Mentoplastia de reducción en armonización facial: reporte de caso / Reduction genioplasty in facial harmonization: case report

Introducción: la mentoplastia es una herramienta importante en la cirugía estética del tercio inferior de la cara, permite la armonización mediante movimientos del segmento osteotomizado en diferentes planos. Objetivo: describir el análisis prequirúrgico para una mentoplastia en un paciente con anomalía esquelética y macrogenia en las dimensiones vertical y horizontal. Resultados: el análisis concluye una reducción de mentón en dos planos, un procedimiento infrecuente en el manejo quirúrgico del tercio inferior. Discusión: aunque la mayoría de las correcciones realizadas en la actualidad implican un avance o descenso del mentón en casos de retro o microgenia, es importante reconocer otras deformidades y evaluar las proporciones faciales, la oclusión dental, las mediciones cefalométricas y las imágenes fotográficas identificando las necesidades específicas de cada paciente. Conclusión: realizar una correcta identificación de la clase esquelética y un análisis estético facial permite identificar el tipo de deformidad y planificar su manejo quirúrgico.

Introduction: Sliding Genioplasty is an important tool in the aesthetic surgery of the lower third of the face, it allows the harmonization by moving the osteotomi-zed segment in different planes. Objective: to describe the pre-surgical analysis for a Genioplasty in a patient with skeletal anomaly and macrogenia in the vertical and horizontal dimensions. Results: the analysis concludes a chin reduction in two planes, an infrequent procedure in the surgical management of the lower third. Discussion: although most of the corrections made today involve an advance or descent of the chin in cases of retro or microgenia, it is important to recognize other deformities and evaluate facial proportions, dental occlusion, cephalometric measurements and photographic images identifying the specific needs of each pa-tient. Conclusion: performing a correct identification of the skeletal class and an aesthetic facial analysis allows identifying the type of deformity and planning its surgical management.

Efficacy of W-genioplasty on the broad and short chin / 中华医学美学美容杂志

Objective:To investigate the clinical effect of W-shaped genioplasty in the correction of broad and short chin deformity.Methods:Thirty-eight patients (5 males, 33 females, aged 20 to 41 years, mean 27.3 years) complained with broad and short chin were admitted to the Affiliated Friendship Plastic Surgery Hospitalof Nanjing Medical University from January 2019 to December 2021. CBCT scan and three-dimensional reconstruction were performed to design osteotomy line and determine the distance of chin lengthening, narrowing and advancing or retrocession preoperatively. Under general anesthesia, the W-shaped osteotomy was performed using an intraoral incision, and the angle between the bilateral free bone fragments, the distance of downward and forward movement were adjusted to change the curvature, width, length and prominence of the lower edge of the chin according to the preoperative designs. The results were evaluated by clinical appearances and image analyses at a follow-up of 3-24 months.Results:The amount of vertical lengthening of the chin in 38 cases were 2 mm to 5 mm, with an average of 3.02 mm. The horizontal narrowing width distances were 3-7 mm, with an average of 5.6 mm. The patients were followed up for 3-24 months, with an average of 10.6 months. There were no complications such as hematoma, wound dehiscence, accidental fracture, surgical area infection and permanent neurosensory disorder. 38 patients had transient sensory loss in the lower lip region of varying degrees, but all recovered spontaneously during routine follow-up period. All patients were satisfied with the improvement of facial contour.Conclusions:W-shaped geinoplasty preserves the central bone of the chin and the attachment of genioglossus muscle, which does not affect the normal anatomy and physiological function of the oral cavity. After osteotomy, the bone is removed and the bilateral bone fragments move flexibly. It can effectively change the radian, width, length and protrusion of the lower edge of the chin in three dimensions, so as to correct the wide and short deformity of the chin.

Percepción de las asimetrías del mentón entre ortodoncistas, odontólogos especialistas, estudiantes y pacientes / Perception of chin asymmetries among ecuadorian orthodontists, specialist dentists, students and patients

Introducción: Estudios previos han demostrado diferencias en la percepción de asimetrías dentales y faciales entre profesionales de la odontología y personas no expertas. Sin embargo, la literatura sobre las diferencias en la percepción de las asimetrías del mentón es limitada. Objetivo: Comparar la percepción estética de las asimetrías del mentón entre ortodoncistas, odontólogos especialistas, estudiantes y pacientes de la Facultad de Odontología de la Universidad Central del Ecuador. Métodos: Estudio observacional, analítico y transversal. El universo estuvo conformado por 36 ortodoncistas, 77 odontólogos especialistas, 96 estudiantes y 2580 pacientes de esta Facultad. El tamaño de la muestra fue de 30 participantes para cada grupo. Se modificó digitalmente la posición transversal del mentón de 0° a 6° en las fotografías de dos sujetos (hombre-mujer) ecuatorianos. La evaluación se realizó por medio de una escala visual análoga. Resultados: Las fotografías de asimetrías del mentón con 0° de desviación fueron calificadas como muy estéticas y las asimetrías con 6° fueron poco estéticas para los cuatro grupos. Los ortodoncistas, odontólogos especialistas y estudiantes consideraron como límite estético los 2° de desviación del mentón para la fotografía del sujeto femenino y masculino. Los límites estéticos fueron los 2° de desviación para el sujeto femenino y 3° para el sujeto masculino. Se encontraron diferencias significativas entre los grupos de evaluadores y las fotografías (p < 0,05). Conclusiones: Los ortodoncistas percibieron la estética facial cercana a la norma de la asimetría del mentón, que tiene un papel importante en la percepción de la estética facial(AU)

