Plication of the Suprahyoid Muscles Concomitant with Genioplasty to Improve the Aesthetics of the Submandibular Region / Plicatura de los Músculos Suprahioideos Concomitante con Genioplastia para Mejorar la Estética de la Región Submandibular

In addition to functionally correcting skeletal facial deformities, orthognathic surgery also has a great impact on aesthetics and facial proportions. However, patients who have soft tissue changes, such as tissue flaccidity, may not achieve an ideal result, and require complementary surgical techniques that promote aesthetic refinement. The literature on less invasive techniques is limited, and therefore, this work aims to report a surgical technique performed concomitantly with genioplasty to refine the harmony of the submandibular region, in a simple and effective way. Patient with skeletal class II deformity, with lack of mandibular definition and submandibular flaccidity, underwent bimaxillary advancement orthognathic surgery with advancement genioplasty to correct chin retrusion. Due to limited results with bone repositioning alone, plication of the suprahyoid musculature was performed in association with the same approach used in the genioplasty. As a result, there was traction in the cervical region, with a consequent decrease in the submental-cervical angle and improvement in submandibular aesthetics. Furthermore, there was no need for extensive surgical intervention and no impairment of the functional results of the orthognathic surgery itself. Therefore, it can be concluded that plication of the suprahyoid musculat ure concomitantly with genioplasty is a technique that promotes aesthetic gains in the cervical region.

Además de corregir funcionalmente las deformidades faciales esqueléticas, la cirugía ortognática también tiene un gran impacto en la estética y las proporciones faciales. Sin embargo, los pacientes que tienen cambios en los tejidos blandos, como la flacidez, pueden no lograr un resultado ideal y requieren técnicas quirúrgicas complementarias que promuevan el refinamiento estético. La literatura sobre técnicas menos invasivas es limitada, por lo que este trabajo tiene como objetivo reportar una técnica quirúrgica realizada concomitantemente con la genioplastia para refinar la armonía de la región submandibular, de manera simple y efectiva. Se trató a un paciente con deformidad esquelética clase II, con falta de definición mandibular y flacidez submandibular, intervenida de cirugía ortognática de avance bimaxilar con genioplastia de avance para corregir la retrusión del mentón. Debido a los resultados limitados solo con el reposicionamiento óseo, se realizó la plicatura de la musculatura suprahioidea en asociación con el mismo abordaje utilizado en la genioplastia. Como resultado, hubo tracción en la región cervical, con la consiguiente disminución del ángulo submentoniano-cervical y mejoría en la estética submandibular. Además, no hubo necesidad de una intervención quirúrgica extensa ni deterioro de los resultados funcionales de la cirugía ortognática en sí. Por lo tanto, se puede concluir que la plicatura de la musculatura suprahioidea concomitantemente con la genioplastia es una técnica que promueve ganancias estéticas en la región cervical.

From "Empirical Surgery" to "Precision Surgery": establishment and clinical application of precision orthognathic surgery system / 华西口腔医学杂志

Orthognathic surgery, which involve osteotomy and repositioning of the maxillomandibular complex, has recently emerged as a crucial method of correcting dentofacial deformities. The optimal placement of the maxillomandibular complex holds utmost significance during orthognathic surgery because it directly affects the surgical outcome. To accurately achieve the ideal position of the maxillomandibular complex, with the rapid advancements in digital surgery and 3D-printing technology, orthognathic surgery has entered an era of "Precision Surgery" from the pervious "Empirical Surgery." This article provides comprehensive insights into our extensive research and exploration of the treatment modality known as "precision orthognathic surgery" over the years. We also present the technical system and application in"Ortho+X" treatment modality to offer valuable references and assistance to our colleagues in the field.

Treatment of dentofacial deformities secondary to condylar hyperplasia / 华西口腔医学杂志

Dentofacial deformities secondary to condylar hyperplasiais a kind of disease presenting facial asymmetry, malocclusion, temporomandibular joint dysfunction, and other symptoms caused by non-neoplastic hyperplasia of the condyle. The etiology is still unknown, and currently, pre- and post-operative orthodontics accompanied by orthognathic surgery, temporomandibular joint surgery and jawbone contouring surgery are the main treatment methods. A personalized treatment plan was developed, considering the active degree of condyle hyperplasia, the severity of the jaw deformity, and the patient's will, to correct deformity, obtain ideal occlusal relationship, and regain good temporomandibular joint function. Combined with the author's clinical experience, the etiology, clinical and imageological features, treatment aims, and surgical methods of condylar hyperplasia and secondary dentofacial deformities were discussed in this paper.

