Les implants maxillo-faciaux à plateaux d'assise : troisième partie : reconstructions maxillo-faciales

The facial cranium is at the junction of sensory, respiratory, digestive, postural and dynamic functions. Its architecture remains one of most complex in higher mammalian organisms. And the anatomical lesions of the low and middle face, which are traumatic, tumoral, infectious, congenital or genetic, are extremely difficult to rehabilitate. As in the two preceding articles, the strategies of maxillo-facial reconstruction with set sat back implants imply the orthopaedic concept of leaning osseous cicatrization with external fixers. However, in such losses of substance, the postural and dynamic data become crucial. Therefore, this article presents all the parameters to control for the treatments of these extreme situations, and particularly develops the concepts of balancing pyramids. Then, the theory will be illustrated by the step by step description of a maxillo-facial reconstruction with these implants, in order to discuss the problems met in such treatments and to open our reflexion on the technological improvements still necessary to face all clinical situations.