Determinación de Valores de Armonía del Perfil Facial en la Población Chilena

RESUMEN: El realizar un tratamiento ortodóntico sólo en base a referencias de tejidos duros, puede llevar a resultados estéticos desfavorables, debido a la gran variabilidad que existe en los tejidos blandos que los recubren. Arnett et al. (1999) presentaron un análisis basado en los tejidos blandos y determinó normas que definen un rostro armónico. Sin embargo, éstas normas se obtuvieron de pacientes norteamericanos y puede que no reflejen los conceptos estéticos de nuestra población. El objetivo del presente trabajo fue determinar valores de armonía facial para la población chilena, utilizando el análisis cefalométrico de tejidos blandos presentado por Arnett et al., y compararlos con los valores previamente establecidos para la población caucásica. Se analizaron 200 fotografías y se clasificaron los perfiles en balanceados y no balanceados según el criterio de un grupo de especialistas. Posteriormente se analizaron las telerradiografías correspondientes a los perfiles clasificados, con el análisis cefalométrico de tejidos blandos. Los valores de las diferentes variables fueron analiza dos separadamente por sexo, clase esqueletal y biotipo facial, y se determinaron las diferencias entre las variables presentadas por Arnett et al. y las obtenidas en el presente estudio. Para ello se utilizaron pruebas de significancia estadística como el test t y otros no paramétricos. Sólo se encontró diferencias significativas en dos variables respecto de las normas sugeridas por Arnett et al., correspondientes a un menor espesor del labio inferior en ambos sexos, y una mayor prominencia del pómulo en mujeres chilenas, por lo que consideramos que los valores de armonía de Arnett et al., pueden ser también aplicados como parámetro estético para la población chilena.

ABSTRACT: Performing an orthodontic treatment based only on hard tissue references can lead to unfavorable aesthetic results due to the great variability that exists in soft tissues that cover them. In 1999, W.Arnett, presented an analysis based on soft tissues and determined norms that define a harmonious face. However, these standards that were obtained from North Americans and Chilean aesthetic concepts could be different. The aim of the study was to determine the values of facial harmony for the Chilean population, using the cephalometric analysis of soft tissues presented by Arnett, and compare them with the values previously established for the Caucasian population. In this study 200 photographs were analyzed, and the profiles were classified in balanced and unbalanced according to the criteria of a group of specialists. Subsequently, teleradiographs corresponding to the classified profiles were analyzed, with the cephalometric analysis of soft tissues. The values of the different variables were analyzed separately by sex, skeletal class and facial biotype, and the differences between the variables presented by Arnett et al., and those obtained in the present study. For this purpose, statistical significance tests such as the t test and other non- parametric tests were used. There were only significant differences in two variables: inferior lip variables in both sexes, and a greater prominence of the cheekbone in Chilean women, therefore we consider that the values of harmony of Arnett, can also be applied as an aesthetic parameter for the Chilean population.

Consideraciones acerca de la cirugía plástica en Santiago de Cuba / Considerations on plastic surgery in Santiago de Cuba

El problema de la conformidad del ser humano con las características específicas de su cuerpo puede tener su origen en un problema estético o en un aspecto de carácter puramente físico que limita de manera marcada el desarrollo de sus actividades diarias. Ambos pueden tener solución mediante una cirugía, especialmente la estética. El objetivo de este trabajo es reafirmar que la cirugía plástica estética resuelve verdaderos problemas de salud tanto física como mental al reconocer la labor de los especialistas de cirugía plástica como evaluadores y consejeros de pacientes que acuden a consulta en busca de ayuda en nuestra provincia. Se revisó la literatura nacional e internacional sobre el tema y se concluyó que la cirugía plástica con fines estéticos constituye una solución, al satisfacer las expectativas tanto de las personas que reciben el tratamiento, como de los especialistas que realizan el trabajo.

The problem of dissagrement of the human being with the specific characteristics of his body may have its origin in an esthetical problem or in a purely physical character affair which limits, in a marked way, the development of his daily activities. Both may be solved through a surgery, specially, a esthetic surgery. The objective of this work is to reaffirm that the plastic esthetic surgery solves real physical or mental health problems, so as to recognize the work of plastic surgery specialists as evaluators and advisers of patients visiting the provincial department who look for help. National and international literature on the topic was reviewed and it was concluded that plastic surgery with esthetic aims is a solution, as it satisfies the expectatives either from people searching treatment, as from the specialists who give the service.