Introduction: Previous studies have shown differences in the perception of dental and facial asymmetries between dental professionals and non-experts. However, the literature on differences in the perception of chin asymmetries is limited. Objective: Compare the aesthetic perception of chin asymmetries among orthodontists, specialist dentists, students and patients of the Faculty of Dentistry of the Central University of Ecuador. Methods: Observational, analytical and cross-sectional study. The universe was made up of 36 orthodontists, 77 specialist dentists, 96 students and 2580 patients from this Faculty. The sample size was 30 participants for each group. The transverse position of the chin was digitally modified from 0° to 6° in the photographs of two Ecuadorian subjects (male-female). The evaluation was carried out by means of an analogous visual scale. Results: The photographs of asymmetries of the chin with 0° of deviation were qualified as very aesthetic and the asymmetries with 6° were unsightly for the four groups. Orthodontists, specialist dentists and students considered as an aesthetic limit the 2nd deviation of the chin for the photography of the female and male subject. The aesthetic limits were 2° of deviation for the female subject and 3° for the male subject. Significant differences were found between the groups of evaluators and the photographs (p < 0.05). Conclusions: Orthodontists perceived facial aesthetics close to the norm of chin asymmetry, which has an important role in the perception of facial aesthetics(AU)

Perda de definição do contorno do submento: correto diagnóstico e algoritmo de tratamento / Loss of definition of the submental contouring: correct diagnosis and treatment algorithm

A busca por procedimentos estéticos voltados para a perda de definição do submento é crescente. Um correto diagnóstico é imperativo para o sucesso do tratamento e redução das complicações. Adiposidade localizada, flacidez cutânea e perda da estrutura óssea são os principais achados. Um algoritmo de tratamento foi discutido nesta revisão, lembrando-se, claro, da possibilidade de tratamentos combinados e sequenciais para melhores resultados

The search for aesthetic procedures aimed at the loss of submental definition is increasing. A correct diagnosis is imperative for successful treatment and the reduction of complications. Localized adiposity, skin flaccidity, and loss of bone structure are the main findings. A treatment algorithm was discussed in this review, remembering, of course, the possibility of combined and sequential treatments for better results.

What do black patients expect from orthodontic treatment? The aesthetic perception of facial profile between orthodontists and black laypersons

ABSTRACT Objective: To evaluate the influence of anteroposterior position of the soft tissue on facial attractiveness in black people, and compare the perception of aesthetics and satisfaction between orthodontists and black laypersons. Methods: The sample was composed of 69 orthodontists and 69 laypersons of black ethnicity (n=138). Facial profile photographs of two black volunteers, a man and a woman, were digitally manipulated to change the position of the lips and chin, by making gradual changes of 4mm in relation to the true vertical line, simulating advance or retrusion of the soft tissues by -2, -6, -10, +2, +6, +10mm, totalling six images per sex. The photographs were classified by the research participants using a visual analogue scale (VAS), from 0 (unpleasant) to 100 (pleasant). The results were analyzed by generalized linear model and by the Fisher's exact test, considering the level of significance of 5%. Results: The orthodontists and black laypersons considered straight profiles the most pleasant. The two groups classified the male profile as being more unpleasant in comparison with the female facial profile, which was concave. When evaluating all the images together, the image most indicated as being the most pleasant, once again, was the one with the straight profile, for both sexes. Conclusion: The influence of orthodontists' and laypersons' aesthetic perception on evaluating the facial profile of blacks was similar. The straight profile was classified as the most pleasant and the concave, as the most unpleasant.

RESUMO Objetivo: Avaliar a influência do posicionamento anteroposterior dos tecidos moles na atratividade facial de indivíduos negros, e comparar sua agradabilidade entre ortodontistas e leigos. Métodos: A amostra foi composta por 138 avaliadores, 69 ortodontistas e 69 indivíduos leigos da raça negra. Fotografias de perfil de dois pacientes negros, um homem e uma mulher, foram modificadas quanto ao posicionamento dos lábios e do mento, deslocados digitalmente em incrementos de 4 mm em relação a uma linha vertical verdadeira, simulando avanços e recuos dos tecidos moles de -2, -6, -10, +2, +6, +10 mm, totalizando seis imagens por sexo, classificadas pelos participantes da pesquisa usando uma escala visual analógica (EVA) de 0 (desagradável) a 100 (agradável). Os resultados foram analisados por meio de modelos lineares generalizados, considerando-se que todos os observadores avaliaram todas as imagens. A análise das escolhas das imagens consideradas mais agradáveis ou mais desagradáveis foi realizada pelo teste exato de Fisher, com um nível de significância de 5%. Resultados: Os ortodontistas e leigos consideraram mais agradáveis as alterações que se aproximavam do perfil reto. Nas imagens em que havia birretrusão facial, os dois grupos classificaram como mais desagradável o perfil do homem do que o perfil da mulher. Ao avaliar todas as imagens juntas, a imagem mais indicada como a mais agradável foi, novamente, a com perfil reto, para os dois sexos. Conclusão: A influência da percepção estética dos ortodontistas e leigos na avaliação do perfil facial de negros foi semelhante, sendo o perfil reto classificado como o mais agradável e o côncavo, o mais desagradável.

