Craniomaxillofacial Trauma & Reconstruction

9 pages, 904 KiB

Open AccessCase Report

“Phossy Jaw” and “Bis-Phossy Jaw” of the 19th and the 21st Centuries: The Diuturnity of John Walker and the Friction Match

by Richard A. Pollock, Ted W. Brown, Jr. and David M. Rubin

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 262-270; https://doi.org/10.1055/s-0035-1558452 - 24 Jul 2015

Cited by 8 | Viewed by 79

Abstract

Some 200 years ago, workers developed gingivitis, periodontal disease, alveolar crest bone sequestra, and draining fistulae after exposure to phosphorous fumes and phosphorous paste in the manufacture of the friction match. Many also suffered loss of teeth and pathologic fracture of the mandible. [...] Read more.

Some 200 years ago, workers developed gingivitis, periodontal disease, alveolar crest bone sequestra, and draining fistulae after exposure to phosphorous fumes and phosphorous paste in the manufacture of the friction match. Many also suffered loss of teeth and pathologic fracture of the mandible. Known as “phossy jaw”, the constellation rather abruptly vanished following the International Berne Convention of 1906. Today, “bis-phossy jaw” (bisphosphonate-induced osteonecrosis of the jaw) has surfaced with pathologic fractures and other features common to its predecessor, “phossy jaw”. This modern equivalent is reported with ever-increasing frequency and is presented here in the format of a brief historical review and a case report that includes segmental en bloc extirpation of necrotic mandible and pain-free salvage. Computerized imagery and three-dimensional printing technology were successfully chosen to create and apply a custom titanium bone plate, without free-tissue transfer. Full article

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5 pages, 337 KiB

Open AccessCase Report

Management Issues in the Treatment of an Ameloblastoma with an Atypical Presentation

by Juan José Larrañaga, Axel Sahovaler, Pedro Ignacio Picco, Eduardo Luis Mazzaro and Marcelo Fernando Figari

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 257-261; https://doi.org/10.1055/s-0035-1549012 - 19 Mar 2015

Cited by 1 | Viewed by 78

Abstract

Benign ameloblastoma (BA) is the most common tumor arising from the odontogenic epithelium. Surgical resection with adequate margins is the mainstay of treatment due to the high index of tumor recurrence when not completely excised. Although locoregional spread has been described in the [...] Read more.

Benign ameloblastoma (BA) is the most common tumor arising from the odontogenic epithelium. Surgical resection with adequate margins is the mainstay of treatment due to the high index of tumor recurrence when not completely excised. Although locoregional spread has been described in the literature, it is very uncommon. We describe the treatment and follow-up of a 22-year-old woman with multiple recurrences and locoregional spread of a mandibular ameloblastoma who was referred to our center after several tumor resections with subsequent reconstructions. After a complete macroscopical removal of a new recurrence, the mandible was primarily reconstructed. A local homolateral recurrence and a second lesion in the contralateral maxilla were detected after 1-year follow-up and accordingly treated. After 4 years the patient showed a new tumor in the temporal fossa and was reoperated. The histopathology was consistent with a BA in all cases. Even though it is rare, locoregional spread of BA has been reported previously. Recurrences discovered during follow-up may require further resections. A close follow-up is mandatory, and treatment of these cases may result demanding requiring a multiple team approach, including oncologists and radiotherapists. Full article

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6 pages, 297 KiB

Open AccessCase Report

Posttraumatic Delayed Enophthalmos: Analogies with Silent Sinus Syndrome? Case Report and Literature Review

by Gabriele Canzi, Valeria Morganti, Giorgio Novelli, Alberto Bozzetti and Davide Sozzi

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 251-256; https://doi.org/10.1055/s-0034-1399799 - 14 Jan 2015

Cited by 14 | Viewed by 69

Abstract

Acute posttraumatic enophthalmos is a well-known symptom occurring in orbital blowout fractures. Its late onset in the absence of radiologic evidence of displaced fractures is rare and traditionally attributed to ischemic liponecrosis or fibrotic scarring of endo-orbital soft tissues. In this article, we [...] Read more.

