BackgroundClassical flaps for perinasal defect reconstruction, such as forehead or nasolabial flaps, have some disadvantages involving limitations of the arc of rotation and two stages of surgery. However, a perforator-based flap is more versatile and allows freedom in flap design. We introduced our experience with reconstruction using a facial artery perforator-based propeller flap on the perinasal area. We describe the surgical differences between different defect subtypes.MethodsBetween December 2005 and August 2013, 10 patients underwent perinasal reconstruction in which a facial artery perforator-based flap was used. We divided the perinasal defects into types A and B, according to location. The operative results, including flap size, arc of rotation, complications, and characteristics of the perforator were evaluated by retrospective chart review and photographic evaluation.ResultsEight patients were male and 2 patients were female. Their mean age was 61 years (range, 35-75 years). The size of the flap ranged from 1 cm×1.5 cm to 3 cm×6 cm. Eight patients healed uneventfully, but 2 patients presented with mild flap congestion. However, these 2 patients healed by conservative management without any additional surgery. All of the flaps survived completely with aesthetically pleasing results.ConclusionsThe facial artery perforator-based flap allowed for versatile customized flaps, and the donor site scar was concealed using the natural nasolabial fold.

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The skeletal class III relationship presents complex dentoalveolar problems, requiring multidisciplinary treatment. In edentulous people, severe atrophy of the jawbone simulates the clinical appearance of a skeletal class III relationship (pseudoskeletal class III), which presents major problems for rehabilitation. This article describes the rehabilitation of a 67-year-old patient with a pseudoskeletal class III relationship. The mandible was restored with two implant-supported bar-retained overdentures using clips for retention. The extremely atrophic maxilla was restored with a combination of sinus augmentation, implant placement, and classic prosthodontic treatment using an electroformed mesostructured overdenture with swivel lock attachments on an implant-supported bar. By performing minimal augmentative and implant surgeries and using the possibilities and advantages of classic prosthetic dentistry, the clinical situation described here could be managed and the atrophic maxilla could be rehabilitated.

Study Design. Experimental study.Objective. In this study, the ambient temperature of a radiofrequency (RF) electrode tip was compared and analyzed in terms of products, mode, flow quantity, and flow rate. Summary of Background Data. Endoscopic spine surgery is a widely used operation for degenerative lumbar stenosis and herniated lumbar disc. To perform endoscopic spine surgery, dedicated instruments like a RF generator and electrode are essential.Methods. An evaluation system capable of measuring temperature under equal conditions at a certain distance from the electrode tip was manufactured. The distance between the electrode tip and the temperature sensor was set to 1, 5, and 10 mm. The flow quantities of 0, 50, 100, and 150 mL/min and the flow rates of 0, 0.20, 0.53, and 0.80 m/s were compared and statistically analyzed.Results. The temperatures measured in the experiments conducted on the four combinations of RF device showed similar values, and showed differences according to the characteristics of each mode of the RF. As the distance between the electrode tip and the temperature sensor increased, the temperature decreased, and as flow quantity or flow rate increased, the temperature decreased. The maximum temperatures differed significantly according to flow quantity, between flow quantities of 0 and 100 mL/min (P ¼ 0.03) and between 0 and 150 mL/min (P 0.01). The maximum temperatures also differed significantly between the flow rate of 0 m/s, and the flow rates of 0.20, 0.53, and 0.80 m/s, with P 0.01 in all three comparisons. Conclusion. This is the first study in which we made a customized RF temperature evaluation system and verified the temperature changes in various environments. When irrigation was performed, we could confirm that the maximum temperature was less than 608C. Irrigation is considered essential in endoscopic spine surgery.