Tubérculo marginal del hueso cigomático / Marginal tubercle of zygomatic bone

El hueso cigomático, ubicado en la parte superior y lateral de la cara, es un hueso par e irregular con forma cuadrilátera o romboidal. Se describen 2 caras, 4 aristas y 4 ángulos, forma cavidades, permite la inserción muscular y aponeurótica, es parte de la arquitectura facial, distribuye las fuerzas masticatorias y permite el paso del nervio cigomático. Su margen postero-superior presenta una prominencia ósea conocida como tubérculo marginal, en el que se observa la inserción de la fascia temporal. El objetivo de este trabajo fue describir las características particulares de esta prominencia. La muestra correspondió a 30 cráneos de adultos chilenos de ambos sexos. A través de una serie de puntos óseos, se describió la presencia, ubicación, tamaño, forma, cortical y trabeculado del tejido óseo del tubérculo marginal. Para realizar las mediciones se utilizaron cámara digital, compas de precisión y cáliper digital. El análisis radiográfico requirió tomografía computarizada de alta resolución. Los resultados mostraron que el tubérculo marginal del hueso cigomático es una prominencia constante, ubicada en el tercio medio del proceso frontal del hueso y que la mayoría de los individuos mostraron una forma semilunar. Su altura fluctúa entre 3 y 4 mm, siendo más pronunciada en hombres que en mujeres. El grosor de la corteza ósea es directamente proporcional a la prominencia del tubérculo, mientras que el trabeculado esponjoso está inversamente relacionado con este último. El análisis de estos resultados parece indicar que las fuerzas biomecánicas ejercidas por la musculatura masticatoria y transmitidas por la fascia temporal, determinan la morfología externa e interna de esta prominencia y del propio hueso cigomático. Concluimos, declarando la necesidad de revisar el conocimiento anatómico a la luz de las nuevas técnicas de imagen e integración disciplinar.

The zygomatic bone, located in the upper and lateral area of the face, is an even and irregular quadrilateral or rhomboid shaped bone. It presents 2 faces, 4 margins and 4 angles. It forms cavities, allows muscular and aponeurotic insertion, is part of the facial architecture, distributes masticatory forces and allows the passage of the zygomatic nerve. Its postero-superior margin presents a bony prominence known as a marginal tubercle, in which the insertion of the temporal fascia is observed. The objective of this work was to describe the particular characteristics of this prominence. The sample corresponded to 30 skulls of Chilean adults of both sexes. Through a series of bone points, the presence, location, size, shape, cortical and trabeculate of the bone tissue of the marginal tubercle was described. A digital camera, precision compass and digital caliper were used to perform the measurements. The radiographic analysis required high-resolution computed tomography. The results showed that the marginal tubercle of the zygomatic bone is a constant prominence, located in the middle third of the frontal process of the bone and that most individuals showed a semilunar shape. Its height fluctuated between 3 and 4 mm, being more pronounced in men than in women. The thickness of the bone cortex was directly proportional to the prominence of the tuber, while the spongy trabeculate was inversely related to the latter. The analysis of these results seems to indicate that the biomechanical forces exerted by the masticatory musculature and transmitted by the temporal fascia, determine the external and internal morphology of this prominence, and of the zygomatic bone itself. In conclusion, it is recommended to review anatomical knowledge in the light of new imaging techniques and disciplinary integration.

Bizygomatic width and personality traits of the relational field / Ancho bizigomático y rasgos de personalidad del campo relacional

SUMMARY: The bizygomatic width when compared to the bigonial width (WD) has been proposed as a craniofacial marker of some social and personality traits, such us self-reliance or the ability to express emotions. However, no studies have examined the association between WD and psychopathic traits, as happens with other craniofacial variables such us the facial width-to-height ratio (fWHR). In a sample of 70 adults (male and female) we took measures of the bizygomatic and the bigonial arches. Subjects performed self-assessment tests to evaluate their self-reliance, their alexithymia and emotional expressiveness and their coldheartedness or callousunemotional. Results showed a significant relationship between WD and self-reliance, emotional expression and alexithymia, and a tendency towards significance with general psychopathic scores. Additionally, we found a modificatory effect of the variables sex and age when analyzing the influence of the WD on the Factor 3 - "Coldheartedness" of the Psychopathic Personality Inventory-Revised (PPI-R), where this effect diminished depending on the subject's sex and age. Results suggested that the WD seem to be a good marker to be taken into consideration in further research that examines craniofacial traits and personality traits of the socio-emotional field.

RESUMEN: La anchura bicigomática en comparación con la anchura bigonial (WD) se ha propuesto como marcador craneofacial de algunos rasgos sociales y de personalidad, como la independencia/gregarismo o la capacidad de expresión emocional. Sin embargo, ningún estudio ha examinado la asociación entre la WD y los rasgos psicopáticos, como ocurre con otras variables craneofaciales, como la ratio anchura / altura facial (fWHR). En una muestra de 70 adultos (hombres y mujeres) tomamos medidas de los arcos bizigomático y bigonial. Los sujetos realizaron pruebas de autoevaluación para evaluar la capacidad de incorporarse al grupo, la alexitimia y la expresividad emocional, y la frialdad o la insensibilidad emocional. Los resultados mostraron una relación significativa entre WD con independencia/gregarismo, expresión emocional y alexitimia, así como una tendencia hacia la significación con la psicopatía en general. Adicionalmente, encontramos un efecto modificador de las variables sexo y edad al analizar la influencia de la WD en el Factor 3 - "Coldheartness" del Inventario de Personalidad Psicopática-Revisado (PPI-R), donde este efecto disminuye según sexo y edad. Los resultados sugieren que el WD parece ser un buen marcador para tener en cuenta en futuras investigaciones que examinen los rasgos craneofaciales y los rasgos de personalidad del campo socioemocional.