Advance in chin-down maneuver in aspiration for dysphagic patients (review) / 中国康复理论与实践

ObjectiveTo identify the appropriate definition, scope of application, the mechanism and the efficacy of the chin-down maneuver in aspiration reduction or prevention. MethodsLiteratures about chin-down published before July, 2021 were reviewed. ResultsA total of 13 articles were included. Chin-down refered to the action of bending the neck and leaning the chin as far as possible toward the chest. Chin-down maneuver could change the position and pressure of the pharyngeal structure to guide the food safely into the esophagus, to prevent or reduce aspiration. Chin-down maneuver was effctive on dysphagia caused by insufficient laryngeal elevation, delayed pharyngeal reflex, epiglottal defect, lychee cartilage defect, and glottis closure defect. However, this action worked in patients with premature overflow of food clumps, weak pharyngeal contraction muscle strength, and poor oral preservation. ConclusionChin-down maneuver is beneficial to aspiration dysphagia after dysphagia.

Morfología cefalométrica de la sínfisis del mentón en individuos jóvenes de la ciudad de Quito-Ecuador / Cephalometric morphology of chin symphysis in young individuals from the city of Quito-Ecuador

Resumen Introducción: La sínfisis del mentón aporta equilibrio, simetría y armonía al rostro. Por ser una estructura anatómica mandibular muy importante y altamente modificable en cirugía estética, se considera indispensable conocer su morfología y así obtener una correcta interacción en el diagnóstico, pronóstico y terapéutica médico-odontológica. Objetivo: Determinar la morfología sínfisis del mentón en jóvenes adultos de la ciudad de Quito- Ecuador, año 2019, mediante la identificación de las longitudes sagitales y coronales. Metodología: Este estudio tuvo un enfoque cuantitativo, tipo descriptivo-observacional, con temporalidad retrospectiva. Se calibraron, analizaron y trazaron 384 radiografías digitales laterales de adultos jóvenes de la ciudad de Quito-Ecuador, año 2019 en el software AutoCAD-2019. Resultados: Existió una elevada frecuencia de la forma geométrica cuadrada (60%) con respecto a la rectangular (40%), adicionalmente se identificó que la figura cuadrada es más frecuente en individuos de sexo femenino y sujetos clase I (56%) y II (70%), además de todos los patrones de crecimiento vertical hipodivergentes (58%), normodivergentes (64%) e hiperdivergentes (57%). Conclusiones: La forma cuadrada de la sínfisis del mentón es mayor que la forma rectangular. Por la originalidad de los resultados, se sugiere realizar nuevos estudios que correlacionen la morfología mentoniana con las diferentes estructuras cráneo-maxilofaciales.

Abstract Introduction: The chin symphysis contributes to the balance, symmetry and harmony of the face. Since it is an important anatomical jaw structure and highly modifiable in aesthetic surgery, it is considered crucial to know its morphology and, thus, obtain a correct interaction in the diagnosis, prognosis and medical-dental therapy. Objective: To determine the symphysis morphology of the chin in young adults in the city of Quito, Ecuador, in the year 2019, through the identification of sagittal and coronal lengths. Methodology: This study had a quantitative approach, descriptive-observational type, with retrospective temporality. We calibrated, analyzed and plotted 384 lateral digital radiographs of young adults from the city of Quito-Ecuador, year 2019 in the software AutoCAD-2019. Results: There was a high frequency of the square geometric shape (60%) in comparison to the rectangular one (40%). Additionally, it was identified that the square figure is more frequent in female individuals and class I (56%) and II (70%) subjects, in addition to all the hypodivergent (58%), normodivergent (64%) and hyperdivergent (57%) vertical growth patterns. Conclusions: The square shape of the chin symphysis is larger than the rectangular shape. Due to the originality of the results, it is suggested to carry out new studies that correlate chin morphology with the different cranio-maxillofacial structures.