Subcutaneous lateral brow lift, an option with local anesthesia / Levantamiento de cejas lateral con acceso subcutáneo, una opción con anestesia local

The aim of this article is to present a case series of subcutaneous lateral brow lifts withlocal anesthesia. The case series includes 9 subjects operated on between 2014 and 2016, with an averageage of 57 years and with no limitations on ethnic group or gender. The surgery was done bilaterally entirelyunder local anesthesia. After a minimum follow-up of 3 months, no major complications were observed, onlypartial suture dehiscence at two surgical sites that did not require surgical management of the zone. Goodresults were established, being fast, economical and with low morbidity. It is concluded that the subcutaneousbrow lift with local anesthesia can be applied with a low rate of complications and good results.

El objetivo de este articulo es presentar una serie de casos operados para levantamiento lateral de cejas, con disección subcutánea y con uso de anestesia local. Se diseño un estudio de serie de casos, incluyendo 9 sujetos operados entre el año 2014 y 2016, con una edad promedio de 57 años y sin restricción de etnia o sexo. Se realizó la cirugía totalmente bajo anestesia local de forma bilateral. Después de un seguimiento mínimo de 3 meses, no se observaron complicaciones mayores, presentado solo dehiscencia parcial de sutura en dos sitios quirúrgico que no requirieron manejo quirúrgico de la zona; se establecieron buenos resultados, siendo ellos rápidos, de baja morbilidad y de bajo costo. Se concluye que la técnica de levantamiento de cejas con disección subcutánea y anestesia local puede ser aplicado con bajo índice de complicaciones y buenos resultados.

Foreign Body in Jugal Mucosa

Introduction Foreign body in the oral cavity may be asymptomatic for long time and only sometimes it can lead to a typical granulomatous foreign body reaction. Some patients may complain of oral pain and present signs of inflammation with purulent discharge. A granuloma is a distinct, compact microscopic structure composed of epithelioid-shaped macrophages typically surrounded by a rim of lymphocytes and filled with fibroblasts and collagen. Nowadays, the increase of cosmetic invasive procedures such as injection of prosthetic materials in lips and cheeks may lead to unusual forms of inflammatory granulomas. Objectives Describe an unusual presentation of a foreign body reaction in the buccal mucosa due to previous injection of cosmetic agent. Resumed Report A 74-year-old woman was referred to the Department of Otorhinolaryngology, Head and Neck Surgery to investigate the presence of multiple painless, bilateral nodules in the buccal mucosa, with progressive growth observed during the previous 2months. The histologic results showed a foreign body inflammatory reaction. Conclusion Oral granulomatosis lesions represent a challenging diagnosis for clinicians and a biopsy may be necessary. Patients may feel ashamed to report previous aesthetic procedures, and the clinicians must have a proactive approach.(AU)

Asociación entre obesidad e infecciones: un estudio de corte transversal / Association between obesity and infection: a study of cross section / Associação entre obesidade e infecções: um estudo transversal

Antecedentes: Desde hace más de dos décadas se reportan observaciones que plantean que la obesidad se asocia a la presencia de infecciones. Sin embargo, los diferentes hallazgos han sido contradictorios y la dirección de la posible asociación no ha sido clarificada. En nuestro país no se encontraron trabajos al respecto que contribuyan a aclarar esta pregunta. Métodos: se realizó una serie de casos retrospectivo (N= 4840 con muestreo por conglomerados n= 100), evaluando Índice de Masa Corporal (IMC) e infección por Helicobacter pylori, Streptococcus β Hemolítico, Infección Urinaria (IVU) y Vaginosis. Se obtuvieron estadísticos descriptivos y se realizaron cruces de variables para obtener OR. Resultados: 85% sexo femenino, procedentes de la zona andina en un 77% que consultan en su mayoría para lipólisis laser, IMC: 32 (DS 5,4), la relación entre infección y obesidad fue: IVU OR 1,4 (IC 1,02-3,62), (p:0,042), VAGINITIS: OR 1,4 (IC: 1,09-3,019), (p:0,028), Helicobacter pylori: Pearson 0,25 (p:0,064) y Streptocccus: 0,56 (p:0.046). Conclusiones: La presencia de infección Urinaria y la vaginitis se asocian a la obesidad. Estos hallazgos confirman previos estudios, se discuten las implicaciones de los mismos.