Establishing Cephalometric Norms in Primary Dentition Using Comprehensive Craniofacial Growth Analysis - A Digital Cephalometric Study

ABSTRACT Objective: To establish cephalometric norms in primary dentition among males and females using novel customized Comprehensive Cephalometric Growth (CCG) Analysis. Material and Methods: The study was conducted on 67 subjects with a mean age of 5.5 yrs. Digital lateral cephalometric radiographs were obtained using Planmeca Pro One. The digital images were then transferred to Nemoceph software. Craniofacial Growth (CCG) Analysis was configured in the software with five sub-groups. This sub-grouping was done such that related components were grouped together and comprehensively; it would provide an assessment of every component of the craniofacial region that could be affected either by treatment maneuver or growth process. The same was used for the cephalometric analysis and to determine the cephalometric norms in the primary dentition. Results: Certain linear measurements were higher among males when compared to females. However, most measurements remained similar among males and females during this age group. The CCG analysis provided a comprehensive knowledge of the craniofacial parameters during the growth process. Conclusion: The cephalometric norms during primary dentition thus established using Comprehensive Craniofacial Growth analysis would provide the data for early diagnosis and treatment planning in interceptive orthodontic treatment procedures.

Body mass index and weight loss in patients submitted to orthognathic surgery: a prospective study

ABSTRACT Objective: To compare the body mass index (BMI) and the weight loss (WL) in patients with dentofacial deformities who underwent monomaxillary versus bimaxillary orthognathic surgery. Materials and Methods: This prospective longitudinal study included 69 patients with dentofacial deformities who underwent surgical orthodontic treatment. Patients were divided into two groups according to the type of orthognathic surgery: monomaxillary or bimaxillary. A preoperative nutritional assessment based on BMI was performed; the percentage of involuntary WL between the preoperative and postoperative periods was also calculated. Data were collected at preoperative and 10, 40, and 90 days postoperative (PO). Statistical analysis was performed using SPSS 17.0 (IBM Corp., Armonk, NY, USA), and data are reported with 95% confidence interval. Results: According to BMI, patients who underwent monomaxillary surgery presented: underweight = 2.6%, normal weight = 51.3%, overweight = 35.9%, and obese = 10.3%. The subjects who underwent bimaxillary surgery presented: normal weight = 43.3%, overweight = 36.7%, and obese = 20%. BMI was similar between the groups at all time points (preoperative, p= 0.237; 10 days PO, p= 0.325; 40 days PO, p= 0.430; and 90 days PO, p= 0.609). All patients lost weight postoperatively, and WL was similar among the PO measurements (p= 0.163). Conclusions: Although both monomaxillary and bimaxillary orthognathic surgeries resulted in WL and lower BMI, there was no statistically significant difference in these metrics between the two types of surgery.

RESUMO Objetivo: Comparar o Índice de Massa Corporal (IMC) e a perda de peso (PP) de pacientes com deformidades dentofaciais após cirurgia ortognática monomaxilar e bimaxilar. Material e Métodos: Foi realizado um estudo longitudinal prospectivo em 69 pacientes com deformidade dentofacial submetidos a tratamento cirúrgico-ortodôntico. Os pacientes foram divididos em dois grupos: cirurgia ortognática monomaxilar e bimaxilar. Foi realizada avaliação nutricional pré-operatória de acordo com o IMC. Foi calculada a porcentagem de PP involuntária entre o pré e o pós-operatório (PO). A coleta de dados foi realizada no pré-operatório e aos 10, 40 e 90 dias PO. A análise estatística foi realizada no software SPSS v. 17.0, com intervalo de confiança de 95%. Resultados: De acordo com o IMC, os indivíduos submetidos à cirurgia monomaxilar apresentaram: baixo peso = 2,6%, peso normal = 51,3%, sobrepeso = 35,9% e obesidade = 10,3%. Entre os indivíduos submetidos à cirurgia bimaxilar, 43,3% estavam com peso normal, 36,7% estavam com sobrepeso e 20% eram obesos. O IMC foi semelhante em todos os períodos (pré-operatório, p= 0,237; 10 dias PO, p= 0,325; 40 dias PO, p= 0,430; e 90 dias PO, p= 0,609). Todos os pacientes perderam peso no pós-operatório. A PP foi semelhante entre os tempos de PO (p= 0,163). Conclusões: A cirurgia ortognática monomaxilar ou bimaxilar pode causar redução do peso corporal e diminuição no IMC, mas não há diferença estatisticamente significativa entre esses dois tipos de cirurgia em relação à PP e ao IMC.