Factors associated with the morphology of the mandibular symphysis and soft tissue chin

ABSTRACT Objectives: This study aimed to (I) assess the morphology of the symphysis and soft tissue chin associated with sex, age and sagittal/vertical skeletal patterns, and (II) identify the individual and combined contributions of these variables to different portions of the symphysis. Methods: This cross-sectional study included 195 lateral cephalometric radiographs from untreated adults. Alveolar, basal, and soft tissue of the symphysis were measured by an X/Y cranial base coordinate system, and divided in accordance to four predictor variables: sex, age, and sagittal/vertical skeletal patterns. Parametric tests were conducted for comparison and correlation purposes, while multiple regression analysis was performed to explore combined interactions. Results: Alveolar inclination is related to sagittal and vertical patterns, and both explained 71.4% of the variations. Alveolar thickness is weakly predicted and poorly influenced by age. Symphysis height was 10% higher in males, and associated with a vertical skeletal pattern and sex, and both explained 43.6% of variations. Basal symphyseal shows an individual thickness, is larger in males, and vertically short-positioned with age. Soft tissue chin is not necessarily related to the size of the underling skeletal pattern, and enlarges with age, even in adulthood. Conclusions: The symphysis and surrounding tissues are influenced by sex, age, and sagittal and vertical patterns, acting differently on the alveolar, basal and soft tissue portions. Sagittal and vertical skeletal patterns are the strongest association on alveolar symphysis inclination, whereas sex and age acts on the vertical symphysis position and soft tissues thickness.

RESUMO Introdução: O presente estudo objetivou: 1) avaliar a morfologia da sínfise mandibular e dos tecidos tegumentares do mento, associada ao sexo, idade, padrões sagital e vertical; e 2) identificar as contribuições dessas variáveis, individualmente ou combinadas, às diferentes regiões da sínfise. Métodos: Este estudo transversal incluiu 195 radiografias cefalométricas laterais de adultos não tratados ortodonticamente. Os tecidos alveolar, basal e mole da sínfise foram medidos por um sistema de coordenadas x, y e z da base do crânio e divididos de acordo com quatro variáveis preditoras: sexo, idade e padrões esqueléticos sagitais e verticais. Testes paramétricos foram conduzidos para fins de comparação e correlação, enquanto a análise de regressão múltipla foi realizada para explorar as interações combinadas. Resultados: A inclinação alveolar está relacionada aos padrões sagitais e verticais, e ambos explicaram 71,4% das variações. A espessura alveolar é fracamente prevista e pouco influenciada pela idade. A altura da sínfise foi 10% maior no sexo masculino e esteve associada ao padrão esquelético vertical e ao sexo, sendo que ambos explicaram 43,6% das variações. A sínfise basal mostra espessura individual, é maior no sexo masculino e verticalmente curta com a idade. O tecido mole do mento não está necessariamente relacionado ao tamanho do padrão esquelético subjacente e aumenta com a idade, mesmo na idade adulta. Conclusões: A sínfise e os tecidos circundantes são influenciados pelo sexo, idade e padrões sagitais e verticais, que atuam de forma diferenciada nas porções alveolar, basal e de tecidos tegumentares. Os padrões esqueléticos sagitais e verticais são a associação mais forte na inclinação da sínfise alveolar, enquanto o sexo e a idade atuam na posição vertical da sínfise e na espessura dos tecidos tegumentares.

Influence of mentalis muscle relaxation on oronasal breathing / A repercussão do relaxamento do músculo mentual na respiração oronasal

ABSTRACT Purpose: to investigate the existence of changes in the electromyographic patterns of the mentalis and inferior orbicularis oris muscles in oronasal breathers, submitted to massage therapy on the mentalis muscle. Methods: a controlled blind placebo experiment, with a sample of 19 oronasal breathers (1 man and 18 women), mean age (standard deviation) 22.3 (2.63) years, randomly divided into control and experimental groups, respectively with 7 and 12 volunteers. The experimental group alone underwent myotherapy with massages for 3 months, while electromyographic data were collected from both groups at the beginning and end of the treatment, both at rest and when swallowing water. The analysis of variance was conducted to test the existence of differences between the means; the 5% significance level was used. Results: the analysis of variance revealed signs of interaction between the group and phase effects when analyzing the root mean square values of both the inferior orbicularis oris and the mentalis muscles. As expected, no signs of significant differences were found between the means of the phases in the control group. On the other hand, signs of significant difference were found in the experimental group, with reduced root mean square values in both muscles. The inferior orbicularis oris muscle, which in the pre-phase had a mean (standard deviation) of 202.10 (161.47) µV, had, in the post-phase, values of 131.49 (159.18) µV. The mentalis muscle, in its turn, had in the pre- and post-phase, respectively, a mean (standard deviation) of 199.31 (279.77) µV and 114.58 (253.56) µV. Conclusion: given that no effect was detected in the control group, the decrease in the root mean square values of the mentalis and inferior orbicularis oris muscles in oronasal breathers was attributed to the massage therapy on the mentalis muscle.

