Correlation between vertical dimension of occlusion and different facial measurements among a sample of sudanese adults / Correlación entre la dimensión vertical de la oclusión y diferentes medidas faciales en una muestra de adultos sudaneses

Aim: This study aimed to evaluate the correlation between vertical dimension of occlusion (VDO) and various facial measurements in a sample of Sudanese adults. Material and Methods: A total of 113 dental students (33 males and 80 females) with a mean age of 21.7±1.26 years were enrolled in this study. Different facial measurements including (Eye-Mouth, Eye-Eye, Eye-Ear, and Ear Height) were compared with two different measurements of VDO: N-Gn (from the tip of the nose to the tip of the chin), and Sn-Me (from the base of the nose to the bottom of the chin). Pearson's correlation coefficient test was utilized for the correlation between the measured parameters. A p-value of less than 0.05 was considered significant for all analyses. Results: A significant positive correlation was shown between all measured facial distances and both measured VDO distances. Though, the strongest correlation was seen for the eye-mouth distance (r= 0.725, p<0.001), while the weakest was for ear height (r= 0.254, p= 0.007). A paired t-test revealed a significant longer N-Gn distance than Sn-Me distance. Also, it has been shown that there were no significant differences between right and left sides of the face. Conclusion: The distance measured from the outer canthus of the eye to the angle of the mouth can be used to predict Subnasale-Menton (Sn-Me) distance.

Objetivo: Este estudio tuvo como objetivo evaluar la correlación entre dimensión vertical oclusal (DVO) y varias medidas faciales en una muestra de adultos sudaneses. Material y Métodos: Un total de 113 estudiantes de odontología (33 hombres y 80 mujeres) con una edad media de 21,7 ± 1,26 años se inscribieron en este estudio. Se compararon diferentes medidas faciales que incluyen (ojo- boca, ojo-ojo, ojo-oído y altura de la oreja) con dos medidas diferentes de DVO: N-Gn (desde la punta de la nariz hasta la punta del mentón) y Sn -Yo (desde la base de la nariz hasta la parte inferior del mentón). Se utilizó la prueba del coeficiente de correlación de Pearson para la correlación entre los parámetros medidos. Un valor de p inferior a 0,05 se consideró significativo para todos los análisis. Resultados: Se mostró una correlación positiva significativa entre todas las distancias faciales medidas y ambas distancias DVO medidas. Sin embargo, la correlación más fuerte se observó para la distancia ojo-boca (r=0,725, p<0,001), mientras que la más débil fue para la altura de las orejas (r=0,254, p=0,007). Una prueba de t pareada reveló una distancia N-Gn significativamente más larga que la distancia subnasal-mentón. Además, se ha demostrado que no hubo diferencias significativas entre los lados derecho e izquierdo de la cara. Conclusión: La distancia medida desde el canto externo del ojo hasta el ángulo de la boca puede utilizarse para predecir la distancia subnasal-mentón.

Revisión anatómica de la cavidad oral, glándulas salivares y esófago de dos ejemplares de pudú (Pudu puda) / Anatomical review of the oral cavity, salivary glands and esophagus of two specimens of pudú (Pudu puda)

RESUMEN: El pudú (Pudu puda), pertenece al orden Artiodactyla y a la familia Cervidae, corresponde al segundo cérvido más pequeño del mundo y es endémico de Chile y Argentina. Son herbívoros que se alimentan de hojas jóvenes y brotes de algunos árboles, arbustos, hierbas, frutos y flores. Esta especie está catalogada en estado Vulnerable, por lo que se prohíbe su caza y captura, esto debido a que su población ha disminuido sustancialmente a causa de la pérdida y fragmentación de la vegetación nativa, los incendios forestales, ataques de perros asilvestrados y caza furtiva. Existe escasa información científica anatómica de esta especie, y más aún referente a su morfología digestiva, por lo que se requieren estudios que aporten información específica de este cérvido. Se utilizaron dos cadáveres de pudú hembras adultas, los cuales fueron donados por el Servicio Agrícola y Ganadero (SAG) de Talca, Región del Maule, Chile. Dentro de los resultados, podemos indicar que la cavidad oral, glándulas salivares y esófago se asemejan a otros rumiantes domésticos, como también existen semejanzas con el venado de campo, sin embargo, existen diferencias como la forma y desarrollo de la glándula parótida; el conducto parotídeo pasa ventral al músculo masetero y se abre en una papila a nivel del tercer premolar superior; la glándula mandibular se divide en tres lobos; la glándula sublingual solo posee porción polistomática, las glándulas bucales dorsales poseen un menor tamaño que las bucales ventrales, la glándula bucal ventral es alargada y de forma compacta y se observa la presencia de una redondeada glándula bucal intermedia, poseen 11 crestas palatinas por lado en el paladar duro y además la papila incisiva se encuentra rodeando al pulvino dental. Esta información es relevante y corresponde a un aporte al conocimiento específico de esta especie, la cual es endémica, vulnerable y protegida.