Correlation between craniofacial growth and upper and lower body heights in subjects with Class I occlusion

ABSTRACT Objective: To correlate skeletal age, standing height, upper and lower body lengths, and selected craniofacial growth features in a sample of growing individuals, and to model craniofacial growth using multivariate regression. Methods: This was a retrospective cross-sectional study with 447 African black boys and girls, between the ages 8 and 16 years, who attended the dental clinic at one hospital. The skeletal maturational age was determined from hand-wrist radiographs using the Greulich and Pyle atlas. Craniofacial measurements representing maxillary length (Ar-ANS), mandibular length (Ar-Gn), and lower facial height (ANS-Me) were calculated from lateral cephalograms in habitual occlusion. Body lengths were clinically measured in centimeters. Results: Moderate correlations (r=0.42 to 0.68) were observed between skeletal age and the three selected craniofacial measurements. Statistically significant correlations were also found between the craniofacial measurements and both upper and lower body lengths. The mandibular length had a stronger correlation with the upper body length than with the lower body length. Multiple regression analyses to determine maxillary and mandibular lengths suggested that sex, upper and lower body lengths might be used to determine maxillary length; while skeletal age, upper and lower body lengths might help determine mandibular length. Conclusions: Based on the relatively strong correlation between upper body length and mandibular length, further research in this area may warrant its use as a predictor for mandibular growth modification timing.

RESUMO Objetivo: correlacionar a idade esquelética, a estatura, as alturas corporais superior e inferior, e algumas características específicas do crescimento craniofacial, em uma amostra de indivíduos em crescimento, e delinear o crescimento craniofacial usando regressão multivariada. Métodos: esse estudo transversal retrospectivo foi feito com 447 meninos e meninas negros africanos, com idades entre 8 e 16 anos, atendidos na clínica odontológica de um hospital. A maturação esquelética, em anos, foi determinada a partir de radiografias de mão e punho, usando o atlas de Greulich e Pyle. As medidas craniofaciais representando o comprimento maxilar (Ar-ENA), o comprimento mandibular (Ar-Gn) e a altura facial anterior inferior (ENA-Me) foram calculadas a partir de cefalogramas laterais em oclusão habitual. Os comprimentos corporais foram medidos clinicamente, em centímetros. Resultados: correlações moderadas (r = 0,42 a 0,68) foram observadas entre a idade esquelética e as três medidas craniofaciais selecionadas. Também foram encontradas correlações estatisticamente significativas entre as medidas craniofaciais e as alturas corporais superior e inferior. O comprimento mandibular teve uma correlação mais forte com a altura corporal superior do que com a inferior. As análises de regressão múltipla para determinar os comprimentos maxilar e mandibular sugeriram que o sexo e as alturas corporais superior e inferior podem ser usados para determinar o comprimento maxilar, enquanto a idade esquelética e as alturas corporais superior e inferior podem ajudar a determinar o comprimento mandibular. Conclusões: com base na correlação relativamente forte entre a altura corporal superior e comprimento mandibular, pesquisas adicionais nessa área poderiam justificar seu uso como indicador para o período de modificação do crescimento mandibular.

Breathing mode influence on craniofacial development and head posture / Influência do modo de respiração sobre o desenvolvimento craniofacial e a postura da cabeça

Abstract Objective The incidence of abnormal breathing and its consequences on craniofacial development is increasing, and is not limited to children with adenoid faces. The objective of this study was to evaluate the cephalometric differences in craniofacial structures and head posture between nasal breathing and oral breathing children and teenagers with a normal facial growth pattern. Method Ninety-eight 7-16 year-old patients with a normal facial growth pattern were clinically and radiographically evaluated. They were classified as either nasal breathing or oral breathing patients according to the predominant mode of breathing through clinical and historical evaluation, and breathing respiratory rate predomination as quantified by an airflow sensor. They were divided in two age groups (G1: 7-9) (G2: 10-16) to account for normal age-related facial growth. Results Oral breathing children (8.0 ± 0.7 years) showed less nasopharyngeal cross-sectional dimension (MPP) (p = 0.030), whereas other structures were similar to their nasal breathing counterparts (7.6 ± 0.9 years). However, oral breathing teenagers (12.3 ± 2.0 years) exhibited a greater palate length (ANS-PNS) (p = 0.049), a higher vertical dimension in the lower anterior face (Xi-ANS-Pm) (p = 0.015), and a lower position of the hyoid bone with respect to the mandibular plane (H-MP) (p = 0.017) than their nasal breathing counterparts (12.5 ± 1.9 years). No statistically significant differences were found in head posture. Conclusion Even in individuals with a normal facial growth pattern, when compared with nasal breathing individuals, oral breathing children present differences in airway dimensions. Among adolescents, these dissimilarities include structures in the facial development and hyoid bone position.

Resumo Objetivo A incidência da respiração anormal e de suas consequências no desenvolvimento craniofacial aumenta e não é limitada a crianças com fácies adenoideanas. O objetivo deste estudo foi avaliar as diferenças cefalométricas nas estruturas craniofaciais e na postura da cabeça entre crianças e adolescentes com respiração nasal e respiração bucal com padrão de crescimento facial normal. Método 98 pacientes com idades entre 7-16 anos com padrão de crescimento facial normal foram avaliados de forma clínica e radiológica. Eles foram classificados como pacientes com respiração nasal ou respiração bucal de acordo com a predominância do modo de respiração por meio da avaliação clínica e histórica e da predominância da frequência respiratória conforme qualificado por um sensor de fluxo de ar. Os pacientes foram divididos em duas faixas etárias (G1: 7 a 9) (G2: 10 a 16) para contabilizar o crescimento normal facial relacionado à idade. Resultados As crianças com respiração bucal (8,0 ± 0,7 anos) mostraram menor dimensão transversal nasofaríngea (MPP) (p = 0,030), ao passo que outras estruturas foram semelhantes a seus pares com respiração nasal (7,6 ± 0,9 anos). Contudo, os adolescentes com respiração bucal (12,3 ± 2,0 anos) mostraram maior comprimento do palato (espinha nasal anterior-espinha nasal posterior [ENA-ENP]) (p = 0,049), maior dimensão vertical na menor face anterior (Xi-ENA-Pm) (p = 0,015) e menor posição do osso hioide a respeito do plano mandibular (H-PM) (p = 0,017) do que seus pares com respiração nasal (12,5 ± 1,9 anos). Não foram constatadas diferenças estatisticamente significativas na postura da cabeça. Conclusão Mesmo em indivíduos com padrão de crescimento facial normal, em comparação com indivíduos com respiração nasal, as crianças com respiração bucal apresentam diferenças nas dimensões das vias aéreas. Entre os adolescentes, essas dissimilaridades incluem estruturas no desenvolvimento facial e na posição do osso hioide.

