Evaluación cefalométrica y electromiográfica de niños y niñas con incompetencia labial y anomalías dentomaxilares

Objetivo: Describir las características craneofaciales, dentoalveolares, de tejido blando, vía aérea y el patrón de actividad muscular determinadas a través de los estudios cefalométricos y electromiográficos de individuos incompetentes labiales y con presencia de anomalías dentomaxilares de 7 a 12 años de edad. Materiales y método: Cuarenta y seis participantes con incompetencia labial fueron sometidos a una toma de radiografía lateral de perfil para el análisis cefalométrico. Para el estudio electromiográfico se consideró el patrón de actividad de los músculos Orbicular superior de los labios, orbicular inferior de los labios y temporal anterior en funciones: reposo, fonoarticulación, deglución, máximo apriete labial. Resultados: Se observó clase II esqueletal y molar, retrusión mandibular, biprotrusión incisal, biprotrusión labial, disminución de vía aérea superior. La mayor actividad muscular fue observada en máximo apriete labial. Conclusión: Los niños y niñas con incompetencia labial y anomalías dentomaxilares presentan alteraciones en las características craneofaciales, dentoalveolares, de tejido blando, vía aérea y actividad muscular determinadas a través de los estudios cefalométricos y electromiográficos.

Objective: To describe craniofacial, dentoalveolar, soft issue and airway features, and the muscular activity, determined through a cephalometric and electromyographic study in individuals with lip incompetence and dentomaxillary anomalies aged 7 to 12 years. Methods: Forty-six participants with lip incompetence underwent lateral profile radiography for cephalometric analysis. For the electromyographic study, the activity of the superior orbicularis oris, inferior orbicularis oris and anterior temporalis muscles was considered in the following functions: rest, speaking, swallowing, and reciprocal compression of the lips. Results: Skeletal and molar class II, mandibular retrusion, labial biprotrusion, incisal biprotrusion, and upper airway dysfunction were found. The highest muscular activity was observed in reciprocal compression of the lips. Conclusion: Children with lip incompetence and dentomaxillary anomalies have alterations in the craniofacial, dentoalveolar, soft issue, and airway features, and in the muscular activity , determined through a cephalometric and electromyographic study.

Queiloplastia de Castañón: una técnica viable y efectiva en la reconstrucción parcial del labio inferior / Castañón Cheiloplasty: a viable and effective technique in the partial reconstruction lower lip

Introducción: Para el tratamiento del carcinoma epidermoide labial existen varias modalidades terapéuticas, pero la cirugía constituye la primera elección. Numerosas técnicas han sido descritas para el manejo de lesiones que afectan más de un tercio del labio inferior. Sin embargo, la selección de alguna en particular depende del cumplimiento de los principios reconstructivos de esta unidad. Objetivo: Ejemplificar los beneficios de la utilización de la queiloplastia de Castañón, para la reconstrucción labial parcial, en un paciente con carcinoma epidermoide de labio inferior. Presentación de caso: Se presenta un paciente masculino de 68 años de edad, con antecedentes de hábito de fumar y alcoholismo, que acudió a consulta de Cirugía Oncológica de Cabeza y Cuello por presentar lesión localizada en bermellón de labio inferior. Se realizó biopsia, mediante incisión, que informó un carcinoma epidermoide moderadamente diferenciado. Se estudió como un T2N0M0, etapa II y se trató quirúrgicamente mediante queilectomía subtotal y reconstrucción con técnica de Castañón. Conclusiones: Se presentó el caso clínico de un paciente con carcinoma epidermoide de labio inferior, entidad patológica de alta incidencia. La cirugía constituyó la única modalidad de tratamiento utilizada. Una vez realizada la resección quirúrgica de la lesión, se reconstruyó el defecto, para lo que se utilizó la queiloplastia descrita por Castañón, opción útil para lograr el cumplimiento de los principios estéticos y funcionales(AU)

Introduction: For the treatment of labial squamous cell carcinoma there are several therapeutic modalities, but surgery is the first choice. Numerous techniques have been described for the management of lesions affecting more than a third of the lower lip. However, the selection of any particular one depends on the fulfillment of the reconstructive principles of this unit. Objective: Exemplify the benefits of using Castañón cheiloplasty for partial lip reconstruction in a patient with squamous cell carcinoma of the lower lip. Case presentation: A 68-year-old male patient with a history of smoking and alcoholism was presented, who went to the Head and Neck Oncological Surgery consultation for presenting a lesion located in vermilion of the lower lip. An incisional biopsy reported moderately differentiated squamous cell carcinoma. It was studied as a T2N0M0, stage II and was treated surgically by subtotal cheilectomy and reconstruction with Castañón technique. Conclusions: The clinical case of a patient with squamous cell carcinoma of the lower lip, a pathological entity of high incidence, was presented. Surgery was the only treatment modality used. Once the surgical resection of the lesion was performed, the defect was reconstructed, for which the cheiloplasty described by Castañón was used, a useful option to achieve compliance with the aesthetic and functional principles(AU)

Force balance reconstruction of orbicularis oris in correction of unilateral cleft lip deformity / 华西口腔医学杂志

OBJECTIVES@#Short-term outcome evaluation for the correction of unilateral cleft lip deformity with a new technique.@*METHODS@#Forty-four patients with unilateral cleft lip deformity were included in the study and in which the orbicularis oris muscle was reconstructed to achieve the optimal force balance of reconstructed orbicularis oris. The photometric two-dimensional indexes, including the philtrum oblique angle and asymmetry ratios (lip height, lip width, vertical distance from the white roll to the vermilion bottom at the Cupid's bow point, and vertical distance from the Cupid 's bow points to facial midline), were employed to measure and evaluate the outcome.@*RESULTS@#Several indexes showed statistically significant difference, and they included the philtrum oblique angle, asymmetry ratio of the lip height, and asymmetry ratio of the vertical distance from the white roll to the vermilion bottom at Cupid ' s bow points (@*CONCLUSIONS@#The results suggested that the new muscle reconstruction technique can significantly improve the short-term outcome of the correction of unilateral cleft lip deformity.