SUMMARY: The pudu (Pudu puda), belongs to the Artiodactyla order and the Cervidae family, corresponding to the second smallest deer in the world and is endemic to Chile and Argentina. They are herbivores that feed on young leaves and shoots of certain trees, shrubs, herbs, fruits, and flowers. The status of is species is classified as Vulnerable; therefore, its hunting and capture is prohibited, this because its population has decreased substantially due to the loss and fragmentation of native vegetation, forest fires, attacks by feral dogs and poaching. There is little scientific anatomical information available on this species, and even more so regarding its digestive morphology, which is why studies are required to provide specific information on this deer. Two adult female pudu specimens were used, which were donated by the Agricultural and Livestock Service (SAG) of Talca, Maule Region, Chile. Among the results, we can indicate that the oral cavity, salivary glands and esophagus resemble other domestic ruminants; there are also similarities with the field deer, however, there are differences such as the shape and development of the parotid gland; the parotid duct passes ventral to the masseter muscle and opens into a papilla at the level of the upper third premolar; the mandibular gland is divided into three wolves; the sublingual gland only has a polystomatic portion, the dorsal buccal glands are smaller than the ventral buccal glands, the ventral buccal gland is elongated and compact and the presence of a rounded intermediate buccal gland is observed, it has 11 palatal ridges per side in the hard palate and also the incisive papilla is found surrounding the dental pulvino. This information is relevant and corresponds to a report on the specific knowledge of this species, which is endemic, vulnerable, and protected.

Comunicación preliminar acerca de la disposición morfológica, la funcionalidad y las implicancias clínicas del modiolo del ángulo oral (Modiolus anguli oris) / Preliminary communication about the morphological arrangement, functionality and clinical implications of modiolus of angulus oris (Modiolus anguli oris)

RESUMEN: La disposición anatómica de los músculos faciales es de una notable complejidad y requiere de un estudio pormenorizado para lograr su reconomiento preciso. La comprensión de la disposición morfológica y la funcionalidad del modiolo del ángulo oral (Modiolus angulis oris) es de gran relevancia al momento de analizar la constitución muscular de la comisura labial, y para comprender clínicamente las lesiones del ángulo de la cavidad oral, lo que permitirá un abordaje terapéutico adecuado, crucial para la preservación y reconstitución de la armonía facial.

SUMMARY: The anatomical arrangement of the facial muscles is of considerable complexity and requires a detailed study to achieve its precise recognition. The understanding of the morphological disposition and the functionality of the angle of the mouth (Modiolus angulis oris) is of great relevance when analyzing the muscular constitution of the labial commissure, and to understand clinically the injuries of the angulus oris, what that will allow an adequate therapeutic approach, crucial for the preservation and reconstitution of facial harmony.

Inflamación mixta severa con pérdida del techo del canal mandibular: una variación de las infecciones odontogénicas asociada a pericoronaritis / Severe mixed inflammation with loss of the mandibular canal roof: a variation in odontogenic infections associated with pericoronaritis

Las infecciones cuando pasan a ser crónicas y recurrentes como puede ser el caso de una pericoronaritis medicada, mas no tratada una y otra vez, traen como consecuencia resistencia y proliferación bacteriana. Se da el caso de formaciones de tejidos patológicos e imágenes radiográficas que orientan a posibles diagnósticos, que hasta no ser tratadas por medio de diferentes técnicas como la marsupialización o enucleación, con el complemento de la biopsia insicional o exicional que determina el tipo de patología presente. Esto lleva al objetivo general: determinar el tipo de lesión patológica presente en el ángulo y cuerpo mandibular asociado a la ud: 48 Objetivos específicos: Identificar la lesión patológica presente en Angulo y parte del cuerpo mandibular asociada a la ud: 48. Muestra: paciente de 30 años de edad, masculino, caso clínico de una inflamación mixta severa, la clínica y sus hallazgos radiográficos, se sospechaba de un posible queratoquiste, quiste dentígeros o quiste odontogénico ortoqueratinizado, extracción dental ud: 48, retiro y legrado del tejido circundante, toma de biopsia exicional, exámenes de laboratorio, ortopantomografia, tomografía, fotografías clínicas. Metodología: paradigma positivista, enfoque cuantitativo, diseño no experimental. Modalidad de campo, tipo estudio de caso. La entrevista, el instrumento guión de las preguntas para la historia clínica fueron la técnica y el instrumento. Resultados: inflamación mixta severa, lo cual procede de una infección asociada a pericoronaritis recurrente, esto mediante resultado histopatológico. Conclusiones: el estudio histopatológico es quien determina el diagnóstico final a pesar que la clínica induzca a posibles diagnósticos diferenciales(AU)

When infections become chronic and recurrent, such as a medicated pericoronitis, but not treated repeatedly, they result in resistance and bacterial proliferation. There is the case of pathological tissue formations and radiographic images that guide possible diagnoses, which until they are not treated by means of different techniques such as marsupialization or enucleation, with the complement of the incitional or exicional biopsy that determines the type of pathology present. This leads to the general objective: to determine the type of pathological lesion present in the mandibular angle and body associated with ud: 48. Specific objectives: Identify the pathological lesion present in Angle and part of the mandibular body associated with ud: 48. Sample: 30-year-old male patient, clinical case of severe mixed inflammation, clinical symptoms and radiographic findings, suspected of a possible keratocyst, dentigerous cyst or orthokeratinized odontogenic cyst, tooth extraction ud: 48, removal and curettage of the surrounding tissue, exicional biopsy, laboratory tests, orthopantomography, tomography, clinical photographs. Methodology: positivist paradigm, quantitative approach, non-experimental design. Field modality, case study type. The interview, the instrument script the questions for the clinical history were the technique and the instrument. Results: severe mixed inflammation, which comes from an infection associated with recurrent pericoronitis, this through histopathological result. Conclusions: the histopathological study is the one who determines the final diagnosis, despite the fact that the symptoms lead to possible differential diagnoses(AU)