Diagnostic performance of various cephalometric parameters for the assessment of vertical growth pattern

ABSTRACT Introduction: Multiple cephalometric analyses are used to diagnose vertical skeletal facial discrepancy. A multitude of times, these parameters show conflicting results, and a specific diagnosis is hard to reach. Objective: Hence, this study aimed to identify the skeletal analysis that performs best for the identification of vertical skeletal pattern in borderline cases. Methods: The sample consisted of 161 subjects (71 males and 90 females; mean age = 23.6 ± 4.6 years). Y-axis, Sella-Nasion to mandibular plane angle (SN.MP), maxillary plane to mandibular plane angle (MMA), Sella-Nasion to Gonion-Gnathion angle (SN.GoGn), Frankfort to mandibular plane angle (FMA), R-angle and facial height ratio (LAFH.TAFH) were used to evaluate vertical growth pattern on lateral cephalograms. The subjects were divided into three groups (hypodivergent, normodivergent and hyperdivergent groups), as indicated by the diagnostic results of the majority of parameters. Kappa statistics was applied to compare the diagnostic accuracy of various analyses. To further validate the results, sensitivity and positive predictive values (PPV) for each parameter were also calculated. Results: SN.GoGn showed a substantial interclass agreement (k = 0.850). In the hypodivergent group, MMA showed the highest sensitivity (0.934), whereas FMA showed the highest PPV (0.964). In the normodivergent group, FMA showed the highest sensitivity (0.909) and SN.GoGn had the highest PPV (0.903). SN.GoGn showed the highest sensitivity (0.980) and PPV (0.87) in the hyperdivergent group. Conclusions: SN.GoGn and FMA were found to be the most reliable indicators, whereas LAFH.TAFH is the least reliable indicator in assessing facial vertical growth pattern. Hence, the cephalometric analyses may be limited to fewer analyses of higher diagnostic performance.

RESUMO Introdução: diferentes análises cefalométricas são utilizadas para se diagnosticar a discrepância esquelética vertical da face. Muitas vezes, essas análises revelam resultados conflitantes, tornado complicado obter um diagnóstico preciso. Objetivo: o objetivo do presente estudo foi identificar a melhor análise esquelética para identificação do padrão esquelético vertical em casos limítrofes. Métodos: a amostra consistiu em 161 indivíduos (71 homens e 90 mulheres, com idade média de 23,6 ± 4,6 anos). Para avaliar o padrão de crescimento vertical em telerradiografias de perfil, foram utilizados: o eixo Y, o ângulo formado entre a linha sela-násio e o plano mandibular (SN.MP), ângulo formado pelos planos maxilar e mandibular (MMA), ângulo formado pelas linhas sela-násio e gônio-gnátio (SN.GoGn), ângulo formado pelo plano de Frankfort e o plano mandibular (FMA), o ângulo R, e a proporção de altura facial (AFAI.AFAT). Os indivíduos foram divididos em três grupos (hipodivergente, neutro e hiperdivergente), em acordo com os resultados diagnósticos da maioria dessas medidas. A análise estatística Kappa foi empregada para comparar a precisão diagnóstica das diferentes análises. Para uma validação adicional dos resultados, também foram calculados, para cada medida, a sensibilidade e os valores preditivos positivos (VPP). Resultados: o SN.GoGn apresentou um valor alto de concordância interclasses (k = 0,850). No grupo hipodivergente, o MMA apresentou a maior sensibilidade (0,934), enquanto o FMA apresentou o VPP mais alto (0,964). No grupo neutro, o FMA apresentou a maior sensibilidade (0,909), enquanto o SN.GoGn apresentou o VPP mais alto (0,903). No grupo hiperdivergente, o SN.GoGn apresentou a maior sensibilidade (0,980) e o valor mais alto de VPP (0,87). Conclusões: constatou-se que, para avaliação do padrão de crescimento facial vertical, o SN.GoGn e o FMA foram os indicadores mais confiáveis, enquanto o AFAI.AFAT foi o indicador menos confiável. Sendo assim, a análise cefalométrica pode se limitar às análises com maior desempenho diagnóstico.

Morphological and radiographic studies on the skull of Indian blackbuck (Antilope cervicapra) / Estudios morfológicos y radiográficos del craneo del antilope negro (Antilope cervicapra) de la India

The phenotypic appearance of the head of animal species depends strongly on the shape of the skull. The present study has been carried out on morphological and radiographic characteristics of skull of the Indian Blackbuck. The skull comprised of cranial and facial bones. The cranial bones included occipital, sphenoid, ethmoid, interparietal, parietal, frontal and temporal. The occipital was a single bone surrounding the foramen magnum. The sphenoid was a single bone and situated between the occipital posteriorly and the ethmoid anteriorly. The ethmoid was a single bone laid ventral to the frontal and nasal bones. The interparietal was a small quadrilateral bone wedged in between the parietal anterio-laterally and the supraoccipital posteriorly. The parietal was a paired bone. The frontal bone was a paired and formed the roof of the cranial cavity. The occipital bone was roughly pentagonal in shape. The temporal was a paired bone and formed the part of the lateral wall of the cranial cavity. The facial bones included maxilla, premaxilla, palatine, pterygoid, nasal, lacrimal, zygomatic, vomer, turbinates, mandible and hyoid. The maxilla was a roughly triangular flat paired bone. The paired incisive bones were placed on the lower part of the face. The palatine was a paired bone. The pterygoid was a paired, small, slightly curved, flat plate of bone and situated on either side of the posterior nares. The nasal was a paired bone and formed the roof of nasal cavity. The lacrimal was a paired bone and located on the anterior margin of the orbit. The zygomatic was a paired bone and irregularly triangular in outline. The vomer was a single medial bone. The turbinate bone was delicate, scroll-like, complex bony plates, placed vertically in the nasal cavity, being attached to the lateral walls. The mandible was a paired bone. The hyoid bone was situated between the vertical parts of the rami of the mandible.