Lifting labial: uma revisão de literatura / Lip Lift: A Literature Review

Introdução: o lifting labial consiste em remover cirurgicamente uma porção do lábio superior caracterizado como longo, achatado, sem definição das colunas filtrais e com diminuição da borda do vermelhão, o que acontece em paralelo ao avanço da idade. Sendo assim, várias técnicas foram criadas ao longo do tempo por cirurgiões a fim de fornecer ao paciente um lábio mais jovem e atraente. Objetivos: explanar as dimensões e características dos lábios, as indicações do lifting labial e as técnicas cirúrgicas. Método: foi realizado um levantamento na literatura científica nas bases de dados PubMed/Medline. O critério de inclusão adotado foi artigos com disponibilidade do texto integral do estudo e clareza no detalhamento metodológico utilizado. Além disso, um livro foi adicionado para comple-mentar informações necessárias. Os descritores utilizados para seleção dos artigos foram: lifting labial (lip lifting); morfologia dos lábios (lip morphology); lábios ideais (ideal lips). Resultados: lábios envelhecidos tendem a perder a sensualidade por consequência de al-guns fatores como o alongamento do lábio branco, a perda das definições do lábio e das co-lunas do filtro, o achatamento do lábio vermelho e o surgimento de rugas, que resultam em buscas por técnicas clínicas que ajudam a amenizar essas condições e melhorar a autoes-tima dos pacientes. Conclusão: para alcançar resultados satisfatórios com essa técnica, é necessário que o profissional domine o conhecimento sobre as dimensões do terço inferior da face de acordo com idade, sexo e raça, que tenha domínio sobre as técnicas cirúrgicas mais eficazes e as indicações de acordo com a individualidade do paciente.

Introduction: the lip lift consists of surgically removing a portion of the upper lip when it is characterized as long, flat, with no definition of the filter columns, and with a reduction in the vermilion border, which happens in parallel with advancing age. Therefore, surgeons have created several techniques to provide the patient with a younger and more attractive lip. Objectives: explain the dimensions and characteristics of the lips, the indications for lip lifting, and some surgical techniques. Method: a survey was carried out in the scientific literature on the PubMed/Medline databases. The inclusion criterion adopted was articles with the full text of the study and clarity in the methodological details used. Also, a book was added to complement necessary information. The descriptors to select articles were lip lifting, lip morphology, and ideal lips. Results: aged lips tend to lose their sensuality with the lengthening of the white lip, the loss of definitions, thinning of the red lip, and the appearance of wrinkles, which demand searches for techniques that help soften these con-ditions and improve the patient's self-esteem. Conclusion: to achieve satisfactory results with this technique, the professional needs to master the knowledge about the dimensions of the lower third of the face according to age, sex, and race. Also, the professional needs to master the most effective surgical techniques and the indications according to the patient's individuality. Keywords: Lip lift. Morphology of the lips. Characteristics of young lips. Lip aging.

Orofacial functions and forces in male and female healthy young and adults

ABSTRACT Purpose: To determine reference values of orofacial myofunctional condition and orofacial forces in healthy young and adults. Methods: Fifty young and adults were selected from a total of 316 voluntaries. Participants were assessed with the Orofacial Myofunctional Evaluation with Scores (OMES) for the investigation of orofacial myofunctional condition. The maximum forces of bite, cheeks, tongue (anterior and posterior regions), and lips were assessed with an electronic dynamometer (values expressed in Newtons). Force values were obtained by average of three repeated measurement. The technical error of measurements was calculated for all variables. Results: There were no differences in orofacial myofunctional condition between men and women. Men presented higher values of orofacial forces compared to women. Conclusion: The normal values of orofacial myofunctional condition and orofacial forces were determined in healthy and adults Brazilian men and women. The values obtained in this study from healthy Brazilian may help in the diagnosis of alterations in orofacial motor function and contribute for their therapeutic management.

RESUMO Objetivo: determinar valores de referência da condição miofuncional orofacial e forças orofaciais em adultos jovens saudáveis. Método: foram selecionados 50 jovens e adultos de um total de 316 voluntários. Os participantes foram avaliados pelo protocolo de Avaliação Miofuncional Orofacial com Escores (AMIOFE) para a investigação da condição miofuncional orofacial. As forças de mordida, bochechas, língua (regiões anterior e posterior) e lábios foram avaliadas por um dinamômetro eletrônico e os valores foram registrados em Newtons. Os valores de força foram obtidos pela média de três medidas repetidas. O erro técnico do método foi calculado para todas as variáveis. Resultado: Não houve diferenças na condição miofuncional orofacial entre homens e mulheres. Homens apresentaram maiores valores de forças orofaciais em relação às mulheres. Conclusões: Os valores normais da condição miofuncional orofacial e das forças orofaciais foram determinados em homens e mulheres brasileiros saudáveis e adultos. Os valores obtidos neste estudo de brasileiros saudáveis podem auxiliar no diagnóstico de alterações na função motora orofacial e contribuir para o seu manejo terapêutico.

