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Since 1980s, the use of dermal regeneration templates (DRT) for reconstructive purposes has been described in Literature.1 The authors present their experience of 13 patients treated with integra dermal regeneration template and a single-stage surgery for different indications like oncologic reconstruction, trauma injuries, and preprosthetic surgery in the maxillo-facial district.The authors retrospectively reviewed a total of 13 patients treated with DRT at Maxillo-Facial Department of S. Maria Hospital in Terni.Inclusion criteria included the presence of a defect nonapproachable primarily or by secondary intention with an easy locoregional flap reconstruction, a complete clinical record, and a minimum 6 months follow-up.A total of 12 patients underwent surgical reconstruction with DRT at the S. Maria Hospital from June 2018 to February 2020.During follow-up, all patients in which intraoral reconstruction was performed showed first signs of re-mucosization and neovascularization after 10 days.Only in 1 path an easy locoregional flap reconstruction, a complete clinical record, and a minimum 6 months follow-up.A total of 12 patients underwent surgical reconstruction with DRT at the S. Maria Hospital from June 2018 to February 2020.During follow-up, all patients in which intraoral reconstruction was performed showed first signs of re-mucosization and neovascularization after 10 days.Only in 1 patient (8%) a seroma underneath the silicon sheet was observed. Afterward, the patient healed correctly with no other complications.Dermal regeneration template represents an option that should be considered in the head and neck district reconstruction, especially for intraoral defects where, thanks to its long-term functional results and limited alternatives, should represent a relevant choice.

Ectopic lower third molar is an uncommon condition, and its etiology remains unclear. The main approach used for its surgical removal is the intraoral one, but there are cases in which this may not be the best option. When the lower third molar is located below the lower alveolar canal or when it is close to the lower edge of the jaw, the most recommended approach is the extraoral one. The critical issues related to the extraoral approach are the possibility of damaging anatomical structures such as marginal mandibular branch of the facial nerve (craniofacial nerve VII), facial artery and vein, and submental artery. This complication can occur during incision and dissection of the superficial layers or during osteotomy with rotating instruments.This paper reports a case of extraction of ectopic lower third molar using a minimally invasive extraoral approach combined with piezoelectric surgery in order to prevent intraoperative injury of anatomical structures.

Ectopic lower third molar is an uncommon condition, and its etiology remains unclear. The main approach used for its surgical removal is the intraoral one, but there are cases in which this may not be the best option. When the lower third molar is located below the lower alveolar canal or when it is close to the lower edge of the jaw, the most recommended approach is the extraoral one. The critical issues related to the extraoral approach are the possibility of damaging anatomical structures such as marginal mandibular branch of the facial nerve (craniofacial nerve VII), facial artery and vein, and submental artery. This complication can occur during incision and dissection of the superficial layers or during osteotomy with rotating instruments.This paper reports a case of extraction of ectopic lower third molar using a minimally invasive extraoral approach combined with piezoelectric surgery in order to prevent intraoperative injury of anatomical structures.

Velopharyngeal insufficiency (VPI) after cleft palate repair remains an intriguing problem for the cleft surgeon. While other options for the treatment of VPI, in many ways the sphincter pharyngoplasty has become a reliable and satisfying operation. When the applied to the properly selected patient, it rearranges the palatopharyngeus muscles to provide dynamic closure of the newly created central velopharngeal port. The dynamic action is particularly satisfying to the surgeon. The surgery evolved in part because of the dedication and creativity of Dr Ian Jackson who's description is closest to the design used today. In his memory we felt it fitting to review Dr Jackson's involvement with the surgery over the decades as well as include our own thoughts on the advantages of the procedure.

Velopharyngeal insufficiency (VPI) after cleft palate repair remains an intriguing problem for the cleft surgeon. SB590885 price While other options for the treatment of VPI, in many ways the sphincter pharyngoplasty has become a reliable and satisfying operation. When the applied to the properly selected patient, it rearranges the palatopharyngeus muscles to provide dynamic closure of the newly created central velopharngeal port. The dynamic action is particularly satisfying to the surgeon. The surgery evolved in part because of the dedication and creativity of Dr Ian Jackson who's description is closest to the design used today. In his memory we felt it fitting to review Dr Jackson's involvement with the surgery over the decades as well as include our own thoughts on the advantages of the procedure.