Acute posttraumatic enophthalmos is a well-known symptom occurring in orbital blowout fractures. Its late onset in the absence of radiologic evidence of displaced fractures is rare and traditionally attributed to ischemic liponecrosis or fibrotic scarring of endo-orbital soft tissues. In this article, we describe a case of facial trauma, diagnosed and treated at the Maxillo-Facial Surgical Department of Hospital Ca’ Granda Niguarda of Milan, in which delayed monolateral enophthalmos is associated with CT evidence of remodeling of orbital walls attributed to atelectasis of the maxillary sinus, as occurs spontaneously in patients suffering from silent sinus syndrome (SSS). Despite that classic criteria exclude traumatic etiology of SSS, recent literature suggests the possibility to include it. Our case is the first reported in literature supported by complete clinical and radiological documentation obtained before and after the condition established itself. The analogy with cases of spontaneous obstacle of aeration allows us to choose “two-step” surgical treatment with endoscopic uncinectomy and antrostomy and a delayed surgical correction of orbital volume to improve aesthetic results. The case described in this article and the review of the literature may focus physicians’ attention on evaluating the possible traumatic changes in the physiologic sinus drainage system. Full article

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5 pages, 242 KiB

Open AccessCase Report

Circummandibular Wires for Treatment of Dentoalveolar Fractures Adjacent to Edentulous Areas: A Report of Two Cases

by Karl Maloney

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 246-250; https://doi.org/10.1055/s-0034-1399801 - 13 Jan 2015

Cited by 2 | Viewed by 65

Abstract

In general, dentoalveolar fractures are a common injury seen in emergency departments, dental offices, and oral and maxillofacial surgery practices. These injuries can be the result of direct trauma or indirect trauma. Direct trauma more often causes trauma to the maxillary dentition due [...] Read more.

In general, dentoalveolar fractures are a common injury seen in emergency departments, dental offices, and oral and maxillofacial surgery practices. These injuries can be the result of direct trauma or indirect trauma. Direct trauma more often causes trauma to the maxillary dentition due to the exposure of the maxillary anterior teeth. Indirect trauma is usually the result of forced occlusion secondary to a blow to the chin or from a whiplash injury. Falls are the most common mechanism of injury seen in the pediatric group. In adolescents, many of these fractures are sustained during sporting activities. However, the use of mouth guards and other protective equipment has decreased this number. Most adult injuries are caused by motor vehicle accidents, contact sports, falls, bicycles, interpersonal violence, medical/dental mishaps, and industrial accidents. Early intervention to reduce and stabilize the fracture is required to establish a bony union and ensure correct function. Most dentoalveolar fractures have bilateral stable adjacent dentition and are treated with a closed technique utilizing an acid-etch/resin splint followed by splint removal at 4 weeks. Other inferior stabilization treatments used are arch bars and other wiring techniques. It is widely accepted that semirigid stabilization techniques, such as an acid-etch/resin splint or wiring procedures, are adequate to treat dentoalveolar fractures. This is in contrast to the treatment of mandible fractures where AO principles of rigid fixation are often followed. Fractures that are unable to be reduced sometimes necessitate an open reduction followed by internal fixation, sometimes using a secondary splint for mobile teeth. In those rare cases when there are not stable adjacent teeth bilaterally other modalities must be considered. In the present report, two cases are presented where circummandibular wires were used to treat fractured mandibular dentoalveolar segments adjacent to edentulous areas. Full article

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6 pages, 327 KiB

Open AccessArticle

Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures

by Ahmed Salah Mazeed, Mohammed Abdel-Raheem Shoeib, Samia Mohammed Ahmed Saied and Ahmed Elsherbiny

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 205-210; https://doi.org/10.1055/s-0034-1393735 - 23 Dec 2014

Cited by 2 | Viewed by 59

Abstract

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-L/DL-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3–12 years old) with 14 mandibular fractures. They were treated [...] Read more.