A capillary angioma of the lips: an extremely rare situation in the oral cavity / Angioma capilar de los labios: una situación extremadamente rara en la cavidad oral

Hemangiomas are tumors identified by rapid endothelial cell proliferation in early infancy, followed mostly by involution over the time. However, 10-12 % of true hemangiomas don't involute and require surgical treatment. Hemangiomas are classified on the basis of their histological appearance as capillary, mixed and cavernous. We report a case of capillary angioma in a 13-year old boy who presented with a budding into the lower lip. The lesion was excised and histopathological report confirmed the diagnosis.

Los hemangiomas son tumores identificados por la rápida proliferación de células endoteliales en la primera infancia, seguidos principalmente por involución a lo largo del tiempo. Sin embargo, entre el 10 y el 12 % de los hemangiomas no intervienen y no requieren tratamiento quirúrgico. Los hemangiomas se clasifican en función de su aspecto histológico como capilares, mixtos y cavernosos. Reportamos un caso de angioma capilar en un niño de 13 años que presentó un brote en el labio inferior. La lesión fue extirpada y el informe histopatológico confirmó el diagnóstico.

Effect and Mechanism of Modified Buzhong Yiqi Tang and Pursed-lips Breathing on Serum TNF-α，IL-8，IL-6，IL-1β and Cys-C in Patients at Stable Stage of COPD / 中国实验方剂学杂志

Objective: To observe the effect and mechanism of modified Buzhong Yiqi Tang and pursed-lips breathing (PLB) on serum tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), IL-6, IL-1β and serum cystatin C (Cys-C) in patients of chronic obstructive pulmonary disease (COPD) at the stable stage. Method: Totally 120 cases of COPD treated at Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2017 to March 2018 conformed to the inclusion criteria, and were randomly divided into treatment group (60 cases) and control group (60 cases). Cases of control group received Tiotropium (18 μg/time, qd). In addition to the therapy of control group, cases of treatment group were also given Buzhong Yiqi Tang and PLB. Both groups were treated for 6 months. Percent of forced expiratory volume in one second in predicted value (FEV1%), ratio of FEV1 to forced vital capacity (FEV1/FVC), six-minute walk distance (6MWD),TNF-α, IL-8, IL-6, IL-1β and Cys-C were compared between both groups. Result: After treatment, the clinical efficacy rate of observation group was 93.33%, which was evidently higher than 86.67%of control group (Pa,IL-8, IL-6,IL-1β, Cys-C but increases in FEV1%, FEV1/FVC (Pa, IL-8, IL-6, IL-1β, Cys-C but increases in FEV1%, FEV1/FVC (PConclusion: Buzhong Yiqi Tang and PLB has an anti-inflammatory effect on COPD by reducing levels of inflammation cytokines TNF-α, IL-8,IL-6, IL-1β and chronic inflammation markers serum Cys-C and inflammatory reaction, and alleviating airflow obstruction, promoting the levels of FEV1%, FEV1/FVC, pulmonary function control inflammatory factors, so as to improve pulmonary function and the quality of life in patients with COPD.

Análisis de huellas labiales en una muestra de estudiantes de odontología de la Universidad de Costa Rica mediante la clasificación de Renaud: estudio piloto / Lip prints analysis in a sample of dentistry students of the University of Costa Rica based in Renaud's classification: pilot study

Resumen El presente estudio, tuvo como objetivo, analizar los distintos patrones morfológicos presentes en las huellas labiales de una determinada población costarricense y su correlación con las variables, sexo, edad y afinidad biológica. Se analizaron 105 huellas labiales pertenecientes a estudiantes de quinto y sexto año de la carrera de odontología de la Universidad de Costa Rica durante el II semestre del 2016. De las 105 huellas labiales analizadas mediante el método de Renaud, el patrón más prevalente fue el tipo C de manera general, mientras que, de manera individual, en labio superior predomina el patrón tipo A y en labio inferior predomina el patrón tipo C. De la totalidad de muestras analizadas, se destaca que todas revelaron patrones distintos y la correlación estadística entre las variables, sexo, edad y afinidad biológica, permitió conocer la existencia de elementos que podrían ser útiles para identificación de individuos en el ámbito forense. Los resultados demuestran que, con la aplicación de las técnicas adecuadas en la toma de muestras y un análisis estandarizado, las huellas labiales pueden ser utilizadas en el ámbito forense como método de identificación de individuos. Este estudio, además, pone en evidencia la necesidad de realizar más investigación sobre huellas labiales en Costa Rica, no sólo por la necesidad de un aumento en el número de muestras y así obtener mayores resultados estadísticos, si no también, para desarrollar las herramientas necesarias en la toma, revelado y análisis de huellas labiales, así como su aplicabilidad al servicio de la justicia costarricense.