La apariencia fenotípica de la cabeza de las especies animales depende principalmente de la forma del cráneo. El objetivo fue estudiar las características morfológicas y radiográficas del cráneo del antílope negro de la India. El cráneo consta de los huesos craneales y faciales. Los huesos craneales incluyen occipital, esfenoides, etmoides, interparietal, parietal, frontal y temporal. El occipital es un hueso singular que circunda el foramen occipital. El esfenoides se sitúa entre el occipital posterior y el etmoidal anterior. El etmoidal es un hueso singular situado de forma ventral a los huesos frontal y nasal. El interparietal es un pequeño hueso cuadrilátero ubicado entre el parietal anterolateral y posterior del supraoccipital. El parietal es un hueso bilateral. El hueso bilateral frontal cubría la cavidad craneal. El hueso occipital era más o menos de forma pentagonal. El hueso temporal formaba parte de la pared lateral de la cavidad craneal. Los huesos faciales incluyen el hueso maxilar, premaxila, palatina, pterigoideo, nasal, lacrimal, cigomático, vómer, conchas nasales, mandíbula y el hueso hioides. El maxilar se presentó como un hueso bilateral plano más o menos triangular. Los huesos incisivos estaban colocados en la parte inferior de la cara. El hueso palatino es un hueso bilateral. El hueso pterigoideo bilateral, plano pequeño, de hueso y situado a ambos lados de las fosas posteriores. El hueso nasal en ambos lados formaba la cubierta de la cavidad nasal. El lagrimal es un hueso asociado y situado en el margen anterior de la órbita. El cigomático es un hueso irregular de contorno triangular. El vómer esun solo hueso medial. La concha nasal delgada con forma de espiral, placas óseas complejas y colocadas verticalmente en la cavidad nasal unidas a las paredes laterales. La mandíbula es un hueso bilateral. El hueso hioides estaba situado entre las partes verticales de las ramas de la mandíbula.

Estudo cefalométrico comparativo da análise de Ricketts para jovens brasileiros leucodermas, melanodermas e mestiços (feodermas) com oclusão normal / Cephalometric patterns comparison of Ricketts cephalometric analysis in white, black and afrocaucasian young Brazilian descents with normal occlusion

Os diferentes grupos étnicos podem apresentar características faciais próprias e específicas que devem ser consideradas durante o tratamento ortodôntico. Sendo assim, o estudo e a padronização de variáveis cefalométricas específicas para cada etnia devem ser estabelecidos para facilitar o diagnóstico e o planejamento de tratamento entre as diferentes etnias. O objetivo do presente trabalho foi obter e comparar os valores médios de normalidade para as variáveis cefalométricas da análise de Ricketts em leucodermas, melanodermas e mestiços (feodermas) brasileiros, e avaliar o dimorfismo entre os sexos. A amostra foi constituída de 146 telerradiografias em norma lateral de indivíduos jovens brasileiros não tratados ortodonticamente, apresentando oclusão normal, divididos em três grupos: grupo 1 – 50 indivíduos leucodermas; grupo 2 – 56 indivíduos melanodermas; e grupo 3 – 40 indivíduos feodermas. A partir das telerradiografias foram obtidos os traçados cefalométricos, utilizando-se o software Dolphin Imaging 11.5 para avaliação das grandezas esqueléticas e dentoalveolares. Foram realizados os testes estatísticos: Anova a dois critérios e Ancova. Os jovens brasileiros melanodermas apresentaram a maior protrusão maxilar, incisivos mais vestibularizados, lábios mais proeminentes e maior convexidade facial em relação aos leucodermas, com diferenças estatisticamente significantes entre os três grupos. O grupo feoderma apresentou valores intermediários entre as amostras estudadas e não foi observado dimorfismo entre os sexos. Dessa maneira, afirma-se que é evidente a importância de se estabelecer padrões cefalométricos específicos para a análise de Ricketts em diferentes etnias, uma vez que os mesmos auxiliam no diagnóstico e na escolha da melhor terapia ortodôntica...

The different ethnic groups can present specific facial characteristics that would be considered during orthodontic treatment. Therefore, the study and padronizing of specific cephalometrics partners to any ethnics should be established to facilitate the diagnosis and the treatment plan between the different ethnics and standards of miscegenation. This study objected obtain and compare the mean normal values for skeletal Cephalometric variables for Ricketts analysis in caucasian, black and afrocaucasian young Brazilian descents with normal occlusion, in addition to verifying ethnic and sexual dimorphism. The sample consisted of 146 lateral cephalograms of untreated young Brazilian subjects, with normal occlusion, that were divided into three groups: group 1 – 50 caucasian subjects (25 of each gender) with an average age of 13.59 years; group 2 – 40 afro caucasian subjects (20 of each gender) with an average age of 13.08 years and group 3 – 56 black subjects (28 of each gender) with an average age of 13.40 years. Cephalometric tracings were performed, using Dolphin Imaging 11.5 program, to obtain the skeletal and dental variables. Statistical test was performed: two-way Anova and Ancova. The present study found a bimaxillary skeletal, dentoalveolar and soft tissue protrusion in black Brazilian subjects compared to white Brazilian subjects. Afrocaucasian showed intermediate values. It was not observed the presence of sexual dimorphism. It becomes evident the importance of establishing specific Cephalometric standards for Ricketts analysis in mixed ethnics, since they help to diagnose and choose the best orthodontic therapy...