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-L/DL-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3–12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1 week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact. Full article

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7 pages, 178 KiB

Open AccessArticle

Orbital Roof Fractures: A Clinically Based Classification and Treatment Algorithm

by Felicity Victoria Connon, S. J. B. Austin and A. L. Nastri

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 198-204; https://doi.org/10.1055/s-0034-1393728 - 17 Dec 2014

Cited by 34

Abstract

Orbital roof fractures are relatively uncommon in craniofacial surgery but present a management challenge due to their anatomy and potential associated injuries. Currently, neither a classification system nor treatment algorithm exists for orbital roof fractures, which this article aims to provide. This article [...] Read more.

Orbital roof fractures are relatively uncommon in craniofacial surgery but present a management challenge due to their anatomy and potential associated injuries. Currently, neither a classification system nor treatment algorithm exists for orbital roof fractures, which this article aims to provide. This article provides a literature review and clinical experience of a tertiary trauma center in Australia. All cases admitted to the Royal Melbourne Hospital with orbital roof fractures between January 2011 and July 2013 were reviewed regarding patient characteristics, mechanism, imaging (computed tomography), and management. Forty-seven patients with orbital roof fractures were treated. Three of these were isolated cases. Forty were male and seven were female. Assault (14) and falls (13) were the most common causes of injury. Forty-two patients were treated conservatively and five had orbital roof repairs. On the basis of the literature and local experience, we propose a four-point system, with subcategories allowing for different fracture characteristics to impact management. Despite the infrequency of orbital roof fractures, their potential ophthalmological, neurological, and functional sequelae can carry a significant morbidity. As such, an algorithm for management of orbital roof fractures may help to ensure appropriate and successful management of these patients. Full article

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8 pages, 129 KiB

Open AccessArticle

Delayed Cranioplasty: Outcomes Using Frozen Autologous Bone Flaps

by Daniel Hng, Ivan Bhaskar, Mumtaz Khan, Charley Budgeon, Omprakash Damodaran, Neville Knuckey and Gabriel Lee

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 190-197; https://doi.org/10.1055/s-0034-1395383 - 17 Dec 2014

Cited by 32 | Viewed by 68

Abstract

Reconstruction of skull defects following decompressive craniectomy is associated with a high rate of complications. Implantation of autologous cryopreserved bone has been associated with infection rates of up to 33%, resulting in considerable patient morbidity. Predisposing factors for infection and other complications are [...] Read more.

Reconstruction of skull defects following decompressive craniectomy is associated with a high rate of complications. Implantation of autologous cryopreserved bone has been associated with infection rates of up to 33%, resulting in considerable patient morbidity. Predisposing factors for infection and other complications are poorly understood. Patients undergoing cranioplasty between 1999 and 2009 were identified from a prospectively maintained database. Records and imaging were reviewed retrospectively. Demographics, the initial craniectomy and subsequent cranioplasty surgeries, complications, and outcomes were recorded. A total of 187 patients underwent delayed cranioplasty using autologous bone flaps cryopreserved at −30 °C following decompressive craniectomy. Indications for craniectomy were trauma (77.0%), stroke (16.0%), subarachnoid hemorrhage (2.67%), tumor (2.14%), and infection (2.14%). There were 64 complications overall (34.2%), the most common being infection (11.2%) and bone resorption (5.35%). After multivariate analysis, intraoperative cerebrospinal fluid (CSF) leak was significantly associated with infection, whereas longer duration of surgery and unilateral site were associated with resorption. Cranioplasty using frozen autologous bone is associated with a high rate of infective complications. Intraoperative CSF leak is a potentially modifiable risk factor. Meticulous dissection during cranioplasty surgery to minimize the chance of breaching the dural or pseudodural plane may reduce the chance of bone flap. Full article