RESUMO Objetivo: investigar a existência de modificações dos padrões eletromiográficos dos músculos mentual e orbicular inferior da boca em respiradores oronasais submetidas à massoterapia no músculo mentual. Métodos: experimento cego placebo controlado, com amostra de 19 respiradores oronasais, 1 homem e 18 mulheres, com média de idade (desvio-padrão) de 22,3 (2,63) anos, aleatoriamente dividida nos grupos controle e experimental, respectivamente com 7 e 12 voluntários. Apenas no grupo experimental foi aplicada mioterapia por meio de massagens, por três meses e em ambos os grupos foram coletados dados eletromiográficos no início e no final do tempo de tratamento nas condições de repouso e deglutição de água. A análise de variância foi aplicada para testar a existência de diferenças entre as médias e foi adotado o nível de significância de 5%. Resultados: a análise de variância revelou indícios de interação entre os efeitos de grupo e fase quando analisados os valores de Root Mean Square (RMS), tanto do músculo orbicular inferior como do músculo mentual. Como esperado, não foram encontrados indícios de diferenças significantes entre as médias das fases no grupo controle, entretanto, foram encontrados indícios de diferença significante no grupo experimental havendo redução das médias de RMS em ambos os músculos. O orbicular inferior, que na fase pré apresentava média (desvio padrão) de 202,10 (161,47) µV, apresentou valores de 131,49 (159,18) µV na fase pós, enquanto que o músculo mentual apresentou, respectivamente, nas fases pré e pós, média (desvio padrão) de 199,31 (279,77) µV e 114,58 (253,56) µV. Conclusão: tendo em vista a não detecção de efeito no grupo controle, atribui-se à massoterapia no músculo mentual a redução das médias de Root Mean Square dos músculos mentual e orbicular inferior da boca em respiradores oronasais.

Value of ultrasonographic measurement of submental soft tissue distance in predicting poor ventilation with laryngeal mask airway / 中华麻醉学杂志

Objective:To determine the value of ultrasonographic measurement of submental soft tissue distance in predicting poor ventilation with laryngeal mask airway (LMA).Methods:A total of 272 American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 25-78 yr, weighing 40-85 kg, with mechanical ventilation time 30-120 min, scheduled for elective lower limb vascular surgery or lithotripsy under general anesthesia with LMA, were selected.The parameters of submental soft tissue of tongue thickness (TT), distance from skin to the hyoid bone (DSHB), distance from skin to epiglottis midway (DSEM) and distance from skin to anterior commissure of the vocal cords (DSAC) were measured using ultrasonography before operation.The type of LMA was chosen according to the instruction book.The development of failure of LMA placement at the first attempt, air leakage around LMA cuff during mechanical ventilation, peak airway pressure >20 cmH 2O and gastric insufflation detected by ultrasonography were recorded.The development of one or more adverse events mentioned above was considered to be poor ventilation.The patients were divided into normal ventilation group (N group) and poor ventilation group (P group) according to whether poor ventilation occurred.The receiver operating characteristic curve for ultrasonographic measurement of submental soft tissue distance in predicting poor ventilation with LMA was drawn, and the area under the curve (AUC) and 95% confidence interval (CI), sensitivity and specificity and cut-off value were calculated.The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify the risk factors for poor ventilation with LMA. Results:The AUC for TT, DSHB, DSEM and DSAC measured using ultrasonography in predicting poor ventilation with LMA (95%CI) was 0.866 (0.813-0.919), 0.755 (0.683-0.827), 0.835 (0.772-0.899) and 0.705 (0.628-0.782) ( P<0.05 or 0.01), respectively.The results of logistic regression analysis showed that TT≥6.140 cm, DSHB≥1.145 cm, DSEM≥2.175 cm and DSAC≥1.075 cm were risks factor for poor ventilation with LMA. Conclusion:Ultrasonographic measurement of TT, DSHB, DSEM and DSAC can predict the development of poor ventilation with LMA.

About chin (genioplasty) surgery / Sobre cirugía del mentón (genioplastía)

Facial harmony is the consequence of a proper balance between all facial structures. The identification and classification of morphologic characteristics that detract from facial harmony is most effectively accomplished by clinical examination. The maintenance of the ratios between the facial thirds, correct spatial bone position and soft tissues accommodation are all factors that directly contribute in a balanced facial profile. The chin, likewise, contributes significantly in facial balance, mainly in the profile view. Expressive changes on chin position are associated with the perception of strong or delicate characters. Thus, over the years, a series of studies has been constructed focusing on mandibular osteotomies techniques that enable changes in chin position: advances, setback, extrusion, intrusion, widening, narrowing and asymmetry. This study aims to address historical and technical aspects of genioplasty; associating patient's condition with the surgical techniques that can be applied for correction of chin deformities.

La armonía facial es la consecuencia del balance entre las estructuras facial. La identificación y clasificación de las características morfológicas que están acompañando la armonía facial son mas efectivas al realizar un estudio de análisis facial. La obtención de promedios entre los tercios, corrección especial de la posición del hueso y la acomodación de los tejidos blandos son factores directamente involucrados en el balance del perfil. El mentón, contribuye significativamente en este balance. Cambios expresivos en la posición del mentón son asociados con la percepción de características fuertes o delicadas. Durante los años, una serie de estudios han sido desarrollados enfocándose en las osteotomías mandibulares y técnicas capaces de alcanzar los cambios en la posición del mentón: avances, retrocesos, extrusiones, ensanchamientos, estrechamientos y asimetrías. Este estudio pretende orientar las condiciones históricas y técnicas respecto de la genioplastia; la asociación de las características del paciente con la técnica quirúrgica pueden ser aplicadas para la corrección de las deformidades.