Abstract The objective of this study was to analyze the different morphological patterns present in the lip prints of a certain Costa Rican population and its correlation with the variables, sex, age and biological affinity. 105 lip prints were analyzed belonging to fifth and sixth year students of the dental career of the University of Costa Rica during the second semester of 2016. Of the 105 labials analyzed by the Renaud method, the most prevalent pattern was type C in general, while, individually, in the upper lip, predominantly, the type of pattern, A and the lower lip, predominantly the type C pattern. Of the total of the analyzed samples, the different patterns and the statistical correlation between the variables, sex, age and biological affinity, remarks information that can be useful to identify individuals in the forensic field. The results show that, with the application of the appropriate techniques in the taking of samples and a standardized analysis, the lip prints can be used in the field of forensic science as a method of identification of individuals. This study also highlights the need to conduct more research on lip prints in Costa Rica, not only to increase the number of samples, but also to obtain more extended statistical results. Besides, this research can be used to develop the necessary tools in the taking, development and analysis of lip print. Moreover, the results obtained may be taken into consideration in order to improve forensic research in the Costa Rican justice system.

Queilite esfoliativa: diagnóstico diferencial e tratamento / Queilitis exfoliativa: diagnóstico diferencial y tratamiento / Exfoliative cheilitis: differential diagnosis and treatment

Introdução: a queilite esfoliativa é uma condição dermatológica incomum que ocorre principalmente em mulheres jovens e que afeta o vermelhão dos lábios. Embora a doença seja de etiologia desconhecida, ela tem sido associada a períodos de estresse e ansiedade, como também a hábitos parafuncionais. O seu diagnóstico e manejo constituem um desafio devido à semelhança clínica entre a queilite esfoliativa e outras lesões labiais, o que muitas vezes resulta em recorrência. Objetivo: relatar dois casos clínicos de queilite esfoliativa enfatizando o diagnóstico diferencial com outras lesões que podem acometer os lábios. Relato de Casos: O primeiro caso ocorreu em um paciente do sexo masculino, 21 anos, leucoderma, com queixa de que há dois anos sentia ardência e coceira nos lábios associada a formação de crostas. Ele relatou ter realizado tratamento prévio e possuir problemas de saúde de ordem geral. Exames complementares foram realizados e não mostraram alterações. Assim, a hipótese de queilite esfoliativa foi estabelecida. O paciente foi submetido à biópsia incisional, sob anestesia local, no qual o exame histopatológico confirmou o diagnóstico clínico de queilite esfoliativa, sendo tratado com laserterapia, porém não houve sucesso no tratamento. No segundo caso, uma paciente do sexo feminino, 43 anos, melanoderma, exibindo manchas, fissuras e crostas nos lábios, além de prurido como sintomatologia. Foram solicitados exames complementares que apresentaram padrões de normalidade, assim, o diagnóstico clínico foi de prurigo actínico. Após a realização de biópsia incisional, sob anestesia local, o diagnóstico de queilite esfoliativa foi estabelecido. A paciente foi tratada com corticosteroide tópico, havendo regressão da lesão. Conclusão: o diagnóstico e manejo clínico da queilite esfoliativa é um desafio, deste modo, se faz necessário o estabelecimento de um diagnóstico correto, descartando a hipótese de outras doenças com o auxílio de exames complementares(AU)

Introducción: la queilitis exfoliativa es una condición dermatológica inusual que ocurre principalmente en mujeres y que afecta la superfície de los labios. Aunque es una enfermedad de causa desconocida, ha sido asociada a estrés y ansiedad, así como a hábitos parafuncionales. Su diagnóstico y manejo es un desafío debido a la similitud clínica entre la queilitis exfoliativa y otras lesiones labiales, ya que a menudo estas lesiones tienen recurrencia. Objetivo: describir dos casos clínicos de queilitis exfoliativa enfatizando en el diagnóstico diferencial. Presentación de casos: el primer caso ocurrió en un paciente del sexo masculino de 21 años, raza blanca. Relató que hace dos años sentía ardor en los lábios asociado a la formación de costras. Afirma haber realizado tratamiento previo y no presentar ningún problema de salud. Se realizaron exámenes complementarios y no mostraron ninguna alteración. Así, se estableció la hipótesis de queilitis exfoliativa. El paciente fue sometido a biopsia incisional, bajo anestesia local, en el cual el examen histopatológico confirmó el diagnóstico clínico de queilitis exfoliativa, siendo tratado con laserterapia, sin embargo, no hubo éxito en el tratamiento. En el segundo caso, una paciente de sexo femenino, 43 años, raza negra, exhibiendo manchas, fisuras en los labios, además de prurito como sintomatología. Se solicitaron exámenes complementarios que presentaron valores dentro de la normalidad, por lo que el diagnóstico clínico fue de prurito actínico. Después de la realización de la biopsia incisional, bajo anestesia local, fue establecido el diagnóstico de queilitis exfoliativa. La paciente fue tratada con corticoesteroides tópicos, habiendo regresión de la lesión. Conclusiones: el diagnóstico y manejo clínico de la queilitis exfoliativa es un desafío, por lo que se hace necesario el establecimiento de un diagnóstico correcto, excluyendo otras afecciones con el apoyo de exámenes complementarios(AU)