Teaching and learning strategies of oral histology among dental students / Estrategias de enseñanza y aprendizaje de histología oral en estudiantes de odontología

Dental education is in a continuous state of development to adapt to the changing learning strategies of the millennial students. The introduction of electronic learning resources (ELR) is a good example, which has added immense value to the traditional methods of teaching oral histology. The main purpose of the study was to analyze the dental students' perception of learning oral histology the way it was taught. A pre-approved questionnaire survey was electronically distributed to 129 students who had completed the oral histology course. The majority of the students viewed oral histology course to be difficult and irrelevant to their dental career. Similarly, most of them preferred studying alone and used ELR in place of books and atlases. More than three quarters believed using a microscope in practical training sessions will make the oral histology course easier and more interesting. The results of this study will be used to formulate recommendations to be implemented in oral histology course.

La educación dental se encuentra en un estado de desarrollo continuo para adaptarse a las cambiantes estrategias de aprendizaje de los estudiantes milenios. La introducción de recursos de aprendizaje electrónico (RAE) es un buen ejemplo, el cual ha agregado un valor importante a los métodos tradicionales de enseñanza de histología oral. El objetivo principal del estudio fue analizar la percepción de los estudiantes de odontología de aprender histología oral de la forma en que se enseñó. Una encuesta de cuestionario preaprobada se distribuyó electrónicamente a 129 estudiantes que habían completado el curso de histología oral. La mayoría de los estudiantes consideraron que el curso de histología oral era difícil e irrelevante para su carrera dental. Del mismo modo, la mayoría de ellos preferían estudiar solos y usaban RAE en lugar de libros y atlas. Más de las tres cuartas partes creen que usar un microscopio en sesiones de capacitación práctica, permitiría que el curso de histología oral sea más fácil e interesante. Los resultados de este estudio se utilizarán para formular recomendaciones que se implementarán en el curso de histología oral.

Relación entre Síntomas de Trastornos Témporomandibulares Auto-Reportados y el Movimiento Mandibular de Sujetos Adultos Jóvenes / Relationship Between Symptoms of Self-Reported Temporomandibular Disorders and Mandibular Movement of Young Adult Subjects

RESUMEN: Tanto la limitación del movimiento mandibular como el auto reporte de síntomas de trastornos témporomandibulares (TTM) son utilizados como elementos para el diagnóstico de pacientes en la clínica. Sin embargo, la relación entre la presencia de síntomas y el movimiento mandibular no está del todo clara. Por ello, el objetivo de este estudio fue relacionar la presencia de síntomas asociados a TTM con el movimiento mandibular en una muestra de sujetos adultos jóvenes y sanos. En este estudio exploratorio participaron 40 estudiantes de Odontología, médicamente sanos, con arco dentario maxilar y mandibular continuo y completo (hasta el primer molar). A cada uno se les solicitó responder un cuestionario de auto-reporte de síntomas asociados a TTM recomendado por la American Academy of Orofacial Pain (AAOP). También se realizó un registro y análisis de sus movimientos mandibulares utilizando articulografía electromagnética 3D, con el objetivo de correlacionar la presencia de síntomas con el rango y trayectoria de apertura, y el área comprendida en lo que se describe como polígono de Posselt en el plano frontal y sagital. No se encontraron diferencias significativas entre las respuestas a cada pregunta entre hombres y mujeres. De acuerdo a las respuestas y según Delcanho (1994), 12 participantes resultaron necesitar una evaluación más exhaustiva. En este grupo se encontró que el área del polígono de Posselt en el plano frontal, fue significativamente menor que el de aquellos participantes que no requieren una evaluación más exhaustiva (p=0,003). Los valores de la trayectoria de apertura mandibular varían según de que síntoma se trate. Los principales síntomas que afectarían los valores de los movimientos bordeantes son la "dificultad para abrir la boca" y el "ruido en las articulaciones mandibulares". Con este estudio, hemos puesto de manifiesto que la limitación del movimiento mandibular como signo de TTM debe evaluarse con cautela, debido a que según la presencia de determinados síntomas y otras características de los sujetos (como el sexo), su valor podría variar.

ABSTRACT: Both the limitation of mandibular movement and the self-report of symptoms of temporomandibular disorders (TMD) are used for the diagnosis of patients in clinical diagnosis. However, the relationship between the symptoms and mandibular movement is not entirely clear. Therefore, the objective of this study was to relate the presence of symptoms associated with TMD with mandibular movement in a sample of young and healthy adult subjects. This exploratory study involved 40 medically healthy dentistry students with a continuous and complete maxillary and mandibular arch (up to the first molar). Each subject was asked to answer a self-report questionnaire for symptoms associated with TTM recommended by the American Academy of Orofacial Pain (AAOP). We also recorded and analyzed their mandibular movements using 3D electromagnetic articulography, with the aim of correlating the presence of symptoms with the range and trajectory of opening, and the area included in what is described as a polygon of Posselt in the frontal and sagittal plane. No significant differences were found between the answers to each question between men and women. According to the responses and to Delcanho, 12 participants turned out to need a more exhaustive evaluation. In this group it was found that the area of the Posselt polygon in the frontal plane was significantly smaller than that of those participants who did not require a more extensive evaluation (p = 0.003). The values of the mandibular opening path vary depending on the symptom involved. The main symptoms that would affect the values of the bordering movements are the "difficulty to open the mouth" and "noise in the mandibular joints". With this study, we have shown that the limitation of mandibular movement as a sign of TMD should be assessed with caution, as, according to the presence of certain symptoms and other characteristics of subjects (such as sex), its value may vary.