Effect of Advanced Strengthening Program on Physical Fitness Test Performance in Injury Prone Pre-Military Trainee Cadets.

The pre military trainee cadets are mostly unaware about proper training techniques and because of their lack of knowledge they are prone to have musculoskeletal problems especially their shoulder, spine, and knee joint are more prone to any injury. So, in order to avoid injuries, effort was made to make them aware about the risk of getting injured and proper fitness techniques which will prevent their injuries as well as help them to improve fitness level and field performance also. We wanted to evaluate the effect of advance strengthening program on physical fitness test performance in pre-military trainee cadets.METHODSIn this comparative study, injury prone trainee cadets were randomly allocated in to two groups of 25 each with advanced training program. Group one did conventional type of routine exercise; group two followed advanced training protocol. Physical fitness test performance was assessed and compared between the two groups. Outcome measures were Burpees test, shoulder press, chin-ups, planks, leg press, 1600 meters running.RESULTSIn Burpees test, 37% improvement was seen by conventional exercise program; whereas, it was 63% for advanced strengthening exercise program. In shoulder press, 38% improvement was seen for conventional exercise program; whereas, it was 62% for advanced strengthening exercise program. In chin ups, 34% improvement was seen for conventional exercise program; whereas, it was 66% for advanced strengthening exercise program. In planks, 45% improvement was seen with conventional exercise program; whereas, it was 55% for advanced strengthening exercise program. In leg press, 39% improvement was seen with conventional exercise program; whereas, it was 61% with advanced strengthening exercise program. In 1600 meters running, 37% improvement was seen with conventional exercise program; whereas, it was 63% by advanced strengthening exercise program. P value was <0.0001 which is significant.CONCLUSIONSA significant improvement was found in muscle performance, and occurrence of injury was seen to be reduced with advanced training program in injury prone trainee cadets.

Facial Angle Profiles in Turkish Healthy Population

The knowledge of the facial angles is essential for safe and accurate plastic surgery interventions. Facial angles are used as a reference value for comparison during diagnosis and treatment planning. Also, the facial angles will provide valuable data in evaluation of facial aesthetics. So, the aim of this study was to determine the ideal values of the facial angles in Turkish healthy adults.METHODSTwo hundred and forty seven (129 females; 118 males) subjects aged between 18 and 25 years were included in this study. Frankfort horizontal plane was chosen to determine the angles related with face. Photographs were acquired using a Digital SLR Camera with fixed shooting values. (Canon EOS 80D; ISO 100 f/4.5). In all the shoots, a printed scale with known dimensions was present. Acquired images were then transferred to a computer station. Measurements were made using Image J 1.52a with 1/100 mm sensitivity. Statistical analysis was done using SPSS Ver. 22.00. A p<0.05 value was considered as significant. Student’s T Test was used to determine the significance between gender, while Pearson Correlation analysis was done to evaluate the relation between gender.RESULTSStatistically significant difference was found between the genders and the frontonasal angle, the nasofrontal angle, the nasolabial angle, the chin neck angle, and the nasal projection. Also, the fronto nasal angle, chin neck angle, and nasal projection measurements were higher in males than in females, whereas the nasofrontal angle and nasolabial angle were lower in males than in females. Additionally, there was a significant, negative very low correlation between fronto-nasal angle (-0.148), chin-neck angle (r=-0.179) and gender; a significant, negative and low correlation (r=-0.243) between nasal projection and gender, a significant, positive and low correlation between nasolabial angle and gender (r=0.259); and nasofrontal angle and gender (r=0.388).CONCLUSIONSFacial angle values of healthy population provide important and useful knowledge in terms of comparison of abnormalities clinically, and data may be valuable for the representatives of clinical disciplines.

Aumento mentoniano com retalho cervical associado à ritidoplastia / Chin augmentation with cervical flaps associated with rhytidoplasty

Introdução: A falta da projeção mentoniana no terço inferior da face algumas vezes é responsável pela quebra da harmonia do contorno facial. A utilização de implantes aloplásticos, preenchimentos submetidos à ritidoplastia para correção destas deformidades. Neste estudo, propomos uma nova manobra para aumento da projeção mentoniana com uso de um retalho cervical associado à ritidoplastia. Métodos: Foram avaliados 11 pacientes operados no período de 01/2017 a 01/2018, utilizando-se o retalho cervical para projeção mentoniana, e tendo como critério de inclusão somente pacientes que almejavam um aumento mentoniano, sem utilização de próteses, preenchimentos ou abordagem óssea, e que seriam submetidos à ritidoplastia. Resultados: Através da análise cefalométrica evidenciou-se melhora da projeção mentoniana e do contorno cervical, e não houve complicações no pós-operatório imediato ou tardio. Conclusão: O retalho cervical utilizado para aumento mentoniano além de apresentar resultados e aceitação satisfatórios, elimina o uso de materiais sintéticos, redução de custos, segurança e durabilidade, alcançando um contorno mandibular mais refinado e uma projeção mentoniana mais natural.