7 pages, 298 KiB

Open AccessCase Report

Carotid-Cavernous Fistula as a Complication of Facial Trauma: A Case Report

by Maria Lazaridou, Eleni Bourlidou, Konstantinos Kontos and Doxa Mangoudi

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 239-245; https://doi.org/10.1055/s-0034-1396524 - 16 Dec 2014

Cited by 2 | Viewed by 49

Abstract

Posttraumatic carotid-cavernous fistula is a very rare complication that can occur in patients with craniomaxillofacial trauma. Symptoms involve headache, diplopia, ptosis of the upper lid, conjunctival chemosis, pulsating exophthalmos, and ophthalmoplegia. Diagnosis can be challenging because various pathologic entities can present with similar [...] Read more.

Posttraumatic carotid-cavernous fistula is a very rare complication that can occur in patients with craniomaxillofacial trauma. Symptoms involve headache, diplopia, ptosis of the upper lid, conjunctival chemosis, pulsating exophthalmos, and ophthalmoplegia. Diagnosis can be challenging because various pathologic entities can present with similar symptoms such as superior orbital fissure syndrome, orbital apex syndrome, retrobulbar hematoma, and cavernous sinus syndrome. However, accurate and early diagnosis is of utmost importance because treatment delay may lead to blindness or permanent neurologic deficits. In this article, a case of posttraumatic carotid-cavernous fistula that was twice misdiagnosed is presented. Full article

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5 pages, 279 KiB

Open AccessCase Report

Temporal Approach to Removal of a Large Orbital Foreign Body

by Hécio Henrique Araújo de Morais, Jimmy Charles Melo Barbalho, Tasiana Guedes de Souza Dias, Rafael Grotta Grempel and Ricardo José de Holanda Vasconcellos

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 234-238; https://doi.org/10.1055/s-0034-1396523 - 8 Dec 2014

Cited by 2 | Viewed by 81

Abstract

Accidents with firearms can result in extensive orbital trauma. Moreover, gun parts can come loose and impale the maxillofacial region. These injuries can cause the loss of visual acuity and impair eye movements. Multidisciplinary treatment is required for injuries associated with this type [...] Read more.

Accidents with firearms can result in extensive orbital trauma. Moreover, gun parts can come loose and impale the maxillofacial region. These injuries can cause the loss of visual acuity and impair eye movements. Multidisciplinary treatment is required for injuries associated with this type of trauma. Computed tomography with three-dimensional reconstruction is useful for determining the precise location and size of the object lodged in the facial skeleton, thereby facilitating the planning of the correct surgical approach. The temporal approach is a fast, simple technique with few complications that is indicated for access to the infratemporal fossa. This article describes the use of the temporal approach on a firearm victim in whom the breech of a rifle had impaled orbital region, with the extremity lodged in the infratemporal fossa. Full article

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6 pages, 349 KiB

Open AccessCase Report

Management of Ossifying Fibroma in a Suspicious Case of Hyperparathyroid–Jaw Tumor Syndrome

by Érica Cristina Marchiori, Blair Alexander Isom and Albert Thomas Indresano

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 228-233; https://doi.org/10.1055/s-0034-1395381 - 2 Dec 2014

Cited by 5 | Viewed by 69

Abstract

The purpose of this article is to report a case of ossifying fibroma in the mandible associated with hyperparathyroid–jaw tumor syndrome, in a 46-year-old Caucasian female, surgically resected and reconstructed with iliac crest bone, followed by implant placement. This is a rare syndrome [...] Read more.

The purpose of this article is to report a case of ossifying fibroma in the mandible associated with hyperparathyroid–jaw tumor syndrome, in a 46-year-old Caucasian female, surgically resected and reconstructed with iliac crest bone, followed by implant placement. This is a rare syndrome with an autosomal dominant pattern, with the development of primary hyperparathyroidism mainly due to parathyroid adenomas. Fibro-osseous lesions in the jaws can be present and can also precede the development of the endocrine disorder. As renal abnormalities and uterine tumors can develop, an interdisciplinary approach is imperative for its diagnosis and management, due to the possibility of recurrence and potential for malignancy. Full article