Bichectomia e sua contribuição para harmonia facial / Bichectomy and its contribution to facial harmony

Introdução: O tecido gorduroso bucal foi descrito pela primeira vez em 1732, por Heister. Em 1802, Bichat diagnosticou sua natureza adiposa. Há uma estreita relação entre a gordura bucal e músculos da mastigação, auxiliando os lactentes na sucção do leite por atuar com um tecido de deslizamento. Sua projeção diminui com o aumento da idade, tanto pela redução discreta de seu volume quanto pelo crescimento facial. A bichectomia ou bichatectomia é o procedimento cirúrgico que visa remover a "bola gordurosa de Bichat", com fins estéticos e/ ou funcionais. O objetivo é demonstrar que a bichectomia é um procedimento de baixo risco cirúrgico e com bons resultados, desde que seja bem indicada e siga os padrões técnicos, respeitando a anatomia das estruturas faciais. Métodos: Estudo prospectivo de coorte, realizado entre janeiro de 2016 e abril de 2018, totalizando 59 pacientes, com média de idade de 31 anos. O tempo de seguimento foi de 12 a 26 meses. Resultados: Foram avaliados 59 pacientes, com média de idade de 31 anos, sendo 46 do sexo feminino e 13 do sexo masculino. Todos os pacientes receberam alta no mesmo dia. Em média, foram retirados 3,2ml de volume da gordura de Bichat. Conclusão: A retirada de porções das gorduras de Bichat é segura, desde que sejam observados os detalhes anatômicos. Pode oferecer maior harmonia entre os três terços da face. O sucesso dos resultados depende de uma indicação precisa para o procedimento.

Introduction: Buccal fat removal was described for the first time by Heister in 1732. In 1802, Bichat identified the adipose nature of this tissue. There is a close association between buccal fat and masticatory muscles, which helps infants suck owing to the sliding motion of the tissues. Its prominence diminishes with age, both through modest reduction in volume and facial growth. Bichectomy or bichatectomy is a surgical procedure that involves extraction of Bichat's fat pad for aesthetic and/or functional purposes. This study aimed to show that bichectomy is a low-risk surgical procedure with good results, provided it is appropriately indicated and is performed following technical standards according to the anatomy of the facial structures. Methods: This prospective cohort study was conducted between January 2016 and April 2018 and included 59 patients with a mean age of 31 years. The follow-up time was 12-26 months. Results: Of 59 patients, 46 were female, and 13 were male. All patients underwent same-day surgery. On average, 3.2 mL of fat was removed. Conclusion: Removal of Bichat's fat according to anatomical principles is safe. This technique can improve facial harmony. Success depends on application of appropriate techniques.

Uso de terminologia histologica en textos de histología oral: capítulo esmalte / Use of terminologia histologica in oral histology texts: enamel chapter

Para la enseñanza y aprendizaje de cualquier disciplina es clave el uso de una terminología clara y definida. Particularmente en el caso de Morfología, el rol de Programa Federativo Internacional de Terminología Anatómica (FIPAT) ha permitido avanzar a lograr la máxima unificación de la terminología asociada a esta disciplina, que considera múltiples variaciones lingüísticas en sus términos, dificultando su comprensión y difusión. Para que esta labor tenga un impacto más profundo en el uso correcto de la terminología internacional se debe articular un trabajo con los procesos de formación profesional que incorporan esta disciplina. El objetivo principal del presente estudio fue analizar la correcta utilización de Terminologia Histologica en los textos de estudios de Histología Oral, disponibles en Chile. Para este trabajo, se realizó un análisis de 4 textos de Histología Oral, dentro de los cuales se encontraban los 2 más utilizados por los estudiantes según las bases de datos de biblioteca de tres Universidades chilenas tanto públicas como privadas, además de 2 textos del área en idioma distinto al español (inglés y portugués). El análisis consistió, comparar el uso de los términos histológicos del capítulo "Esmalte" con los términos incluidos en Terminologia Histologica. Además de registrar errores en la denominación de términos tales como, eponimias, sinonimias y comparar con dos idiomas distintos al español, con el fin de descartar la traducción como problema principal. De los textos analizados el 100 % presentaba una mayor cantidad de términos histológicos en comparación con los 14 descritos por Terminologia Histologica, de los cuales solo 7 son nombrados en la totalidad de los textos. Se encontraron 59 términos para las distintas estructuras del esmalte entre todos los textos, de éstos, solo 15 son nombrados conjuntamente en los cuatro textos y 7 poseen un término asignado en FIPAT. Además son descritas múltiples estructuras que no están construidas bajo las consideraciones de la FIPAT, presentando eponímias y sinonimias. Llama la atención que la mayoría de los términos extraídos no poseen representación en Terminologia Histologica además del uso predominante de epónimos y sinónimos tanto entre los textos de estudio como dentro de los mismos encontrándose veinte términos con más de un nombre. A partir de estos resultados se sugiere realizar las modificaciones pertinentes además de proponer focos para mejorar el uso de Terminologia Histologica en la formación de los futuros profesionales.