Características cefalométricas en jóvenes con oclusión normal y perfil armónico en población chilena / Cephalometric characteristics in young individuals with normal occlusion and harmonic profiles in Chilean population

Las normas cefalométricas facilitan el diagnóstico y planificación terapéutica en ortodoncia, siendo estas obtenidas primariamente de población caucásica adulta. Dichas normas variarían entre etnias siendo escasa la información respecto de las de población chilena en crecimiento. Se obtuvo una muestra de 48 telerradiografías de perfil de individuos en crecimiento (23 mujeres y 25 hombres) con oclusión normal y perfil armónico de los registros de la Universidad de los Andes tomados entre Enero y Julio del año 2012, incluyendo 414 individuos. Las radiografías fueron analizadas cefalométricamente, obteniéndose valores de parámetros verticales y sagitales en tejidos blandos y duros. Se obtuvieron estadísticas descriptivas, y las diferencias entre sexos se analizaron con la prueba t de Student. Al compararse con normas caucásicas, los sujetos de la muestra tienen una tendencia a la Clase II esqueletal, por una mandíbula retrognática, eje facial abierto, y biprotrusión incisiva. También mostraron labios superiores e inferiores protruidos respecto de las normas caucásicas. Existen diferencias entre las medidas cefalométricas de la muestra y las de las normas internacionales, manifestadas a nivel mandibular, dentario y labial.

Cephalometric norms facilitate diagnosis and treatment planning in orthodontics. These are obtained primarily from adult Caucasian population. It has been suggested that these norms may vary between different ethnic groups, and there is still little information about Chilean cephalometric norms in growing individuals. A sample of 48 lateral radiographs was obtained from growing individuals (23 women and 25 men) with normal occlusion and harmonious profile taken between January and July 2012 at Universidad de los Andes, including 414 individuals. Radiographs were analyzed cephalometrically, obtaining soft and hard tissue values for vertical and sagittal parameters. Descriptive statistics were obtained, and differences between sexes were analyzed with student´s t-test. When compared to Caucasian standards, subjects in the sample present with a Class II skeletal tendency due to a retrognathic mandible, an open facial axis, with upper and lower incisor protrusion. They also showed more protruded upper and lower lips with respect to Caucasian standards. There are differences between the cephalometric measurements observed on the individuals of the sample compared to international standards, which are evidenced at mandibular, dental and labial structures.

Analysis of Age-Related Changes in Asian Facial Skeletons Using 3D Vector Mathematics on Picture Archiving and Communication System Computed Tomography

PURPOSE: There are marked differences in facial skeletal characteristics between Asian and Caucasian. However, ethnic differences in age-related facial skeletal changes have not yet been fully established. The aims of this study were to evaluate age-related changes in Asian midfacial skeletons and to explore ethnic differences in facial skeletal structures with aging between Caucasian and Asian. MATERIALS AND METHODS: The study included 108 men (aged 20-79 years) and 115 women (aged 20-81 years). Axial CT images with a gantry tilt angle of 0 were analyzed. We measured three-dimensional (3D) coordinates at each point with a pixel lens cursor in a picture archiving and communication system (PACS), and angles and widths between the points were calculated using 3D vector mathematics. We analyzed angular changes in 4 bony regions, including the glabellar, orbital, maxillary, and pyriform aperture regions, and changes in the orbital aperture width (distance from the posterior lacrimal crest to the frontozygomatic suture) and the pyriform width (between both upper margins of the pyriform aperture). RESULTS: All 4 midfacial angles in females and glabellar and maxillary angles in males showed statistically significant decreases with aging. On the other hand, the orbital and pyriform widths did not show statistically significant changes with aging. CONCLUSION: The results of this study suggest that Asian midfacial skeletons may change continuously throughout life, and that there may be significant differences in the midfacial skeleton between both sexes and between ethnic groups.

Brachycephalic, dolichocephalic and mesocephalic: is it appropriate to describe the face using skull patterns?

The use of a standardized terminology in the medical sciences is essential for both clinical practice and scientific research. In addition to facilitating communication between professionals, it enhances the reliability of comparisons made between studies from different areas, thereby contributing to a higher level of scientific evidence. Examples of attempts made to standardize the terminology in other areas dedicated to the study of craniofacial morphology can be found in the literature. On the other hand, one can find in the orthodontic literature a variety of terms that render the consensus and communication between orthodontists and other researchers even more problematic. As an example, one could cite the use of the terms brachyfacial, mesofacial and dolichofacial, which form part of a cranial index terminology used to describe facial types. Thus, a reflection on the origin and differences of the terms used to describe the human facial phenotype may pave the way toward a consensus regarding the meaning that best represents the craniofacial patterns.

A padronização da nomenclatura utilizada nas ciências médicas é fundamental tanto para a prática clínica quanto para a pesquisa científica. Além de facilitar a comunicação entre os profissionais, aumenta a confiabilidade da comparação entre trabalhos de diferentes áreas, favorecendo um melhor nível de evidência científica. Exemplos de esforços, em áreas também voltadas ao estudo da morfologia craniofacial, no sentido de uniformização da terminologia podem ser encontrados na literatura médica. Por outro lado, observa-se na literatura ortodôntica uma diversidade de termos que torna mais difícil o consenso e a comunicação entre ortodontistas e demais pesquisadores. Como exemplo, pode-se citar o uso dos termos braquifacial, mesofacial e dolicofacial, terminologia relativa ao índice craniano utilizada para descrever o tipo facial. Sendo assim, a reflexão sobre a origem e diferenças dos termos utilizados para descrever o fenótipo facial humano pode ser útil ao consenso do significado que melhor representa o padrão craniofacial.