Background: From almost two decades ago, some reports had suggested that obesity is associated with active infections, however, these findings have been contradictory and the address of possible associations has not been clarified. In our country, no search was founded to clarify the question. Methods: In a retrospective case series fashion (N = 4840 with conglomerate sampling n = 100) we evaluate Body Mass Index (BMI) and infection by Helicobacter pylori , β Hemolytic Streptococcus , Urinary Tract Infection (UTI ) and Vaginosis. We get descriptive statistics and Odds Ratios. Results: 85 % female, 77% from the Andean region 77 % ,consulting mostly for laser lipolysis, BMI: 32 (SD.5.4) , the relationship between infection and obesity was : UTI OR: 1 4 (CI 1.02 to 3.62 ) (p : 0.042 , vaginitis : OR 1.4 ( IC: 1 ,09 -3, 019), (p : 0.028), Helicobacter pylori: Pearson 0.25 (p : 0.064 ) Streptococcus 0.56 (p = 0.046 ) These findings confirm previous studies. Implications are discussed. Conclusions: in our search Urinary tract infections and vaginitis are associated with obesity, this data confirm previous reports.

Justificativa: Observações durante duas décadas sugerem uma relação entre obesidade e a presença de infecções, no entanto, os diferentes achados têm sido contraditórios e a associação ainda não foi verificada. No nosso país, não foram achadas pesquisas no tema. Métodos: Numa série de casos retrospectiva (N = 4840 amostragem por conglomerados com n = 100), avaliando do índice de massa corporal (IMC) e infecção pelo H. pylori. Métodos: uma série de casos retrospectiva (N = 4840 amostragem por conglomerados com n = 100), a avaliação do índice de massa corporal (IMC) e infecção pelo Helicobacter Pylori, Estreptococcus β Hemolítico, infecção do trato urinário (ITU) e vaginose. As estatísticas descritivas foram obtidas e variáveis transversais foram realizadas para o odds ratio (OR). Resultados: 85% do sexo feminino, 77% da região andina consultantes principalmente de lipólise por laser, IMC: 32 (DE 5.4), a relação entre infecção e obesidade foi: IVU OR 1,4 (IC 1,02-3,62) (p: 0,042), VAGINITE: OU 1,4 (IC: 1,09-3,019) (p: 0,028), H. pylori: Pearson de 0,25 (p = 0,064) e Estreptococos 0,56 (p: 0,046). Conclusões: A presença de infecção urinária e vaginite estão associadas com a obesidade. Estas constatações confirmam estudos anteriores, as suas conseqüências são discutidas.

Forehead Contouring Augmentation Surgery with Particulated Mandibular Bone Graft

Up to this date, the forehead contouring augmentation surgery was perfomed with silicone or microfat graft. However, augmentation with silicone has given complications such as postoperative infection, extrusion, long linear scar, and displacement of implant. Moreover, augmentation using microfat graft often requires re-operation due to fat resorption. Surgical technique was performed in 10 patients from September 2008 to April 2009. Eight patients had macrogenia and two had prognathism. Particulated bone was harvested from squared mandibular bone. The particulated mandibular bone was then grafted on the frontal bone through a 2cm incision posteriorly to the midforehead line. As a result from the three-dimensional Computer Tomogram, the frontal bone was engrafted 6 months after the particulated bone graft. Even though, traditional concept using prothesis for forehead augmentation is still popular, the author suggests autologous augmentation can make better facial contour which is named as 'facial bone redistribution concept'. Facial bone redistribution concept is the distribution of residual bone(mandible or zygoma) to deficient area(frontal bone) to achieve better facial contour. To achieve better survival rate of bone, bone marrow stem cell and platelet rich plasma(PRP) should be applied in next study to increase the survival rate of particulated bone.