For the teaching and learning of any discipline the use of a clear and defined terminology is key. Particularly in the case of Morphology, the role of the International Federative Program of Anatomical Terminology (FIPAT) has made it possible to advance towards the maximum unification of the terminology associated with this discipline, which considers multiple linguistic variations in its terms, hindering its understanding and dissemination. For this work to have a more profound impact on the correct use of international terminology, work must be articulated with the vocational training processes that incorporate this discipline. The main objective of the present study was to analyze the correct use of Terminologia Histologica in the texts of Oral Histology studies, available in Chile. For this work, an analysis of 4 texts of Oral Histology was carried out, among which were the 2 most used by students according to the library databases of three Chilean universities, both public and private, as well as 2 texts from the area. in a language other than Spanish (English and Portuguese). The analysis consisted in comparing the use of the histological terms of the "Enamel" chapter with the terms included in Terminologia Histologica. In addition to registering errors in the denomination of terms such as, eponymias, synonimies and compare with two languages ??other than Spanish, in order to rule out translation as the main problem. Of the texts analyzed, 100 % had a greater number of histological terms compared to the 14 described by Terminologia Histologica, of which only 7 are named in all the texts. 59 terms were found for the different enamel structures among all the texts, of these, only 15 are named together in the four texts and 7 have a term assigned in FIPAT. In addition, multiple structures are described that are not constructed under the considerations of the FIPAT, presenting eponyms and synonyms. It is noteworthy that most of the extracted terms do not have representation in Terminologia Histologica besides the predominant use of eponyms and synonyms either, between the various texts or within them, and twenty terms can be found with more than one name. From these results it is suggested that pertinent modifications be made, in addition to proposing foci to improve the use of Terminologia Histologica in the training of future professionals.

Características morfológicas encontradas na cavidade oral de neonatos: revisão de literatura / Morphological characteristics found in the oral cavity of newborns: a literature review

Objetivo: revisar a literatura sobre as característicasmorfológicas da cavidade oral de recém-nascidos. Revisãode literatura: as profissões da área de saúde estãocada vez mais voltadas para um acompanhamentoprecoce do indivíduo, iniciando-se antes mesmo donascimento ou nos primeiros dias de vida da criança.Sendo assim, recém-nascidos apresentam na cavidadeoral características peculiares da sua fase de desenvolvimentoque podem trazer dúvidas para os pais e/ouresponsáveis. As principais variações da cavidade oralde recém-nascidos envolvem tecidos duros e tecidosmoles. Considerando o posicionamento dos maxilares,as alterações mais comuns são: mordida aberta anterior,sobremordida e mordida topo a topo. Em relação aos tecidosmoles, o contorno dos lábios dos recém-nascidosse apresenta triangular e, com a amamentação constante,forma-se um aumento de volume na linha média dolábio superior. Considerações finais: além de ser necessárioque os profissionais da área tenham conhecimentodas características morfológicas da cavidade oral dosrecém-nascidos, também é imprescindível que estessaibam diagnosticar possíveis anormalidades e, quandohouver necessidade, indicar tratamento adequado. (AU)

Objective: to review the literature on the morphological characteristics of the oral cavity of newborns. Literature review: health professions are increasingly focused on the early follow-up of individuals, starting even before birth or during the first days of life of the child. Therefore, the oral cavity of newborns presents characteristics particular to their development phase, which may cause doubts to parents and/or caregivers. The major variations of the oral cavity of newborns involve both hard and soft tissues. Considering the positioning of the jaws, the most common changes are anterior open bite, overbite, and edge-to-edge bite. Regarding the soft tissues, the contour of the lips of newborns is triangular and constant breastfeeding causes an increase of volume formed in the midline of the upper lip. Final considerations: therefore, health professionals are required not only to understand the morphological characteristics of the oral cavity of newborns, but it is also essential that they are able to diagnose potential abnormalities and to indicate appropriate treatment when necessary. (AU)

The implications of different lateral wall thicknesses on surgical access to the maxillary sinus

Abstract: The objective of this study was to measure the topographic thickness of the lateral wall of the maxillary sinus in selected Asian populations. Measurements were made on the lateral walls of maxillary sinuses recorded using CBCT in a convenient sample of patients attending an Asian teaching hospital. The points of measurement were the intersections between the axes along the apices of the canine, first premolar, and second premolar and along the mesiobuccal and distobuccal apices of the first and second molars and horizontal planes 10 mm, 20 mm, 30 mm and 40 mm beneath the orbital floor. The CBCT images of 109 patients were reviewed. The mean age of the patients was 33.0 (SD 14.8) years. Almost three quarters (71.8%) of the patients were male. The mean bone thickness decreased beginning at the 10-mm level and continuing to 40 mm below the orbital floor. Few canine regions showed encroachment of the maxillary sinus. The thickness of the buccal wall gradually increased from the canine region (where sinus encroachment of the canine region was present) to the first molar region, after which it decreased to the thickness observed at the canine region. The buccal wall of the maxillary sinus became thicker anteroposteriorly, except in the region of the second molar, and thinner superoinferiorly. These changes will affect the approach used to osteotomize the lateral sinus wall for oral surgery and for the sinus lift procedure.