Correlation between transverse and vertical measurements in Brazilian growing patients, evaluated by Ricketts-Faltin frontal analysis

INTRODUCTION: Currently in orthodontic diagnosis, besides the lateral cephalometric analysis which evaluates the anteroposterior and vertical direction, the frontal analysis may be added, leading us to another important dimension in space: the transverse dimension. OBJECTIVE: Few longitudinal samples with the frontal radiograph were published, so this cephalometric study was designed to correlate the transversal and vertical measures by Ricketts-Faltin frontal analysis into two radiographic times. METHODS: The sample consisted of 45 Brazilian children, 25 girls and 20 boys, all presenting mixed dentition, with balanced facial aesthetics and no previous orthodontic/orthopedic treatment. The initial average age (T1) was 7.7 years and the final (T2) 13.3 years. The measurements evaluated were: FTD, MxTD, NTD, LITD, MdTD (transversal), OVD and TVD (vertical). RESULTS: All transversal measures were positively correlated with a medium or high correlation with each other and the vertical measurements; only LITD presented a low correlation with these measurements. CONCLUSION: It was concluded that the face has interdependent regions and that this feature remains with growth.

INTRODUÇÃO: atualmente no diagnóstico ortodôntico, além da análise cefalométrica lateral - que avalia os sentidos anteroposterior e vertical -, deve-se acrescentar a análise no sentido frontal, a qual propicia outra dimensão importante no espaço, a transversal. OBJETIVO: poucas são as amostras longitudinais publicadas utilizando telerradiografias frontais; portanto, o presente estudo cefalométrico teve o intuito de correlacionar as medidas transversais e verticais por meio da análise frontal de Ricketts-Faltin, em dois tempos radiográficos. MÉTODOS: a amostra constou de 45 crianças brasileiras, sendo 25 meninas e 20 meninos, todos apresentando dentição mista, com perfil harmonioso e sem nunca terem sido tratadas ortodonticamente e/ou ortopedicamente. A idade média inicial (T1) foi de 7,7 anos e a final (T2) de 13,3 anos. As medidas avaliadas foram: DTF, DTMx, DTN, DTII e DTMd (transversais); DVO e DVT (verticais). RESULTADOS: todas as medidas transversais estavam correlacionadas positivamente, em grau médio ou forte, entre si e com as medidas verticais; somente DTII estava correlacionada em grau fraco com essas medidas. CONCLUSÃO: concluiu-se que a face possui regiões interdependentes, e assim mantém-se mesmo com o crescimento.

Study of landmarks in dried skulls in a Brazil population

Craniofacial bone variations, considered to be radiological landmarks, have been studied since the beginningof the century using dried skulls and cadavers. These pitfalls are important bone landmarks used in theplanning and execution of anesthetic and surgical procedures. The present study analyzed craniofacial bonevariations in dried skulls in terms of gender and laterality. Supraorbital foramen (SOF), mastoid foramen(MF), parietal foramen (PF), accessory oval foramen (aOF), anterior ethmoidal foramen (AEF), intermediateethmoidal foramen (iEF), posterior ethmoidal foramen (PEF), precondylar tubercle (PCT), metopism andsutural bones were assessed in male (n=20) and female (n=11) dried skulls by direct observation and using aMitutoyo caliper. No statistically significant differences were observed between genders as to SOF distancesto the medial nasal prominence and to superior orbital ridge, in both sides of skulls. The same was observedfor distances between FP and sagittal line and between FP and lambdoid suture. No multiple foramina weredetected. aOF was observed in 80.96% of skulls. Right aEF, iEF and PEF prevailed in female skulls. PCT wereseen in 35.5% of female skulls and in 64.5% of male skulls. MF occurrence was higher in right male skulls,and multiple foramina were present in 60% of male skulls (both sides), and in 36.4% of female skulls (bothsides). Only one skull presented sutural bone. No metopism was observed. The identification and recordingof craniofacial variations is important in the preparation of anesthetic blocks in surgical procedures and in theevaluation of regional neurovascular anatomy, to avoid misinterpretations in planning. This study confirms theexistence of significant morphological variations in terms of gender and side in a given population.

Reproducción facial experimental / Experimental facial reproduction

Este trabajo describe la realización de una reproducción facial experimental en el marco de un curso práctico en la Facultad de Odontología de la Universidad Católica del Uruguay. Dentro de los muchos objetivos se destacan: el objetivo didáctico y académico, el testeo del método empleado y la pericia de los operadores.Para la realización de la misma se cuenta con una cabeza ósea que tenía sus partes blandas momificadas y a la que se le tomaron registrosfotográficos previos para la posterior comparación. Una vez limpio el cráneo se procede a la realización de la reproducción facial empleando una técnica de modelado de las partes blandas, usando topes de goma según medidas obtenidas en las tablas de Stewart y material plástico para el relleno de las mismas. Es de destacar que los operadores no tenían experiencia previa ni conocían el material fotográfico testigo. Una vez finalizada la misma se compara con la fotografía del cadáver y se constata un aceptable parecido entre ambos.Esta reproducción facial experimental pone en manifiesto, una vez más, la utilidad que puede tener esta técnica de acercamiento a una identificación positiva y que la misma puede y debe ser utilizada cuando han fracasado todas las otras técnicas de cetreza conocidas.

This paper describes the realization of experimental facial reproduction within a workshop at the School of Dentistry, Catholic University of Uruguay. Among the many objectives are: the learning objective and academic testing of the method used and the skill of the operators. For the realization of the same will have a bone head was mummified soft parts and it were taken prior photographic records for subsequent comparison. After cleaning the skull comes to performing facial reproduction using a modeling technique of soft tissues, using rubber stoppers as measurements obtained in Stewart tables and plastic to fill them. It is noteworthy that the operators had no previous experience or witness knew the photographic material. Once it is compared with the photograph of the corpse and finds an acceptableresemblance between the two.This experimental facial reproduction starts demonstrated once again the usefulness of this technique can have a positive identification approach and that it can and should be used when they have failed all other known certainly techniques.