Introduction: exfoliative cheilitis is an infrequent skin condition that occurs mostly in women, affecting the skin of the lips. Though its etiology is unknown, it has been associated to stress and anxiety, as well as to parafunctional habits. Diagnosis and management are challenging, due to the clinical similarity between exfoliative cheilitis and other lesions of the lips, since these are often recurrent. Objective: describe two clinical cases of exfoliative cheilitis, focusing on the differential diagnosis. Case presentation: the first case was a white male 21-year-old patient who reported having had a burning sensation on his lips associated to crust formation for two years. The patient stated having been under treatment and being in good general health. Complementary tests were indicated which did not reveal any alteration. Thus, the hypothesis of exfoliative cheilitis was put forth. Incisional biopsy was performed under local anesthesia, histopathological examination confirming the clinical diagnosis of exfoliative cheilitis. Laser therapy was indicated, but the treatment was not successful. The second case was a black female 43-year-old patient presenting with spots and fissures on her lips, as well as itching. Complementary tests were indicated which yielded normal values, and thus the clinical diagnosis was actinic prurigo. Incisional biopsy performed under local anesthesia led to the diagnosis of exfoliative cheilitis. The patient was treated with topical corticosteroids, with regression of the lesion. Conclusions: exfoliative cheilitis diagnosis and clinical management are challenging, hence the need to make an accurate diagnosis, excluding other conditions with the aid of complementary tests(AU)

Muscle Activity and Muscle Strength in Atypical Swallowing / Actividad Muscular y Fuerza Muscular en la Deglución Atípica

Abstract Objective: To characterize muscle activity and muscle strength in patients with atypical swallowing (AS; n = 88) and competent lips (CL) or incompetent lips (IL) versus a control group (Ctrl; n = 90) Methods and materials: An analytical case-control study was conducted using surface electromyography (sEMG) of the orbicularis oris, mentalis and masseter muscles. Compression forces of the orbicularis oris, right and left masseters muscle (Cfrmm, Cflmm)), tongue tensile strength (Tts) via myoscan analysis and resistance of the orbicularis oris (Roo) via dynamo-metry were determined. Comparisons were made with the Mann-Whitney U test under a 95% confidence interval. Results: The amplitude of the sEMG record of the orbicularis oris muscle, in maximal contraction, was lower (p<0.01) in the atypical swallowing group (596.40 ± 175.83) compared to controls (659.83 ± 203.79). The muscle strength studied in the experimental group was lower (p<0.01) than in controls (CFo: AS: 0.31 ± 0.13; Ctrl: 0.38 ± 0,11; Cfrmm: AS: 0.40 ± 0.08; Ctrl: 0.50 ± 0.11; Cflmm: AS: 0.41 ± 0.08; Ctrl: 0.58 ± 0.59; Tts, AS: 0.52 ± 0.14, Ctrl: 0.65 ± 0.14, and Roo: AS: 2.47 ± 0.61; Ctrl: 2.73 ± 0.60). Patients with incompetent lips had a greater muscle activity of the orbicularis oris in swallowing (AS of IL: 197.01 ± 85.84; AS of CL: 160.54 ± 97.03; Ctrl: 147.18 ± 80.10). Conclusion: Patients with atypical swallowing showed differences in the strength of studied muscles and the muscle activity of the orbicular oris muscle compared to controls.

Resumen Objetivo: Caracterizar la actividad y fuerza muscular de pacientes con deglución atípica (DA; N=88) con competencia labial (CL) o incompetencia labial (IL) vs un grupo control (Ctrl; N=90). Materiales y métodos: Estudio analítico de casos y controles se realizó una electromiografía de superficie (sEMG) de los músculos orbicular, mental y maseteros; se determinaron las fuerzas compresiva del orbicular de los labios (FCo), contráctil del masetero derecho (FCmd) e izquierdo (FCmi), extensora del músculo lingual (FEl) por mioescanografía y la fuerza de resistencia del orbicular de los labios (FRo) por dinamometría. Resultados: La amplitud del registro sEMG del músculo orbicular de los labios, en contracción máxima, fue menor (p<0.01) en el grupo DA(596,40±175,83) con respecto a los controles(659,83±203,79); la fuerza de los músculos estudiados en el grupo experimental fue menor (p<0,01) que en los controles (FCo: DA: 0,31±0,13; Ctrl: 0,38±0,11; FCmd: DA: 0,40±0,08; Ctrl: 0,50±0,11; FCmi: DA: 0,41±0,08; Ctrl: 0,58±0,59; FEl; DA: 0,52±0,14; Ctrl: 0,65±0,14; y FRo: DA: 2,47±0,61; Ctrl: 2,73±0,60). Los pacientes con DA-IL presentaron mayor actividad muscular del orbicular en deglución (DA-IL: 197,01±85,84; DA-CL: 160,54±97,03; Ctrl: 147,18±80,10). Conclusiones: Los pacientes con DA difieren en la fuerza de los músculos estudiados y en la actividad muscular del orbicular con respecto a los controles. Los pacientes con DA-CL y DA-IL difieren en la actividad y fuerza muscular del orbicular.