Perception of midline deviations in smile esthetics by laypersons

ABSTRACT Objective: To evaluate the esthetic perception of upper dental midline deviation by laypersons and if adjacent structures influence their judgment. Methods: An album with 12 randomly distributed frontal view photographs of the smile of a woman with the midline digitally deviated was evaluated by 95 laypersons. The frontal view smiling photograph was modified to create from 1 mm to 5 mm deviations in the upper midline to the left side. The photographs were cropped in two different manners and divided into two groups of six photographs each: group LCN included the lips, chin, and two-thirds of the nose, and group L included the lips only. The laypersons performed the rate of each smile using a visual analog scale (VAS). Wilcoxon test, Student’s t-test and Mann-Whitney test were applied, adopting a 5% level of significance. Results: Laypersons were able to perceive midline deviations starting at 1 mm. Statistically significant results (p< 0.05) were found for all multiple comparisons of the values in photographs of group LCN and for almost all comparisons in photographs of group L. Comparisons between the photographs of groups LCN and L showed statistically significant values (p< 0.05) when the deviation was 1 mm. Conclusions: Laypersons were able to perceive the upper dental midline deviations of 1 mm, and above when the adjacent structures of the smiles were included. Deviations of 2 mm and above when the lips only were included. The visualization of structures adjacent to the smile demonstrated influence on the perception of midline deviation.

RESUMO Objetivo: este estudo teve por objetivo avaliar a percepção estética dos desvios da linha média dentária superior por indivíduos leigos, assim como se as estruturas adjacentes influenciam nesse julgamento. Métodos: um álbum contendo 12 fotografias frontais do sorriso de uma mulher, aleatoriamente distribuídas e com a linha média desviada digitalmente, foi avaliado por 95 indivíduos leigos. As fotografias frontais de sorriso foram modificadas para criar desvios de 1 mm a 5 mm para a esquerda na linha média superior. As fotografias foram obtidas de duas maneiras e divididas em dois grupos de seis fotografias cada: Grupo LCN, incluindo lábios, mento e dois terços do nariz; e Grupo L, incluindo apenas os lábios. Os indivíduos leigos classificaram o sorriso de acordo com uma Escala Visual Analógica (EVA). Os testes de Wilcoxon, tde Student e Mann-Whitney foram aplicados, adotando-se um nível de significância de 5%. Resultados: os leigos foram capazes de perceber desvios da linha média a partir de 1 mm. Resultados estatisticamente significativos (p < 0,05) foram encontrados para todas as múltiplas comparações dos valores nas fotografias do Grupo LCN e para quase todas as comparações nas fotografias do Grupo L. As comparações entre as fotografias dos grupos LCN e L mostraram valores estatisticamente significativos (p < 0,05) quando o desvio foi de 1 mm. Conclusões: os indivíduos leigos foram capazes de perceber os desvios da linha média de 1 mm; e acima desses, quando estruturas adjacentes ao sorriso apareciam nas fotografias. Desvios de 2 mm ou mais foram percebidos apenas quando os lábios apareciam nas fotografias; a visualização das estruturas adjacentes ao sorriso pareceu ter influência sobre a percepção dos desvios da linha média.

Orofacial-cervical alterations in individuals with upper airway resistance syndrome / Alteração cérvico-orofacial em indivíduos com síndrome da resistência de via aérea superior

ABSTRACT INTRODUCTION: Studies that assess the upper airways in sleep-related breathing disorders have been performed only in patients with obstructive sleep apnea syndrome who seek medical attention. Therefore, in addition to the need for population studies, there are no data on the orofacial-cervical physical examination in subjects with upper airway resistance syndrome. OBJECTIVES: To compare the orofacial-cervical examination between volunteers with upper airway resistance syndrome and without sleep-related breathing disorders. METHODS: Through questionnaires, physical measurements, polysomnography, and otorhinolaryngological evaluation, this study compared the orofacial-cervical physical examination, through a systematic analysis of the facial skeleton, mouth, throat, and nose, between volunteers with upper airway resistance syndrome and volunteers without sleep-related breathing disorders in a representative sample of the adult population of the city of São Paulo. RESULTS: There were 1042 volunteers evaluated; 49 subjects (5%) were excluded as they did not undergo otorhinolaryngological evaluation, 381 (36%) had apnea-hypopnea index > 5 events/hour, and 131 (13%) had oxyhemoglobin saturation < 90%. Among the remaining 481 subjects (46%), 30 (3%) met the criteria for the upper airway resistance syndrome definition and 53 (5%) met the control group criteria. At the clinical evaluation of nasal symptoms, the upper airway resistance syndrome group had more oropharyngeal dryness (17% vs. 29.6%; p = 0.025) and septal deviation grades 1-3 (49.1% vs. 57.7%; p = 0.025) when compared to controls. In the logistic regression model, it was found that individuals from the upper airway resistance syndrome group had 15.6-fold higher chance of having nose alterations, 11.2-fold higher chance of being hypertensive, and 7.6-fold higher chance of complaining of oropharyngeal dryness when compared to the control group. CONCLUSION: Systematic evaluation of the facial skeleton, mouth, throat, and nose, between volunteers with upper airway resistance syndrome and volunteers without sleep-related breathing disorders, showed that the presence of upper airway resistance syndrome is mainly associated with nasal alterations and oropharyngeal dryness, in addition to the risk of hypertension, regardless of gender and obesity.

