With an average frequency of 1/800 births in France, labio-maxillo-palatal clefts (LMPC) are among the most frequent congenital malformations. They raise functional, esthetic, psychological and socio-familial problems that must be managed with an interdisciplinary approach. Within the medical team, the dentist must, by way of prosthetic restorations, compensate for certain sequelae and deficiencies. According to the severity of the case and the success of the treatments, the typical restoration can be limited to replacing the missing lateral incisor, or the restoration may require undertaking comprehensive treatments involving a much more specialized arsenal of surgical and prosthetic procedures.

Labio-maxillary-palatal clefts, which are caused by fetal nasal buds failing to fuse with the maxillary bud, disrupt the ensemble of the structures that support and interact with the nose and upper jaw creating a rupture of balance that becomes an increasingly exacerbating vicious circle. In correcting these defects practitioners must effect a compromise between the need to re-unite separated parts – under as little tension as possible – and the need to preserve the interrupted potential for growth in the affected facial region. They must carry out this compromise in the double sense of topography and chronology.

Adhering to this therapeutic philosophy, the Nancy protocol closely associates orthopedic preparation and surgical treatment of patients to obtain:

     – high quality morphology,

     – an unblocked, sufficiently broad maxilla,

     – correct nasal breathing,

     – velo-pharyngeal competence.

We use a tibial periosteal graft to repair the oral cleft as an important element of our procedures.

Only competent centres are able to provide the full range of multi-disciplinary specialized therapies that cleft lip and palate rehabilitation requires. Despite some detail differences in conducting treatment, the agreed centres produced consensual treatment philosophy and observe equivalent therapeutic schemes. These sequences, to which orthodontics invariably contributes, are designed to favour the normal outcome of facial development and functions.

Beginning early in mixed dentition, orthodontic rehabilitation is designed to afford patients good dental occlusion through orthopaedic and orthodontic therapies. At the end of the growth period, orthodontics prepares for eventual final surgical and prosthetic repair.

We avoid extraction of permanent teeth as an adjunct to treatment because it has deleterious effect on final skeletal harmony. We prefer basic appliances for mechanical therapy, and after completion of active treatment, a prolonged retention. A trained orthodontist is able to complete the orthopaedic and orthodontic stages in cleft lip and palate repair if he fully understands and follows the general cleft lip and palate treatment scheme and effectively communicates with the competent rehabilitation team.

Two pollen sequences from the Classical city of Sagalassos (Pisidia, southwest Turkey) show that the hills just north of the city were forested during the main occupation period of the city (late Hellenistic to early Byzantine). They demonstrate that there was a mixed needle-leaved forest of Pinus, Cedrus libani and Abies cilicica. The platform on which the city sat was already deforested, as is indicated by the presence of pollen from various light demanding herbs. Furthermore, there is evidence that grapevines (Vitis) were cultivated, indicating that much of the land below the city was already exploited for agricultural purposes. Walnut trees were also cultivated near the city. It is probable that suburban farmsteads were present close to the city. The pollen sequences show that man-made deposits from high altitudes may contain important information on the former natural and cultural vegetation of mountain sites in Anatolia. Archaeologists and palynologists should draw more attention to these pollen rich man-made contexts.

Inspecting and understanding the thermal stability of metal contacts in the context of reliability testing on high power transistors (especially in the GaAs technology) often necessitates to view atomic concentration profiles at deep interfaces. One common method for this purpose is the combined Auger spectroscopy/ion etching technique, where the region to be investigated is etched sequentially (with a “low” etch rate, typically in the Å/second regime) and Auger electron spectra (AES) are recorded at each step of the etching process. The 3 major resolution drawbacks of this approach are first that it is time-consuming, second that the spatial resolution is limited (atomic profiles on contact regions with lateral dimensions smaller that I R~m are difficult to obtain) and third that the interface of interest is “smoothed” during the etch process. The third point yields atomic concentration profiles with an apparent inter-mixing, which sometimes hinders observation of the details of interest for the interface under investigation.

We have used a different approach for this aspect of metal contact testing, in which the interface to be studied is first “revealed” by focused ion beam (FIB) micro-sectioning. After this preparation step, chemical images of the interface are directly obtained by high resolution Auger electron spectra mapping. The different operating conditions for the FIB process (orientation of the cross-section with respect to the transistor surface, preliminary procedures to eliminate residual roughness as well as surface contamination) have been optimized in order to produce Auger spectra free of any artifact. The approach is demonstrated on Au/GeNiAu ohmics contacts to the emitter electrode of GaAs-based hererostructure bipolar transistor, designed for high power amplification in the microwave regime. Ultimate spatial resolution of 20 to 30 nm on the Ayuger chemical images is demonstrated on an Auger microscope equipped with a Schottky field emitting tip.