitation after war injuries: the experience of Paul Tessier in Iran in the late 1980s

International audienceIraq−Iran war resulted in more than 400,000 people requiring prolonged medical care in Iran. An international team of prominent reconstructive surgeons led by Paul Tessier, the founder of craniofacial surgery, was invited to Iran during the war by official organizations entitled to support war victims. This team provided up-to-date oral and maxillofacial rehabilitation to patients with severe trauma defects in the lower third of the face. We collected the medical notes of 43 patients operated on by the Tessier team in Iran in the 1980s (files property of AFCF). The parameters we collected were: age of the patient, nature of the trauma (when available), previous procedures, number of implants placed (mandibular and maxillary), associated procedures (bone grafts, soft-tissue procedures, orthognathic surgery). A protocol based on soft-tissue rehabilitation using local flaps, parietal or iliac bone grafts and implant placement 6 months later was used in all patients. Paul Tessier’s approach emphasizes the importance of keeping high standards of care in difficult situations and maintain standard protocols