Resumo Introdução: Estudos que avaliam a via aérea superior (VAS) nos distúrbios respiratórios relacionados ao sono (DRRS) foram realizadas somente em pacientes com Síndrome da apneia obstrutiva do sono (SAOS) que procuram o atendimento médico. Portanto, além da necessidade de estudos populacionais, não há dados sobre o exame físico cérvico-orofacial em indivíduos com Síndrome de Resistência das Vias Aéreas Superiores (SRVAS). Objetivos: Comparar o exame cérvico orofacial entre voluntário com SRVAS e sem DRRS. Método: Através de questionários, medidas físicas, polissonografia e avaliação otorrino-laringológica comparou-se o exame físico cérvico orofacial, através de uma análise sistemática do esqueleto facial, boca, faringe e nariz, entre voluntários com SRVAS e voluntários sem DRRS em uma amostra representativa da população adulta da cidade de São Paulo. Resultados: Avaliamos 1042 voluntários. Foram excluídos: 49 indivíduos (5%) que não realizaram avaliação otorrinolaringológica; 381 (36%) apresentaram índice de apneia e hipopnéia (IAH) > 5 eventos/hora e 131 (13%) apresentaram saturação da oxihemoglobina < 90%. Entre os 481 voluntários restantes (46%), 30 (3%) preenchiam os critérios estabelecidos para a definição de SRVAS e 53 (5%) que preenchiam os critérios do grupo controle. Na avaliação clínica dos sintomas nasais, o grupo SRVAS apresentou mais ressecamento orofaríngeo (17% vs. 29,6%; p = 0,025), desvio septal grau 1 a 3 (49,1% vs. 57,7%; p = 0,025), comparado ao controle. No modelo de regressão logística observamos que indivíduos do grupo SRVAS apresentaram uma razão de chance 15,6 vezes maior de apresentarem nariz alterado; 11,2 vezes maior de serem hipertensos e 7,6 vezes maior de se queixarem de ressecamento orofaríngeo quando comparados ao grupo controle. Conclusão: A avaliação sistemática do esqueleto facial, boca, faringe e nariz, entre voluntários com SRVAS e voluntários sem DRRS, mostrou que a presença de SRVAS está principalmente associada à alterações nasais e ressecamento orofaríngeo, além do risco de hipertensão arterial, independentemente do gênero e obesidade.

Lipoma gigante do coxim adiposo bucal: relato de caso e revisão da literatura / Giant lipoma of the buccal fat pad: case report and literature review

INTRODUÇÃO: Lipomas são os tumores benignos mesenquimais mais comuns. Entretanto, são pouco frequentes na face, principalmente o tipo considerado gigante, derivado do coxim adiposo bucal. A literatura é escassa e provavelmente a sua incidência é subestimada. MÉTODO: Relato do caso de tratamento cirúrgico de lipoma gigante bucal e temporal recidivado, e revisão da literatura no Pubmed na língua inglesa e na Revista Brasileira de Cirurgia Plástica. RESULTADOS: O tumor, anatômica e morfologicamente, corresponde ao coxim adiposo bucal, foi totalmente retirado pelo acesso facial e temporal, sem sequelas ao nervo facial. Foram encontrados 31 casos relatados de lipoma de origem do coxim adiposo bucal, entretanto, vários casos foram encontrados e relatados sob outras denominações. DISCUSSÃO: O coxim adiposo bucal é maior e mais complexo que se conhecia, e várias patologias se derivam deste, sendo importante o diagnóstico diferencial do lipoma simples com o de células fusiformes e com o lipossarcoma, devido a sua extrema semelhança. CONCLUSÃO:Nas lesões lipomatosas da face, a possível origem no coxim adiposo bucal deve ser considerada. Um estudo amplo dessas lesões com a finalidade de uniformizar a terminologia e de determinar a sua real incidência deve ser realizado.

INTRODUCTION: Lipomas are the most common benign mesenchymal tumors. Nevertheless, they are infrequent in the face, particularly giant lipomas, which are derived from the buccal fat pad. The literature regarding these tumors is scarce and their incidence is likely underestimated. METHODS: We present a case report of surgical treatment of a relapsed giant buccal and temporal lipoma and review the related English literature in Pubmed and that in the Brazilian Journal of Plastic Surgery. RESULTS: The tumor, which anatomically and morphologically corresponded to the buccal fat pad, was completely excised by facial and temporal access without sequelae to the facial nerve. A total of 31 reported cases of lipoma originating from the buccal fat pad were found; however, several were found and reported under other names. DISCUSSION: The buccal fat pad is larger and more complex than assumed, and several pathologies are derived thereof, making the differential diagnosis of simple lipoma with fusiform cell lipoma and liposarcoma difficult due to their extreme similarities. CONCLUSION: In lipomatous lesions of the face, the possible origin in the buccal fat pad must be considered. An extensive study of these lesions with the purpose of standardizing the terminology and determining its real incidence must be performed.