A nasal septal perforation is a defect of cartilage, bone, or mucosa of nasal septum, which is caused by previous septal surgery, trauma, chemicals, inflammatory disease, or drugs. If conservative managements, such as nasal saline irrigation or ointments, are not effective, surgical treatment can be considered. Various methods for the reconstruction of nasal septal perforation were reported, such as local flaps, free flaps, autografts, allografts, or xenografts. However, there is no standardized method due to low success rate and high recurrence rate, especially in large perforations. The authors report a successful repair case of large anteroinferior nasal septal perforation, using inferior based contralateral nasal floor flap. The authors believe that our method is an effective way to repair large nasal septal perforation and to minimalize donor site morbidity, without using other allografts.

A nasal septal perforation is a defect of cartilage, bone, or mucosa of nasal septum, which is caused by previous septal surgery, trauma, chemicals, inflammatory disease, or drugs. If conservative managements, such as nasal saline irrigation or ointments, are not effective, surgical treatment can be considered. Various methods for the reconstruction of nasal septal perforation were reported, such as local flaps, free flaps, autografts, allografts, or xenografts. However, there is no standardized method due to low success rate and high recurrence rate, especially in large perforations. The authors report a successful repair case of large anteroinferior nasal septal perforation, using inferior based contralateral nasal floor flap. The authors believe that our method is an effective way to repair large nasal septal perforation and to minimalize donor site morbidity, without using other allografts.

Mandibular condyle osteochondromas cause morphologic and functional disturbances. Multiple options exist for reconstructing the condylar segment following complete condylectomy. In this series, we describe 3 cases of mandibular condyle osteochondroma treated with complete condylectomy, orthognathic surgery, and a novel free ramus osteotomy graft. This is the first report to reconstruct the temporomandibular joint using a free ramus graft. Through this single-staged approach we were able to avoid recurrence, preserve function, and restore facial balance without a separate donor site or an alloplastic implant.

Mandibular condyle osteochondromas cause morphologic and functional disturbances. Multiple options exist for reconstructing the condylar segment following complete condylectomy. In this series, we describe 3 cases of mandibular condyle osteochondroma treated with complete condylectomy, orthognathic surgery, and a novel free ramus osteotomy graft. This is the first report to reconstruct the temporomandibular joint using a free ramus graft. link2 Through this single-staged approach we were able to avoid recurrence, preserve function, and restore facial balance without a separate donor site or an alloplastic implant.

Autologous ear reconstruction is known as one of the most difficult types of reconstruction to perform in plastic surgery. Very rarely is a trainee exposed to the level of complexity and variety of cases they will treat as a sole care provider in a tertiary care setting. This is because the learning curve is steep and those few surgeons that already perform ear reconstruction are limited in what technical experience they can offer trainees due to the plethora of factors competing against the surgeon. These include patient expectations, level of experience, length of anesthetic and accountability for results and complications. For this reason, once a plastic surgeon is nominated to provide autologous ear reconstruction, they face the daunting prospect of not only performing what is a very complex surgery with a very steep learning curve but also the judgment of their patients and colleagues. This paper charts the endeavors of the senior author to provide a service over the last 5 years. It will hopefully pro very steep learning curve but also the judgment of their patients and colleagues. This paper charts the endeavors of the senior author to provide a service over the last 5 years. It will hopefully provide insight and context on setting up a service, dealing with complications, patient and peer expectations, and finally acknowledgment from both alike as experience is gained and excellence is reached.

Arch asymmetry in cleft patients is a current problem that interdisciplinary treatment aims to solve. This research proposed to analyze the final rehabilitation, according to the arch symmetry of these patients. Thirty-five patients aged between 18 and 30 years, rehabilitated with a fixed partial denture or implants in the cleft area. The analysis was performed using digitalized dental casts with a laser model scanner (R700TM; 3Shape A/S, Holmens Kanal 7, 1060, Copenhagen/Denmark), analyzed with a Vectra Analysis Module software program (VECTRA H1; Canfield Scientific, 4 Wood Hollow Road, Parsippany, NJ 07054). Three linear measurements were evaluated, incisal-canine, canine-molar, and incisal-molar distance. link3 The Student t test was applied to test the significance (P = 0.05) of an observed sample by correlation coefficient test (r-value). Female patients showed a significant correlation in arch symmetry. According to the rehabilitation treatment, patients who received implants showed a high correlation and e linear measurements were evaluated, incisal-canine, canine-molar, and incisal-molar distance. The Student t test was applied to test the significance (P = 0.05) of an observed sample by correlation coefficient test (r-value). Female patients showed a significant correlation in arch symmetry. According to the rehabilitation treatment, patients who received implants showed a high correlation and significant symmetry at all maxillary distances. Finally, according to the cleft side in the maxillary dimensions, even though the majority of patients had clefts on the left side, only patients with a cleft on the right side showed symmetry in this area. Patients rehabilitated with implants in the cleft area showed a more symmetrical maxillary arch than those restored with fixed partial dentures.