A well-documented case of absence of the posterior tibial a. is reported. We have studied 40 personal case-records of dissection of the arteries of the leg in fresh corpses. This study allowed classification of the origins of the leg arteries from the popliteal a. into 7 groups. Several findings emerged: 1) the peroneal a. is constant, for phylogenetic and embryologic reasons, 2) the posterior tibial a. is absent in 1 to 5% of cases [1, 2, 4, 6-8] (Fig. 4), in which case the vascularisation of the fibula remains as normal (the proximal epiphysis of the fibula is vascularised by the anterior tibial a., the diaphysis and the distal epiphysis by the peroneal a.). Other anatomic variations may be found: trifurcation of the popliteal a., origin of the anterior tibial a. from the peroneal a., absence of the anterior tibial a., aplasia of the terminal portions of both the anterior and posterior tibial aa. In practice, absence of the posterior tibial a. can be demonstrated by arteriography and doppler ultrasound. We are dubious about the indications for arteriography, which is not always a risk-free examination, and therefore prefer doppler examination with ultrasound, which supplies adequate information in the majority of cases.

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A gummy smile is one in which excessive amounts of gingival tissue are revealed as individuals begin to laugh or when they show their teeth in a smile.In addition to cosmetic methods of concealing this condition, a variety of orthodontic and surgical procedures can, independently or in conjunction, modify the structural elements that constitute a gummy smile.Nevertheless marked gummy smiles are always characterized by specific dento-maxillary discrepancies, a global vertical maxillary excess or overdevelopment of the alveolar processes, the premaxilla and the proalveolus constituting excess anterior vertical dimension. For each of these instances, the author proposes therapeutic treatment plans and illustrates them with corresponding clinical cases. KEY WORDSOsteotomy, Gummy smile, Premaxilla, Proalveolus.

Résumé -Introduction : L'atteinte primitive buccale par un lymphome malin non hodgkinien (LMNH) est rare. Matériels et méthodes : Au travers de cette étude rétrospective, une série de 18 cas dont le diagnostic a été le plus souvent difficile, avec de fréquents retards de diagnostic, a été analysée. Les critères évalués étaient les signes d'appel, la symptomatologie de ces LMNH, les différents traitements suivis et l'évolution de chaque patient. Résultats : Il existait un grand nombre de LMNH de différents types dans cette étude ; les LMNH diffus à grandes cellules B étant les plus fréquents. Une des difficultés diagnostiques était liée à la grande variabilité clinique des symptômes sans signe pathognomonique. Indépendamment de la classification histologique des LMNH, les protocoles thérapeutiques associaient radiothérapie et chimiothérapie. Discussion : Malgré un fréquent retard de diagnostic, le pronostic du LMNH reste bon grâce aux protocoles thérapeutiques appropriés. L'enjeu majeur pour le spécialiste de la cavité orale est une détection plus précoce.Abstract -Malignant non-hodgkin's lymphoma of the oral cavity: a survey of 18 cases. Introduction: Primary malignant non-Hodgkin's lymphoma (MNHL) is a very uncommon lesion of the jaws and the oral cavity. Materials and Methods: In this retrospective study, a survey of 18 cases of MNHL was performed. The clinical presentation, histological subtype, mode of treatment and long-term prognosis were assessed. Results: Many subtypes of MNHL were noted in this survey; diffuse large B-cell lymphoma was the most frequent subtype. One of the greatest difficulties for the diagnosis was the wide clinical variability of the symptoms without any pathognomonic features. The standard treatment protocol associated chemotherapy with radiotherapy. Discussion: Unless there is a prolonged delay in diagnosis, the prognosis is good thanks to adequate therapeutic protocols. The main and crucial point is the earliest possible detection in patients by oral surgeons and dentists.

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