Avaliação da cavidade orofaríngea da tartaruga da Amazônia, Podocnemis expansa (Schweigger, 1812) / Evaluation of the oropharyngeal cavity of Giant South American turtle Podocnemis expansa (Schweigger, 1812)

Os quelônios são importantes como fonte alimentar e econômica para as comunidades da região amazônica. Sendo assim, a caça, a pesca e a procura por ovos destes animais tem ocorrido frequentemente. Podocnemis expansa (Tartaruga da Amazônia) é o maior quelônio de água doce da América do Sul. É uma espécie largamente distribuída, porém, nota-se que aspectos anatômicos da espécie são insuficientemente descritos. O objetivo desse estudo foi descrever a cavidade orofaríngea desses quelônios. Foram utilizadas 12 cabeças de P. expansa adultas, de ambos os sexos, com idade entre 3 a 8 anos, com peso corpóreo de 5 a 22kg (média de 7,5kg). P. expansa conta com a presença de rafontecas afiadas e bem desenvolvidas que, associadas à musculatura potente da mandíbula e à língua volumosa e bem distribuída no assoalho da orofaringe, atuam na apreensão e deglutição do alimento, garantindo uma maior adaptação em diversos ambientes...

Turtles are important as food and economic resources for the Amazon communities and there is a large demand on its meat and eggs. Podocnemis expansa (Giant South American turtle) is the largest freshwater chelonian of South America. This turtle is a widely distributed specie, however its anatomical features are poorly described. The objective of this study was to describe the oropharyngeal cavity of the turtle. Twelve heads of 3 to 8-year-old female and male P. expansa turtles with an average body weight of 7.5kg were used. P. expansa has a sharp and well developed rhamphotheca, which together with a powerful jaw muscles and a large tongue uniformly distributed on the oropharynx floor works for the apprehension and swallowing of food, what ensures good adaptation in different environments...

Association between morphometric variables and nocturnal desaturation in sickle-cell anemia / Associação entre variáveis morfométricas e dessaturação noturna na anemia falciforme

OBJECTIVE: to evaluate associations between morphometric variables, cervical circumference (CC), and abdominal circumference (AC) with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia. METHODS: all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet), and CC and AC measurements. RESULTS: a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031). The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006) and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028). There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001) and mandibular intermolar distance (r = -0.233, p = 0.037). CONCLUSIONS: the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia. .

OBJETIVO: avaliar associações entre variáveis morfométricas e circunferências cervical (CC) e abdominal (CA) com a presença de dessaturação noturna em crianças e adolescentes com anemia falciforme. MÉTODOS: todos os pacientes foram submetidos à polissonografia basal, medidas da cavidade oral (distância intermolar da maxila, distância intermolar da mandíbula e overje), CC e CA. RESULTADOS: foram avaliados 85 pacientes. Foi observada correlação positiva entre o escore Z altura/idade e a medida da circunferência cervical (r = 0,233 p = 0,031). A presença da dessaturação noturna associou-se com as medidas da circunferência cervical (59,2 ± 9,3 vs 67,5 ± 10,7; p = 0,006) e abdominal (27,0 ± 2,0 vs 29,0 ± 2,1; p = 0,028). Houve correlação negativa entre a dessaturação e a distância entre os segundos molares da maxila (r =-0,365, p = 0,001) e da mandíbula (r = -0,233, p = 0,037). CONCLUSÕES: as variáveis morfométricas e circunferências cervical e abdominal podem contribuir para a suspeita da dessaturação noturna em crianças e adolescentes com anemia falciforme. .

Influencia del pH en las relaciones microbianas de la cavidad bucal: revisión bibliográfica / Influence pH on the oral cavity microbial relations: literature review

El pH es el grado de acidez de una solución. En cavidad bucal, el pH define diferentes sucesos tanto bioquímicos como microbiológicos, entre los factores que ejercen influencia en todos estos eventos intrabucales encontramos: 1) capacidad buffer salival, la saliva no estimulada es de pH ligeramente ácido, la saliva estimulada posee pH básico. 2) carbohidratos exógenos. 3) bacterias acidógenas de la biopelícula dental, las cuales coexisten en microambientes altamente organizados, pudiendo metabolizar rápidamente ciertos azúcares a glucanos y productos finales ácidos. 4) agentes químicos, tales como hidróxido de calcio, el cual libera iones hidroxilos al medio, alcalinizándolo y haciéndolo no viable para el metabolismo bacteriano; clorhexidina, antiséptico de gran sustantividad, activo en bacterias Gram positivas y Gram negativas; fluoruros, que exhiben capacidad de inhibición metabólica, mecanismo antiadherente, producción de cambios en la carga superficial del diente. 5) azúcares alcoholes edulcorantes (xilitol), presenta la propiedad de retardar el flujo metabólico de ciertas bacterias cariogénicas.

pH is the acidity of a solution. In oral cavity, pH defines different events both biochemical and microbiological, factors that influence these intraoral events are: 1) salivary buffer capacity, unstimulated saliva is slightly acidic, stimulated saliva has basic pH. 2) exogenous carbohydrates. 3) acidogenic bacteria of dental biofilm , which coexist in highly organized microenvironments , can rapidly metabolize some sugars to glucans and acidic end products . 4) chemical agents, such as calcium hydroxide , which releases hydroxyl ions to the medium, and makes it non viable for bacterial metabolism; chlorhexidine antiseptic with high substantivity , active in Gram positive and Gram negative bacteria; fluorides exhibit metabolic inhibition capacity, antiadherent mechanism, production of changes in the surface charge of the tooth. 5) Sweeteners sugar alcohols (xylitol), has the property of retarding certain metabolic flux of cariogenic bacteria.