Introduction: The lack of chin projection in the lower third of the face is sometimes responsible for the breaking of the facial contour harmony. Alloplastic implants, fillers, and osseous advancements have been used to correct these deformities. In this study, we propose a new maneuver to increase chin projection by using a cervical flap associated with rhytidoplasty. Methods: We assessed 11 patients who underwent operations using the cervical flap for chin projection between January 2017 and January 2018. The inclusion criteria were only patients who desired chin augmentation without the use of prosthetics, fillers, or osseous approaches, and those who would undergo rhytidoplasty. Results: A cephalometric analysis revealed improvements in chin projection and cervical contour, and no complications in the immediate or late postoperative period. Conclusion: In addition to presenting satisfactory results and acceptance, the cervical flap used for chin augmentation eliminated the use of synthetic materials, reduced surgical costs, and improved safety and durability, achieving a more refined mandibular contour and natural chin projection.

Avaliação da harmonia da face mediante projeções faciais do mento / Evaluation of harmony of the face through facial projections of the men

Introdução: Identificar qual projeção do mento é ideal para compor um rosto harmônico, de acordo com a opinião de leigos e cirurgiões buco-maxilo-faciais (BMF), relacionando as variáveis: sexo, etnia(raça) e região de origem(local). Metodologia: Participaram do estudo 386 leigos e 198 cirurgiões BMF. Este estudo foi realizado por meio de um formulário que continha dezoito imagens da face com diferentes projeções do mento: nove do sexo masculino e nove do sexo feminino, tendo o público escolhido a imagem que mais o agradou. Resultados: Em relação à avaliação da imagem masculina, as categorias: grupo(leigos/cirurgiões), sexo masculino e feminino, regiões (Nordeste e Sudeste) e raça, os entrevistados leigos escolheram um mento retraído em relação à linha vertical verdadeira, semelhante à escolha dos cirurgiões. Em relação à imagem feminina, para as mesmas categorias do sexo masculino, as projeções protruídas de mento foram mais escolhidas, tanto para os leigos como para os cirurgiões. Entretanto, as subcategorias leigos da região Sudeste, leigos de raça branca e leigos do sexo masculino escolheram uma imagem feminina com projeções de mento mais retraída. Conclusões: A harmonia facial pode ser considerada subjetiva, pois engloba padrões pessoais de beleza; assim, os cirurgiões devem estar atentos às peculiaridades dos pacientes... (AU)

Introduction: To identify which projection of the chin is ideal for compose a harmonic face according to the opinion of laypeople and oral maxillofacial surgeons, relating the variables: gender, ethnicity (race) and region of origin (local). Methodology: 386 lay people and 198 surgeons participated in the study. This study was carried out by means of a form. This form contained eighteen images of faces with different projections of the chin: nine males and nine females. So, the audience chose the image that most pleased them. Results: In relation to the evaluation of the male image. The categories: group (laymen/ surgeons), male and female, regions (northeast and southeast) and race, lay interviewee chose a retracted chin in relation to the true vertical line, similar to the surgeons' choice. In relation to the female image, for the same male categories, the protruding projections of the chin were more chosen, both for the laymen and for the surgeons. However, for the lay subcategories of the Southeast region, white laymen and male laymen, both chose a female image with more retracted chin projections. Conclusions: The facial harmony can be considered subjective since it includes personal standards of beauty, so surgeons must be attentive to the peculiarities of the patients... (AU)

Proliferative fasciitis of the chin: A report of the rare case and review of literature

Proliferative fasciitis is a pseudo-sarcomatous myofibroblastic proliferation characterized by the presence of unusual giant cells resembling ganglion cells, which usually occurs in the adult population with a mean age of 54 years. It usually affects the upper extremities and is rare in head and neck region with only 11 cases described in the literature so far. Because of rapid growth and histological similarity to various malignant tumors such as rhabdomyosarcoma, recognition of this benign condition is a matter of utmost importance when a pathologist is concerned. In this study, we report a case of a 11-year-old boy presented with a lesion on the right side of chin, along with a literature review involving those cases reported in the head and neck region.

Temblor Mentoniano: Reporte De Un Caso Aislado / Chin Tremor: Report Of An Isolated Case

Resumen El temblor mentoniano o genioespasmo es un desorden del movimiento de carácter involuntario, rítmico, hereditario autosómico dominante, exacerbado por situaciones de estrés o emocionales. Registrado por primera vez en 1894, en Italia. Se reporta una niña de 4 años de edad con temblor mentoniano desde el año de edad, sin precedente de herencia, con respuesta exitosa al uso de Toxina Botulínica.

Abstract The chin tremor or geniospasm is an involuntary, rhythmic, autosomal dominant hereditary movement disorder, triggered by stress or emotional situations. Registered for the first time in 1894, in Italy. We report a 4-year-old girl with mental tremor from one year of age, with no previous inheritance, with a successful response to the use of Botulinum Toxin.