A queiloscopia na identificação humana: o papel da calibração / Cheiloscopy in human identification: the role of calibration

Introdução: Calibração é um processo metodológico que garante a reprodutibilidade observacional dos dados coletados pelo examinador, sendo, portanto, essencial em estudos de identificação humana. Objetivo: Demonstrar a importância do processo de calibração como parte dos procedimentos necessários a uma pesquisa queiloscópica (técnica de identificação através dos lábios). Material e método: Foram coletadas 20 impressões labiais, sendo a mesma dividida em oito subquadrantes, classificando-se o padrão sulcular (I ­ vertical completo; I' ­ vertical incompleto; II ­ bifurcados; III ­ entrecruzados; IV ­ reticulares e V ­ indefinidos). As impressões foram analisadas em dois momentos (intervalo de 8 dias) para medir a concordância por meio da estatística Kappa. Resultados: Os resultados indicaram concordância insatisfatória, sendo necessário repetir o processo com 20 impressões distintas. Na primeira calibração, obtiveram-se valores de Kappa entre 0,65 à 0,87 com concordância satisfatória (boa à perfeita) em sete das oito regiões analisadas. Apenas um subquadrante obteve Kappa regular (0,54). Na segunda calibração, todos os subquadrantes apresentaram valores de concordância boa à perfeita (0,75 à 1,00) existindo melhora de 75%. Conclusão: A Queiloscopia é uma técnica que exige atenção no quesito da classificabilidade, uma vez que a minuciosidade dos sulcos e subjetividade de predominância requerem calibração efetiva para que a confiabilidade da pesquisa seja mantida.

Introduction: Calibration is an step of the methodological process which ensures reproducibility of observational data collected by the examiner, being therefore essential in human identification studies. Objective: To demonstrate the importance of the calibration process as part of the procedures necessary to a cheiloscopy research (identification technique through the lips). Methods: Twenty lip prints were collected and each one was divided into eight subquadrants. Then, the pattern of grooves of each subquadrant was classified into one of the following patterns: I - complete vertical lines; I'- incomplete vertical lines; II ­ branched lines; III ­ crossed lines; IV - reticular lines; and V ­ undefined lines). The lip prints were analyzed twice, with an interval of 8 days between them, to measure agreement by Kappa statistics. Results: The results showed poor agreement, being necessary to repeat all the process with 20 different lip prints. In the first calibration, the Kappa values varied from 0.65 to 0.87 with a satisfactory reliability (good to perfect) in seven of the eight regions analyzed, but one subquadrant got regular Kappa (0.54). In the second calibration process, all subquadrants showed values of agreement good toperfect (0.75 to 1.00), implying an improvement of 75%. Conclusion: Cheiloscopy is a technique that demands attention in the classification of grooves patterns, since the thoroughness of the grooves and the predominance of subjectivity require calibration so that the research' reliability is maintained.

Cheiloscopy as an additional forensic parameter : a review

@#Criminal activities involving human life always puts lives at stake. Newer advances in other fields especially medicine and dentistry is essential in solving the mysteries of death. Different disciplines insert a part of the puzzle until it is complete. Fingerprints, DNA profiling, Forensic anthropology are commonly employed in personnel identification, mass disasters and others. Investigators may also rely on lip prints to identify possible suspects or to support evidence gained in specific investigations. A lip print at scene of crime can be the basis for inference as to the number of people involved, gender, habits, occupational traits, and others, based on the pathological changes present. This review deals with lip prints and their possible acquisition and usage.

Reação de corpo estranho a material de preenchimento estético: relato de quatro casos / Foreign body reaction due to aesthetic filling materials: report of four cases

Objetivo: o objetivo deste trabalho é relatar quatro casos de reações de corpo estranho a material de preenchimento estético acometendo a cavidade oral. Relato dos casos: quatro pacientes adultas do sexo feminino compareceram à consulta apresentando nódulos submucosos localizados nos lábios e sulcos nasogenianos com histórico prévio de injeção de materiais de preenchimento estético (ácido hialurônico em duas pacientes e polimetilmetacrilato em duas pacientes). O diagnóstico em três dos quatro casos foi baseado nos achados clínicos e histológicos e apenas nos achados clínicos em um caso. O tratamento consistiu de manejo cirúrgico em três pacientes e corticoterapia em uma paciente e todas se encontram bem e em acompanhamento clínico. Conclusão: os cirurgiões-dentistas devem estar atentos aos efeitos adversos provocados por materiais de preenchimento estético, considerando seus diagnósticos diferenciais e as formas mais adequadas de tratamento.

Objective: The aim of the present study is to report 4 cases of foreign body reactions to dermal fillers affecting the oral cavity. Cases report: Four adult females were referred for evaluation of submerse nodules on the lips and nasolabial folds with a previous history of injection of dermal fillers (hyaluronic acid in two cases and polymethylmethacrylate in two cases). Diagnosis was based on clinical and histological aspects in three cases and solely on clinical aspect in one case. Management consisted in surgical excision in three cases and corticosteroid therapy in one and all 4 patients are well, with no signs of recurrence and remain in clinical follow-up. Conclusion: Dental professionals should be aware of the side effects associated with the use of aesthetic fillers, considering their main differential diagnosis and the most adequate management strategy for each individual case.

Repair of upper lip scar by expanded submental flap / 中华医学美学美容杂志

Objective To discuss the repairing methods of the wound after upper lip lesion excision.Methods The wound after upper lip lesion excision was repaired by expanded pedicled submental flap.The 3 cm-long incision was located in 1 cm to sub-mandible.The 100 ml expander was placed beneath the platysma,and the aqueducts and spigots of the expanders were laid out of the skin.After complete expansion,the spastic scars of the upper lip and nasal bottom were resolved,the nasal columella and upper lip were put back to the normal position.The pedicled submental flap was transferred to the wound after upperlip excision according to the size of the wound.The pedicle was severed after 3 weeks.Results There were 5 cases of the expanded pedicled submental flap to repair the wound after upper lip excision.The flap survived without complications.The appearances were satisfied by the patients.Conclusions The method of the expanded submental flap is suitable for the wound after upper lip excision.