Determination of craniofacial relation among the subethnic Indian population: A modified approach - (Sagittal relation).

Aim : To measure the linear cephalometric dimensions of anterior and posterior segments of the craniofacial complex sagittally, to establish ratios between different linear dimensions of sagittal segments and check for dimensional balance among the various segments in subjects with normal occlusion, pleasing profile and facial harmony. Setting and Sample Population : Department of Orthodontics, Saveetha University. Lateral cephalograms of 120 subjects of both sexes in the age group of 17-28 years with normal occlusion belonging to Chennai, India Materials and Methods : Linear dimensions of anterior and posterior segments of the craniofacial complex were measured sagittally with the posterior maxillary plane as a key reference plane. Ratios were established between the various parameters in the anterior and posterior region. Results : A ratio of 1:1 was found to exist between the individual and aggregate sagittal segments of the craniofacial complex in both sexes. There was a statistically significant sexual dimorphism in the aggregate lengths(P=0.028,P=0.005).However, the ratio between the anterior cranial floor and effective maxillary length was 2:3 and 5:8 and that between anterior cranial floor to effective mandibular length was 5:8 and 3:5 in females and males respectively. The difference in the above values was not statistically significant. Conclusion : A dimensional balance was found to exist between the maxilla and mandible both at the dentoalveolar and skeletal level with a ratio of 1:1. There was also a dimensional balance between the posterior cranial floor and ramus width. However, there was no architectural balance between the anterior cranial floor and maxilla and mandible.

Análise histológica e histomorfométrica da osseointegração de implantes de titânio inseridos na tíbia de ratos Wistar induzidos por ácido zoledrônico e dexametasona / Histologic and histomorphometric analysis of the osseointegration of endosseous implants placed on the tibiae of Wistar rats treated with zoledronic acid and dexamethasone

A terapia com bisfosfonatos tem sido frequentemente empregada no tratamento de doenças metabólicas do osso e neoplasias malignas. O objetivo deste estudo foi avaliar através de análise histológica e histomorfométrica em cortes não descalcificados, a influência dos bisfosfonatos nitrogenados endovenosos associados ou não a dexametasona sobre a osseointegração de implantes instalados em tíbias de 27 ratos Wistar. Ácido zoledrônico e dexametasona foram administrados por via subcutânea nos animais dos grupos experimentais. Os animais foram acompanhados por 7, 14 e 28 dias. Nossos resultados mostraram que não houve falha na osseointegração em nenhum animal avaliado e que não foram observadas diferenças estatisticamente significantes entre os 3 grupos com relação à quantidade de contato entre osso e implante e presença de osso em áreas pré determinadas, nos tempos observados. No entanto nossas observações histológicas revelaram que nos animais tratados com bisfosfonatos associados ou não com dexametasona, aos 14 e 28 dias após a colocação do implante não ocorreu o fenômeno de remodelação da cortical óssea, ao contrário do grupo controle. Concluímos que a terapia com bisfosfonatos associada ou não com dexametasona não impediu a osseointegração do implante com o osso mas inibiu severamente a remodelação da cortical óssea pré existente.

Bisphosphonate therapy has been often employed in the treatment of metabolic bone diseases and malignancies. The aim of this study was to evaluate through histological and histomorphometric analysis the influence of intravenous nitrogen-containing bisphosphonates alone or combined with dexamethasone on the osseointegration of implants placed in the tibia of 27 male Wistar rats in non decalcified samples. Zoledronic acid and dexamethasone were administered through sub cutaneous injections. The animals were followed through 7, 14, and 28 days. Our results showed that there was no failure in osseointegration in any animal, and that there were no statistically significant differences among the 3 groups regarding the amount of bone-implant contact and peri-implant bone density in predetermined areas. However our histological observations revealed that animals treated with bisphosphonates, associated or not with dexamethasone, at 14 and 28 days after implant placement has not occurred the phenomenon of cortical bone remodeling, unlike control group. We conclude that bisphosphonate therapy associated or not with dexamethasone did not prevent osseointegration of the implants but severely inhibited the remodeling of pre-existing cortical bone.

Estudo comparativo cefalométrico dos padrões dentofaciais de indivíduos portadores de oclusão normal e de más oclusões de Angle / Comparative cephalometric study of dentofacial patterns of individuals with normal occlusion and Angle malocclusions

OBJETIVO: avaliar os padrões dentofaciais de pacientes portadores de oclusão normal e más oclusões de Angle quanto a possíveis diferenças entre as grandezas estudadas, em relação ao sexo, dentro de cada grupo e entre os grupos. MÉTODOS: a amostra constou de 200 telerradiografias cefalométricas laterais obtidas de jovens brasileiros, de ambos os sexos, na faixa etária de 11 anos e 2 meses a 19 anos e 10 meses, apresentando dentição permanente. O material foi dividido, quanto ao tipo de oclusão, em cinco grupos: um de pacientes portadores de oclusão normal, e quatro de pacientes portadores de más oclusões de Angle, sendo cada grupo dividido igualmente quanto ao sexo. Foram avaliadas grandezas cefalométricas angulares e lineares. RESULTADOS: na grande maioria das grandezas, os sexos masculino e feminino não diferiram; entre os grupos, a posição da maxila não mostrou diferença significativa, o retrognatismo mandibular foi marcante nos grupos de Classe II divisões 1ª e 2ª e foram observados alguns desequilíbrios verticais com diferenças significativas; o padrão foi hipodivergente para os grupos de oclusão normal e Classe II, divisão 2ª, e neutro para os grupos de Classe I; Classe II, divisão 1ª; e Classe III; a compensação dentoalveolar foi evidente nos grupos de Classe III e de Classe II, divisão 2ª; o grupo de oclusão normal apresentou perfil mais convexo que os padrões americanos. CONCLUSÃO: foi possível configurar, de forma geral, algumas características da morfologia facial para alguns tipos de más oclusões. Entretanto, existe a necessidade de avaliar a face individualmente, pois algumas características permeiam entre os diferentes tipos de oclusão.