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7 pages, 519 KiB

Open AccessCase Report

Acute Intraorbital Hemorrhage Following Reduction of a Displaced Orbitozygomaticomaxillary Complex Fracture

by Srinivas Murthy Susarla and Branko Bojovic

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 221-227; https://doi.org/10.1055/s-0034-1395387 - 24 Nov 2014

Viewed by 59

Abstract

Orbitozygomaticomaxillary complex (OZMC) fractures are commonly encountered by the craniomaxillofacial trauma surgeon and may, in fact, be the most common type of orbital fracture. Disruption of articulation with the frontal and sphenoid bones causes disruption of the internal orbital skeleton, which can result [...] Read more.

Orbitozygomaticomaxillary complex (OZMC) fractures are commonly encountered by the craniomaxillofacial trauma surgeon and may, in fact, be the most common type of orbital fracture. Disruption of articulation with the frontal and sphenoid bones causes disruption of the internal orbital skeleton, which can result in diplopia from extraocular muscle swelling or entrapment, or enophthalmos from increased orbital volume. Although there is significant energy transferred to the orbit in these injuries, blindness and intraorbital hematoma are, fortunately, relatively rare complications, typically seen pre- or postoperatively. In this report, we describe the development of acute intraorbital hemorrhage following reduction of a displaced OZMC fracture. Full article

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11 pages, 596 KiB

Open AccessArticle

Lessons Learned in Scalp Reconstruction and Tailoring Free Tissue Transfer in the Elderly: A Case Series and Literature Review

by Michael Sosin, Arif Chaudhry, Carla De La Cruz, Branko Bojovic, Paul N. Manson and Eduardo D. Rodriguez

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 179-189; https://doi.org/10.1055/s-0034-1393725 - 24 Nov 2014

Cited by 15

Abstract

This article aims to demonstrate an individualized approach to an elderly patient requiring scalp reconstruction, to describe the methodology in flap selection, lessons learned, and report outcomes. A retrospective review of a single surgeon's experience of scalp reconstruction (E. D. R.) using free [...] Read more.

This article aims to demonstrate an individualized approach to an elderly patient requiring scalp reconstruction, to describe the methodology in flap selection, lessons learned, and report outcomes. A retrospective review of a single surgeon's experience of scalp reconstruction (E. D. R.) using free tissue transfer from 2005 to 2011, in patients older than 70 years, was completed. A total of eight patients met the inclusion criteria, five males and three females, with a mean age of 80.4 years (range, 73–92). Free tissue transfer achieved 100% soft tissue coverage. Six of the eight patients required cranioplasty. The mean size calvarial defect was 92 cm² (range, 35–285 cm²). The mean flap size was 117.6 cm² (range, 42–285 cm²). Free flaps included three ulnar, three anterolateral thigh, one latissimus dorsi, and one thoracodorsal perforator flap. The mean follow-up time was 18.4 months (range, 3–46 months). Donor site morbidity was minimal. Mortality was 0%. Immediate flap failure was 0%. Other complications occurred in six of the eight patients. Mean revisionary procedures were 1.25 procedures per patient. It was concluded that chronological age does not increase mortality or catastrophic flap complications; however, morbidity is increased in the elderly and revisionary surgery is likely. Full article

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3 pages, 142 KiB

Open AccessCase Report

Pneumosinus Dilatans Helping Subcranial Resection in a Patient with Advanced Ethmoid Malignancy

by Shawn T. Joseph, Krishnakumar Thankappan, Rahul Buggaveeti and Subramania Iyer

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 218-220; https://doi.org/10.1055/s-0034-1393736 - 20 Nov 2014

Viewed by 47

Abstract

Subcranial approach is a useful procedure in the management of limited anterior skull base tumors. But the posterior and superior visualization may be limited, in ethmoid malignancies with a large intracranial extension. A 55-year-old male patient, a case of an ethmoid malignancy, with [...] Read more.

