BackgroundThe reconstruction of segmental mandibular defects remains a challenge for the reconstructive surgeon, from both a functional and an esthetic point of view.MethodsThis clinical review examines the different techniques currently in use for mandibular reconstruction as related to a range of etiologies, including the different bone donor sites, the alternatives to free flaps (FFs), as well as the contribution of computer‐assisted surgery. Recent progress and the perspectives in bone tissue engineering (BTE) are also discussed.ResultsOsseous FF allows reliable and satisfying outcomes. However, locoregional flap, distraction osteogenesis, or even induced membrane techniques are other potential options in less favorable cases. Obtaining an engineered bone with satisfactory mechanical properties and sufficient vascular supply requires further investigations.ConclusionsOsseous FF procedure remains the gold standard for segmental mandible reconstruction. BTE strategies offer promising alternatives.
Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years period ranging from January 1st, 2004 to December 31st, 2013. One hundred and two patients who were hospitalized for symptomatic urolithiasis at the Urology Department of University Hospital of Cotonou were enrolled. Results: Hospital incidence of urolithiasis was 3.7%. Patients mean age was 39.6 years (extremes: 10 years to 73 years). Male to female ratio was 2.2. The main reason for consultation was renal colic for 81 patients (79.4%). Average duration of symptoms at presentation was 5 months (range: 1 day to 10 years). A total of 173 stones were identified with an average size of 12 mm (range: 1 mm to 95 mm). Calyceal stones were seen in 32.9% of cases, renal pelvis stones in 21.4% of cases, ureteral stones in 34.1% and bladder stones in 11.5% of cases. Open surgery was the main treatment for stones that could not be managed medically. 50.8% of patients underwent surgery with extraction of 116 stones. This represented 67.1% of all stones. 9 patients (8.8%) had expelled their stone during urination. The postoperative course was uneventful in 77.5% of cases. Conclusion: Modern treatment options for urolithiasis remain rudimentary in our health facilities. Open surgery is still the main stay of treatment in our countries with limited resources.
Finding alternative strategies for the regeneration of craniofacial bone defects (CSD), such as combining a synthetic ephemeral calcium phosphate (CaP) implant and/or active substances and cells, would contribute to solving this reconstructive roadblock. However, CaP's architectural features (i.e., architecture and composition) still need to be tailored, and the use of processed stem cells and synthetic active substances (e.g., recombinant human bone morphogenetic protein 2) drastically limits the clinical application of such approaches. Focusing on solutions that are directly transposable to the clinical setting, biphasic calcium phosphate (BCP) and carbonated hydroxyapatite (CHA) 3D-printed disks with a triply periodic minimal structure (TPMS) were implanted in calvarial critical-sized defects (rat model) with or without addition of total bone *
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