Verificação da praticabilidade e da unicidade na queiloscopia e na palatoscopia como métodos de identificação humana / Checking the feasibility and uniqueness in cheiloscopy and palatoscopy as human identification methods

Introdução: Na odontologia forense, a cavidade oral tem um importante papel devido a sua anatomiaúnica. A queiloscopia e a rugoscopia são métodos de identificação seguros e acurados. Objetivos: Osobjetivos da presente pesquisa foram: a) avaliar a praticabilidade das técnicas empregadas; b) avaliar aunicidade das amostras; c) traçar um perfil das rugas palatinas e sulcos labiais de alunos do curso deOdontologia da UERN. Materiais e métodos: Foram feitas moldagens no palato com o auxilio demoldeiras de estoque e alginato. Modelos de estudo foram feitos com gesso tipo III. Para a obtenção dasimpressões labiais, foram utilizados um batom de cor vermelha, uma folha de papel de cor branca e umaplaca de vidro. Para classificar as impressões labiais foi utilizado o sistema de classificação de Suzuki eTsuchihashi. Para a classificação das rugas palatinas foi o utilizado o sistema de Martin dos Santos.Resultados: Ao todo foram coletadas 60 amostras, sendo 30 impressões labiais e 30 modelos comimpressões das rugas palatinas. As rugas palatinas do tipo sinuosa foram as mais encontradas. Os sulcoslabiais com maior ocorrência foram dos tipos bifurcados. Conclusões: A queiloscopia e a palatoscopiasão técnicas de identificação humana aplicáveis, porém é necessário que mais estudos sejam realizadospara que as mesmas sejam utilizadas com mais frequência entre os órgãos de investigaçõescompetentes. As técnicas mostraram-se exequíveis e as amostras singulares. Foi encontrada uma maiorocorrência de rugas palatinas sinuosas e uma predominância de sulcos labiais bifurcados.

Introduction: In forensic dentistry, the oral cavity plays a very important role because of the uniqueanatomy. The cheiloscopy and palatoscopy are self and accurate methods of identification. Objectives:The objectives of this research were: a)assess the feasibility of techniques b) assess the uniqueness ofthe sample c) draw a profile of wrinkles and furrows lip palate of students of Dentistry, UERN. Methods:Impressions on the palate were made with stocks trays and alginate and making the study model wasmade with plaster type III. To obtain the lip prints were used lipstick red color, a sheet of white paper and aglass plate. To sort the lip prints it was used the classification system of Suzuki and Tsuchihashi. For theclassification of palatal rugae was the system used Martin dos Santos. Results: Altogether 60 sampleswere collected, with 30 lip prints and 30 models with palatal rugae. The palatal rugae winding type werefound with higher occurrence. The highest occurrence labial furrows were bifurcated type. Conclusions:The cheiloscopy and palatoscopy are applicable human identification techniques, but it is necessary thatmore studies be conducted so that they are used more frequently among competent organs ofinvestigations. The techniques were feasible and the samples were singular. A higher occurrence ofwinding palatine rugae and a predominance of bifurcated labial grooves were found.

Descriptions of five new species of the neotropical cichlid genus Gymnogeophagus Miranda Ribeiro, 1918 (Teleostei: Cichliformes) from the rio Uruguay drainage

Gymnogeophagus is a Neotropical cichlid genus distributed in the río Paraguay, rio Paraná and rio Uruguay drainages and also in the coastal rivers of Uruguay and southern Brazil. Its monophyly is supported by two derived features: the absence of supraneurals and the presence of a forward spine in the first dorsal-fin pterygiophore. Herein, five new species of Gymnogeophagus are described from middle to upper tributaries of the rio Uruguay drainage and from the rio Negro. All these new species belong to a clade, which includes G. gymnogenys , easily recognized by sharing two synapomorphies: the absence of an oblique bar between the dorsal border of the eye and the nape, and the possession of a black bar originating in the dorsal contour near the dorsal-fin origin and directed downward and backward on the dorsum. A key to all species of Gymnogeophagus is provided.

Gymnogeophagus é um gênero Neotropical de ciclídeos que ocorre nas drenagens dos rios Paraguay, Paraná e Uruguay e também em rios costeiros do Uruguay e do sul do Brasil. A monofilia do gênero é baseada em duas sinapomorfias: a ausência de supraneurais e a presença de um espinho dirigido para frente no primeiro pterigióforo da nadadeira dorsal. Neste trabalho são descritas cinco espécies novas de Gymnogeophagus de afluentes do médio ao alto rio Uruguai e rio Negro. Todas as espécies pertencem a um clado que inclui G. gymnogenys , facilmente reconhecido pelo compartilhamento de duas sinapomorfias: a ausência da barra cinza escura oblíqua entre a margem dorsal da órbita e a margem dorsal da cabeça, e a presença de uma barra cinza escura originando-se no dorso, anteriormente à nadadeira dorsal e direcionada para trás e para baixo na lateral do corpo. É fornecida uma chave de identificação para todas as espécies de Gymnogeophagus.

