ABSTRACT
RESUMEN: Introducción: El patrón de crecimiento facial se establece antes de la aparición del primer molar permanente. Un exceso de crecimiento vertical facial, corresponde a individuos de cara larga, con ángulos goniacos abiertos, alturas faciales inferiores aumentadas y músculos masticatorios de menor área transversal. Esto se asocia a presentar mordida abierta anterior, mordida cruzada, clase II esquelético, entre otros. El entrenamiento muscular masticatorio podría controlar el excesivo crecimiento vertical, generando fuerzas opuestas que favorezcan un crecimiento horizontal. Objetivo: Describir el efecto del entrenamiento muscular masticatorio en el desarrollo del patrón vertical facial en niños. Método: Se realizó una revisión narrativa mediante búsqueda electrónica en las bases de datos PubMed, EBSCO, Scopus, Cochrane, Trip Database y Epistemonikos. Se utilizaron las palabras clave: "músculos masticatorios", "maseteros", "temporales", "masticación", "ejercicio", "entrenamiento", "crecimiento vertical", "patrón vertical", "dolicofacial", "control vertical". Los términos MeSH: "músculos masticatorios", "ejercicio". Resultados: Se seleccionaron 15 artículos de los cuales 9 son ensayos clínicos, 4 son reportes de caso y 2 son estudios observacionales transversales. Conclusiones: El entrenamiento muscular masticatorio tiene efectos positivos, favoreciendo un mayor crecimiento horizontal en niños con patrón vertical. No obstante, faltan estudios y ensayos clínicos para establecer y cuantificar los cambios morfológicos generados por el entrenamiento muscular.
ABSTRACT: Background: The pattern of facial growth is established before the eruption of the first permanent molar. An excess of vertical facial growth corresponds to individuals with long faces, open gonial angles, higher inferior facial heights and smaller masticatory muscles associated with different dental anomalies like anterior open bite, Brodie bite, skeletal class II and others. The masticatory muscle training could control the excessive growth in the vertical dimension, making opposing forces that will favor the horizontal growth in the patient. Objective: Describe the effect of the masticatory muscle training in the development of the vertical pattern in children. Method: A narrative review was done by an electronic research in PubMed, EBSCO, Scopus, Cochrane, Trip Database y Epistemonikos. The following key words were used: "masticatory muscles", "masseter", "temporalis", "mastication", "chewing", "exercise", "training", "vertical growth", "vertical pattern", "dolichofacial", "vertical control". The MeSH terms: "masticatory muscles", "exercise". Results: Fifteen articles were selected, 9 of them were clinical trials, 4 were case reports and 2 were observational studies. Conclusions: The literature review shows that the masticatory muscle training has positive effects, favoring the horizontal growth in children with vertical facial pattern. Nevertheless, there is a lack of studies and clinical trials, that could help us to establish and quantify the morphological changes made by the masticatory muscle training.
Subject(s)
Humans , Child, Preschool , Child , Adolescent , Exercise , Open Bite , Mastication , Masticatory Muscles , MolarABSTRACT
OBJETIVO: o presente estudo destinou-se a comparar a morfologia tegumentar de indivíduos segundo a tipologia facial. MÉTODOS: foram utilizadas 90 telerradiografias de pacientes de ambos os sexos, de 12 a 16 anos de idade, divididas em três grupos distintos, referentes a cada padrão morfológico: mesofacial, dolicofacial e braquifacial. Os grupos foram comparados no que se refere às medidas de espessura e altura do lábio superior e inferior, além da espessura do mento mole. Ainda, foi apurada a presença de correlações entre as variáveis de tecido mole avaliadas e medidas cefalométricas de natureza dentária e esquelética. RESULTADOS E CONCLUSÕES: os lábios superiores e inferiores, assim como o mento mole, não apresentaram diferenças em relação às suas espessuras em todos os grupos morfológicos. Porém, as alturas do lábio superior e inferior foram significativamente maiores para os dolicofaciais quando esses foram comparados aos demais grupos. Braquifaciais apresentaram menor altura do lábio superior quando comparados aos mesofaciais, embora ambos não tenham se diferenciado significativamente no que se refere à altura do lábio inferior. A análise das correlações estabelecidas entre as variáveis dos tecidos moles e duros indicou evidências de um desenvolvimento vertical dos lábios superior e inferior em acompanhamento ao desenvolvimento vertical do esqueleto. O posicionamento vertical do incisivo superior se correlacionou significativamente aos mesmos parâmetros labiais, o que garantiu um nível de exposição semelhante desse elemento dentário em todos os grupos.
OBJECTIVE: This study was designed to compare the soft tissue morphology of individuals according to their facial patterns. METHODS: Were used cephalograms of 90 patients of both genders, aged 12 to 16 years, which were divided into three distinct groups, according to their morphological patterns, i.e., mesofacials, dolichofacials and brachyfacials. The groups were compared in terms of thickness and height of the upper and lower lips, and thickness of the soft tissue chin. Correlations between soft tissue variables and dental and skeletal cephalometric measurements were also investigated. RESULTS AND CONCLUSIONS: Thickness of upper lip, lower lip and soft tissue chin showed no differences in all morphological groups. However, upper and lower lip heights were significantly greater in dolichofacials. Brachyfacials showed smaller upper lip height compared with mesofacials, although no differences were found between those two groups in terms of lower lip height. Assessment of the correlations between soft and skeletal/dental variables evidenced vertical development of the upper and lower lips, commensurate with the vertical development of the skeleton. The vertical positioning of upper incisors significantly correlated with the same parameters related to the lips, which ensured a similar exposure level of these teeth in all groups.
Subject(s)
Humans , Male , Female , Child , Adolescent , Cephalometry , Face , Lip , OrthodonticsABSTRACT
The purpose of this study was to compare the arch width of the hyperdivergent group with that of the neutral group in Class III malocclusion based on the vertical patterns and to compare the arch width of Class III neutral group with that of normal occlusion group based on sagittal patterns. The subjects consisted of 118 pairs of study casts, divided into three groups; 37 Class III hyperdivergent group(18 males and 19 females, SN-Mn plane angle>39.5 degrees), 40 Class III neutral group(20 males and 20 females, SN-Mn plane angle: 32+/-2.5 degrees) and 41 Class I normal occlusion group(20 males and 21 females). The intercanine, interpremolar, and intermolar width of the maxillary and mandibular study casts were measured, then the ratios of dental width to basal width and mandibular width to maxillary width were obtained. Basal arch width and dental arch width were measured to obtain the pure basal arch relation in transverse plane as ruled out the transverse dental compensation. The results were as follows: 1. There were no significant differences in any ratios between Class III hyperdivergent group and Class III neutral group as different vertical pattern. 2. As the ratios of dental arch width to basal arch width between normal occlusion group and Class III neutral group were compared, the maxillary teeth flared buccally to the basal bone, and the mandibular teeth tilted lingually to the basal bone in Class III neutral group. 3. The ratios of mandibular arch width to maxillary arch width in basal arch level were significantly different in all regions. Maxillary basal arch width of Class III neutral group was narrower than that of normal occlusion group. 4. The ratios of mandibular arch width to maxillary arch width in teeth level were not significantly different between normal occlusion group and Class III neutral group. In spite of discrepancies of maxillary and mandibular basal arch width, the dental arch width of Class III malocclusion group compensated very well. At the presurgical orthodontic treatment in clinic, it would not be desirable to decompensate for compensated dental arch width too much, for obtaining an appropriate arch compatibility and good results for orthognathic surgery.