OBJECTIVE: To evaluate dentofacial patterns of patients with normal occlusion and Angle malocclusions, examining potential differences between specific cephalometric measures as they relate to gender, both intra- and intergroup.METHODS: The sample consisted of 200 lateral cephalometric radiographs obtained from young Brazilians of both genders, aged between 11 years and 2 months and 19 years and 10 months, with permanent dentition. The material was divided according to the type of occlusion into five groups: One group consisted of patients with normal occlusion and four groups of patients with Angle malocclusions, and each group was also divided by gender. Angular and linear cephalometric measures were evaluated.RESULTS: Genders did not differ in most measures. Position of the maxilla showed no significant differences between groups. Mandibular retrognathia was remarkable in groups with Class II, Divisions 1 and 2. Vertical imbalances were observed with some significant differences. The pattern was found to be hypodivergent for groups with normal occlusion and Class II, Division 2, and neutral for groups with Class I; Class II, Division 1 and Class III. Dentoalveolar compensation was evident in groups with Class III and Class II, Division 2. Finally, the normal occlusion group profile was more convex than the patterns found in the US population.CONCLUSIONS: In general, some features of facial morphology were associated with certain types of malocclusion. However, individual assessment of each face is still necessary as some of the features are shared across different types of occlusion.

Craniofacial anthropometry in a young Nigerian population: the canthal distances / Antropometría craneofacial en una población joven de Nigeria: distancia cantal

The measurement of craniofacial parameters have clinical, forensic and anthropologic significance. Local data on inner canthal and outer canthal distances and the canthal index may reveal the pattern of differential growth in craniofacial features resulting from factors such as sex, diet and genetic distinctions. In the present study, we provide normative data on canthal distances in a Nigerian population which has not been studied previously, utilizing a study design which optimises the effect of age and minimise bias and confounding than previous studies in Nigerian groups. The mean inner canthal distance was 1.85 +/-0.30cm and 2.07 +/- 0.29cm (males vs. females, p= 0.000); mean outer canthal distance, 10.39 +/- 0.56cm and 10.40 +/- 0.98cm (males vs. female, p= 0.899). The results were found to be considerably lower than what has been reported among Nigerian groups.

La medición de parámetros craneofaciales tiene importancia clínica, forense y antropológica. Los datos locales sobre la distancia cantal interna y cantal externa y el índice cantal puede revelar el patrón de crecimiento diferencial en las características craneofaciales como resultado de factores como el sexo, la dieta y las diferencias genéticas. En el presente estudio, se proporcionan datos normativos sobre la distancia cantal en una población de Nigeria que no ha sido estudiada previamente, utilizando un diseño de estudio que optimiza el efecto de la edad, como también minimiza el sesgo y la confusión de estudios anteriores en los grupos de Nigeria. La media de distancia cantal interna fue de 1,85 +/- 0,30cm y 2,07 +/- 0,29cm (hombres v/s mujeres, p = 0,000), mientras que la media de distancia cantal externa fue 10,39 +/- 0,56cm y 10,40 +/- 0,98cm (hombres v/s mujeres, p = 0,899). Los resultados de este estudio son considerablemente más bajos que lo que se han reportado previamente para los grupos nigerianos.

Frontal sinus size on facial plain radiographs

Introduction: Plain radiographs are still routinely used for diagnosis in dentistry. They allow the assessmentof anatomical structures and their variations, and the detection of abnormalities in the region assessed. Theaim of this research was to determine the width and height distances of the frontal sinus on posteroanteriorskull view of Brazilian subjects. Materials and methods: The sample was composed of 158 posteroanteriorfacial radiographs (Caldwell projection). It was measured the height and width of the frontal sinus, both sides,under a standardized protocol, using rules and a viewer box. The relationship between frontal sinus size andside of the face, and size and age were evaluated. Results: Thirteen radiographs were excluded (six of unilateralfrontal sinus, two agenesies, and five showing totally individualized chambers). The final sample studied was of145 subjects. The mean values obtained were a 68 mm for latero-lateral and 39 mm for superoinferior distances.In 39.3% cases both sides were approximately equal or had the left chamber larger than the right one. Therewas a significant correlation between width and height of frontal sinus (Spearman coefficient), however therewas no significant difference among the age groups studied (Kruskal-Wallis, p > 0,05). Conclusion: There is agreat anatomical variety of frontal sinus in this population. The left cavity of frontal sinus is larger or equal tothe right one and the age group differences was not significant regarding the size of the frontal sinus.

Craniofacial characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion

OBJECTIVE: The objective of this study was to compare the skeletal, dental and soft tissue characteristics of Caucasian and Afro-Caucasian Brazilian subjects with normal occlusion and to evaluate sexual dimorphism within the groups. MATERIAL AND METHODS: The sample comprised lateral cephalograms of untreated normal occlusion subjects, divided into 2 groups. Group 1 included 40 Caucasian subjects (20 of each sex), with a mean age of 13.02 years; group 2 included 40 Afro-Caucasian subjects (20 of each sex), with a mean age of 13.02 years. Groups 1 and 2 and males and females within each group were compared with t tests. RESULTS: Afro-Caucasian subjects presented greater maxillary protrusion, smaller upper anterior face height and lower posterior face height, larger upper posterior face height, greater maxillary and mandibular dentoalveolar protrusion as well as soft tissue protrusion than Caucasian subjects. The Afro-Caucasian female subjects had less mandibular protrusion and smaller total posterior facial height and upper posterior facial height than males. CONCLUSIONS: Brazilian Afro-Caucasian subjects have greater dentoalveolar and soft tissue protrusion than Brazilian Caucasian subjects, with slight sexual dimorphism in some variables.