Treatment of severe oral mucositis in a pediatric patient undergoing chemotherapy / Protocolo de tratamento da mucosite oral grave durante o tratamento quimioterápico em paciente pediátrico

This article reports the resolution of a case of severe oral mucositis and the treatment protocol that promoted complete remission of the lesions. A male 13-year-old patient with chondroblastic osteosarcoma in the left distal thigh and acute lymphoblastic leukemia undergoing cancer treatment with methotrexate presented with severe oral mucositis. The treatment protocol included the use of 10ml of a mucositis mouthwash and low-level laser therapy. The lesions remitted after five days of gargling with the mucositis mouthwash and two sessions of low-level laser therapy on the lesions. The use of a treatment protocol consisting of a mucositis solution associated with low-level laser therapy effectively resolved a case of severe chemotherapy-induced oral mucositis. The monitoring and treatment of oral mucositis lesions in children and adolescents undergoing chemotherapy are necessary to prevent the patient from suffering from induced comorbidities.

Esse artigo relata a resolução de um caso de mucosite oral grave e do protocolo de tratamento utilizado para a completa remissão das lesões. Paciente do sexo masculino, 13 anos, portador de osteossarcoma condroblástico na coxa esquerda distal e leucemia linfoblástica aguda apresentou um quadro de mucosite oral grave, encontrando-se sob tratamento antineoplásico fazendo uso de metotrexato. Adotou-se um protocolo de tratamento que incluiu a utilização diária de bochecho com 10ml de uma solução para mucosite e a aplicação de laser de baixa potência. A remissão das lesões de deu após 5 dias de utilização dos bochechos com a solução para mucosite e 2 sessões de irradiação das lesões com laser. A adoção do protocolo de tratamento com uma solução para mucosite associada à aplicação de laser de baixa potência se mostrou efetiva na resolução da mucosite oral grave decorrente da terapêutica antineoplásica. Faz-se necessário o monitoramento e tratamento de lesões por mucosite oral em crianças e adolescentes sob tratamento oncológico com quimioterápicos, a fim de que os pacientes não venham a sofrer em decorrência das comorbidades que são geradas.

Evaluation of the facial dimensions of young adult women with a preferred facial appearance / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the facial dimensions of young adult women with a preferred facial appearance and compare the results with those from the general population. METHODS: Twenty-five linear, nine angular, and three area measurements were made and four ratios were calculated using a sample of standardized frontal and lateral photographs of 46 young adult women with a preferred facial appearance (Miss Korea group) and 44 young adult women from the general population (control group). Differences between the two groups were analyzed using multivariate analysis of variance (MANOVA). RESULTS: Compared with the control group, the Miss Korea group exhibited a significantly greater facial height, total facial height (TFH; trichion-menton), facial width (tragus right-tragus left), facial depth (tragus-true vertical line), and trichion-nasion/TFH ratio and smaller subnasale-menton/TFH and facial width/TFH ratios. Furthermore, the control group had smaller intercanthal and interpupillary widths. CONCLUSIONS: The Miss Korea group exhibited longer, wider, and deeper faces compared with those from the general population. Furthermore, the Miss Korea group had larger eyes, longer but less protruded noses, longer and more retruded lower lips and chins, larger lip vermilion areas, and smaller labiomental angles. These results suggest that the latest trends in facial esthetics should be considered during diagnosis and treatment planning for young women with dentofacial abnormalities.

<b>Three Cases of Trigger Finger which were Successfully Treated with U</b><b>nkeito</b> / 日本東洋医学雑誌

Trigger finger develops because of stenosis around the A1 annular ligament, which causes inhibition of smooth expansion and contraction of the finger. It is effectively treated by an anti-inflammatory analgesic and/or steroid infusion, and by Western style medical surgery. Here, we report 3 cases of trigger finger effectively treated with unkeito. The first case was a 71-year-old female who had been treated with Kampo medicine for an enlarged feeling in the abdomen. She complained of trigger finger, in the knuckle of her right third finger, dry lips, and hot flashes in her hands and feet. The second case was a 56-year-old female who had been treated with Kampo medicine for polyarticular pain in her fingers. She complained of trigger finger of the left fourth finger and hot flashes in her hands. The third case was a 71-year-old female who had been treated for chronic renal failure. She complained of trigger finger in the left first finger and dry skin but had neither hot flashes in the hands nor dry lips. One of the target symptoms of unkeito is hot flashes in the hands and dry lips. Unkeito is composed of herbs which improve <i>ketsu </i>deficiency, <i>oketsu</i>, inflammation, and dry skin. It is possible that these actions of unkeito are effective in trigger finger as well.

Sequela de injeção de silicone em lábio inferior: correção cirúrgica pela técnica do biquíni modificada / Sequelae of inferior lip silicone injection: surgical correction using the modified "bikini" technique

Pacientes portadores de sequelas devido a injeções de substâncias inabsorvíveis tem se tornado cada vez mais frequentes. O silicone injetável ou polidimetilsiloxano fluido é um polímero manufaturado que contém silicone elementar. As complicações consequentes ao uso desta substância podem ser precoces ou tardias. Apresentamos um relato de caso onde uma deformidade por injeção de silicone em lábios foi tratada cirurgicamente usando a técnica do biquíni modificada obtendo um bom resultado funcional e estético.

Increasing numbers of patients have sequelae due to the injection of non-absorbable substances. Injectable silicone or polydimethylsiloxane fluid is a manufactured polymer containing elemental silicon. The complications associated with the use of this substance can present early or late. Here we present a case report in which a deformity due to a silicone injection in the lips was surgically treated using the modified "bikini" technique that produced a functionally and aesthetically favorable result.