Subcranial approach is a useful procedure in the management of limited anterior skull base tumors. But the posterior and superior visualization may be limited, in ethmoid malignancies with a large intracranial extension. A 55-year-old male patient, a case of an ethmoid malignancy, with a large intracranial component was resected with adequate margins by a subcranial approach. The coincident pneumosinus dilatans helped the surgical resection. This case demonstrates that assessment of pneumatization of the frontal sinus is as important as the size and extent of the tumor, while deciding an anterior skull base surgical approach. Even large malignant lesions may be approached subcranially if the frontal sinus is proportionately large. Pneumosinus dilatans, though rare, can be used to the benefit of the patient in selecting a less invasive approach. Full article

8 pages, 270 KiB

Open AccessArticle

Analysis of Mandibular Test Specimens Used to Assess a Bone Fixation System

by Leandro Stocco Baccarin, Renato Correa Viana Casarin, Jorge Vicente Lopes-da-Silva and Luis Augusto Passeri

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 171-178; https://doi.org/10.1055/s-0034-1393732 - 20 Nov 2014

Cited by 1 | Viewed by 50

Abstract

The aim of this study was to assess through biomechanical testing if different synthetic materials used to fabricate test specimens have a different biomechanical behavior in comparison with other materials when simulating in vitro load resistance of a fixation method established for sagittal [...] Read more.

The aim of this study was to assess through biomechanical testing if different synthetic materials used to fabricate test specimens have a different biomechanical behavior in comparison with other materials when simulating in vitro load resistance of a fixation method established for sagittal split ramus osteotomy (SSRO). Thirty synthetic and standardized human hemimandible replicas with SSRO were divided into three groups of 10 samples each. Group A—ABS plastic; Group B—polyamide; and Group C—polyurethane. These were fixated with three bicortical position screws (16 mm in length, 2.0-mm system) in an inverted L pattern using perforation guide and 5-mm advancement. Each sample was submitted to linear vertical load, and load strength values were recorded at 1, 3, 5, 7, and 10 mm of displacement. The means and standard deviation were compared using the analysis of variance (p < 0.05) and the Tukey test. A tendency for lower values was observed in Group B in comparison with Groups A and C. At 3 and 5 mm of displacement, a difference between Groups A and C was found in comparison with Group B (p < 0.05). At 7 and 10 mm of displacement, a difference was found among the three groups, in which Group C showed the highest values and Group B the lowest (p < 0.05). Taking into consideration the results obtained and the behavior of each material used as a substrate, significant differences occurred among the materials when compared among them. Full article

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7 pages, 420 KiB

Open AccessCase Report

Computer-Assisted Three-Dimensional Planning for Orbital Decompression

by Nicholas Mahoney, Michael P. Grant, Srinivas Murthy Susarla and Shannath Merbs

Craniomaxillofac. Trauma Reconstr. 2015, 8(3), 211-217; https://doi.org/10.1055/s-0034-1393731 - 14 Nov 2014

Cited by 14 | Viewed by 61

Abstract

Thyroid-associated orbitopathy is the most common cause of unilateral or bilateral proptosis in adults. A mainstay of surgical treatment is orbital decompression utilizing osteotomies to increase the size of the affected bony orbit to accommodate the larger soft tissue volume. Over the past [...] Read more.

Thyroid-associated orbitopathy is the most common cause of unilateral or bilateral proptosis in adults. A mainstay of surgical treatment is orbital decompression utilizing osteotomies to increase the size of the affected bony orbit to accommodate the larger soft tissue volume. Over the past several decades, numerous approaches have been described for orbital decompression. However, given the intricate osseous and soft tissue anatomy within the orbit, orbital decompression is a potentially hazardous intervention. With advances in three-dimensional imaging and virtual planning, extensive orbital decompressions can be performed safely and efficiently. In this report, we describe two cases of three-wall orbital decompressions using three-dimensional planning. Full article

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Craniomaxillofac. Trauma Reconstr., Volume 8, Issue 3 (September 2015) – 15 articles

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