Ángulo de convexidad facial y proyección del mentón en pacientes en postoperatorio de rinoseptoplastia / Angle facial convexity and projection of the chin in patients undergone of rhinoplasty

Introducción: La relación de la nariz con la morfología facial no es solo estructural. Numerosos estudios sugieren la relación entre la función respiratoria nasal y el de-sarrollo craneofacial. Objetivo: Determinar la mejoría en el ángulo de convexidad facial y proyección del mentón en pacientes en postoperatorio de rinoseptoplastia. Diseño: Estudio observacional analítico tipo corte transversal. Metodología: Mues-tra de 43 pacientes, 26 de género femenino y 17 masculino, entre 12 y 43 años, sometidos a rinoseptoplastia con evolución postoperatoria mínima de 3 meses. Se analizaron las variables de edad, sexo, ángulo de convexidad facial de Legan y proyección del mentón según González Ulloa antes y después de la cirugía, así como tiempo postquirúrgico. Resultados: El ángulo de convexidad facial se redujo 3,72°+2,19. En la técnica de González Ulloa, se evidenció avance del pogonion 2,53 mm+ 1,60. De los 43 pacientes, un 72%, mostró cambios favorables en el án-gulo de convexidad facial y en la proyección del mentón. Los mejores resultados se evidenciaron en menores de 16 años y evolución postquirúrgica mayor a 1 año. Discusión: A diferencia de otras investigaciones, observamos cambios significativos en pacientes adultos. Tal hecho nos lleva a otras interrogantes sobre mecanismos adicionales que pudieran influir en los patrones de crecimiento facial. Conclusiones: La rinoseptoplastia al considerarse un procedimiento que mejora la función respira-toria nasal, favorece cambios neuromusculares y endocrinos que permiten un mejor desarrollo del perfil facial en especial del tercio inferior.

Introduction: The relation between the nose and the facial morphology is not only structural. Numerous studies have demonstrated also a relationship between nasal respiratory function and craniofacial development. Objective: To determine the im-provement in the angle of facial convexity and chin projection in patients in the postoperative period of rhinoseptoplasty. Design: Cross-sectional study. Methods: 43 patients were selected. 26 women and 17 men between 12 and 43 years old, undergoing Rhinoplasty with minimum 3 months of postoperative evolution. We analyzed the variables of age, sex, Legan's angle of facial convexity and projection of the chin according to Gonzalez Ulloa before and after surgery, as well as post-surgical time. Results: The angle of facial convexity was reduced X + D.S 3.72 ° + 2.19. The technique of González Ulloa showed progress of the pogonion X + D.S 2.53 mm + 1.60. Of the 43 patients, 72%, showed positive changes at the angle of facial convexity and the projection of the Chin. Best results were apparent in children under 16 years and more than 1 year postsurgical evolution. Discussion: Unlike other research, we observe significant changes in adult patients. This fact leads to other questions about additional mechanisms that might influence the facial growth patterns. Conclusions: Rhinoseptoplasty is a procedure that improves the nasal respiratory function, favors neuromuscular and endocrine changes that allow better development of the facial profile especially in the lower third.

Case report and literature review of tongue artery embolism caused by hyaluronic acid augmentation of chin / 中华整形外科杂志

In December 2018, a 29-year-old female patient with lingual artery embolism after hyaluronic acid injection was admitted to the Second Affiliated Hospital of Kunming Medical College. The examination showed swelling tongue, the mucosa on the front and back of the right tongue became white, and the tip of the tongue slightly atrophied. The movement of tongue was disturbed. The patient′s pronunciation was unclear. The right tongue was numb, resulted by the weak circulation. Hyaluronidase was injected into tongue. The vasodilator was used. And hyperbaric oxygen chamber was applied. Thereafter, the blood supply and oxygen concentration of embolized area were increased, and collateral circulation was established. Antibiotic therapy and continuous treatment with neurotrophic drugs (rat nerve growth factor + methylcobalt ammonium) were given to promote the repair of nerve. After treatment, the embolism of lingual artery was significantly improved. Three months later, the patients had mild muscular atrophy on the right side of the tongue, with partial recovery of the right tongue mucosa. Tongue movement, sensory and taste functions recovered. Hyaluronic acid injection needs to be standardized, performed by surgeons who masters the anatomical structures, the injection layer and spot. If the vascular embolism occurs, hyaluronidase should be used as early as possible. It also needs to reduce local tension in both injected and affected area, reduce the pressure of injection on blood vessels, improve local blood circulation, so as to achieve better therapeutic effect.

The progress in clinical application of chin plasty / 中华整形外科杂志

The chin, located in the most prominent part of the lower facial profile, maintains the balance and coordination of the face. The chin size, shape, spatial position and proportion can all give rise to various chin malformations. Chin plasty plays an important role in improving facial appearance. Recent studies indicate that it’s difficult to completely meet the mental aesthetic requirements with a single procedure. The combination of different chin plastic surgery has become a hot spot in plastic surgery. In this paper, the morphological analysis of chin, the surgical progress in Chin plasty, the advantages and adverse effects of these methods, and the synthetic application of various surgeriesis were reviewed.