Análise das vias aéreas superiores pós cirurgia ortognática bimaxilar: estudo retrospectivo / Upper airway analysis after bimaxillary orthognathic surgery: retrospective study / Análisis de la vía aérea superior después de la cirugía ortognática bimaxilar: estudio retrospectivo

Objetivo: O objetivo do presente estudo foi avaliar retrospectivamente as mudanças ocorridas nas vias aéreas superiores (VAS) pós cirurgia ortognática bimaxilar. Metodologia: A amostra compreendeu 14 pacientes, que foram divididos em dois grupos, conforme o tipo de movimentação realizada na cirurgia: grupo 1 (n = 6), avanço bimaxilar; grupo 2 (n = 8) cirurgia de avanço de maxila e recuo de mandíbula. Foram realizadas tomografias computadorizadas no pré-operatório (T0) e pós-operatório de 1 ano (T1). Através do software Dolphin Imaging procedeu-se a análise das VAS em três parâmetros: área total (AT), volume total (VT) e área axial mínima (AAM), que foram comparadas entre T0 e T1 em um mesmo grupos pelo Teste de Wilcoxon e entre grupos pelos Teste de Mann-Whitney (p < 0.05). Resultados: Ambos os grupos apresentaram aumento significativo de AT, VT e AAM entre T0 e T1. Contudo, essas variações foram estatisticamente maiores no grupo 1 quando comparadas ao grupo 2. Conclusão: As cirurgias bimaxilares promoveram o aumento da AT, VT e AAM das VAS e essas mudanças foram significativamente superiores nos pacientes submetidos ao avanço bimaxilar... (AU)

Objective: The objective of the present study was to retrospectively evaluate the changes that occurred in the upper airways (UAS) after bimaxillary orthognathic surgery. Methodology: The sample comprised 14 patients, who were divided into two groups, according to the type of movement performed in the surgery: group 1 (n = 6), bimaxillary advancement; group 2 (n = 8) maxillary advancement and mandibular setback surgery. Computed tomography scans were performed preoperatively (T0) and 1 year postoperatively (T1). Through the Dolphin Imaging software, the analysis of the UAS was carried out in three parameters: total area (TA), total volume (TV) and minimum axial area (MAA), which were compared between T0 and T1 in the same groups by the Wilcoxon Test and between groups by the Mann-Whitney test (p < 0.05). Results: Both groups showed a significant increase in TA, TV and MAA between T0 and T1. However, these variations were statistically higher in group 1 when compared to group 2. Conclusion: Bimaxillary surgeries promoted an increase in the TA, TV and MAA of the UAS and these changes were significantly higher in patients undergoing bimaxillary advancement... (AU)

Objetivo: El objetivo del presente estudio fue evaluar retrospectivamente los cambios ocurridos en las vías aéreas superiores (VAS) después de la cirugía ortognática bimaxilar. Metodología: La muestra estuvo compuesta por 14 pacientes, quienes fueron divididos en dos grupos, según el tipo de movimiento realizado en la cirugía: grupo 1 (n = 6), avance bimaxilar; grupo 2 (n = 8) cirugía de avance maxilar y retroceso mandibular. Las tomografías computarizadas se realizaron antes de la operación (T0) y 1 año después de la operación (T1). A través del software Dolphin Imaging se realizó el análisis de la VAS en tres parámetros: área total (AT), volumen total (VT) y área axial mínima (AAM), los cuales fueron comparados entre T0 y T1 en los mismos grupos por el Prueba de Wilcoxon y entre grupos por la prueba de Mann Whitney (p < 0,05). Resultados: Ambos grupos mostraron un aumento significativo de AT, VT y AAM entre T0 y T1. Sin embargo, estas variaciones fueron estadísticamente mayores en el grupo 1 en comparación con el grupo 2. Conclusión: Las cirugías bimaxilares promovieron un aumento de la AT, VT y AAM de las VAS y estos cambios fueron significativamente mayores en los pacientes sometidos a avance bimaxilar... (AU)

Effects of McLaughlin Bennett Treriri straight wire technique on the content of periostin in gingival crevicular fluid of the maxillary first molar / 中国基层医药

Objective:To investigate the effects of McLaughlin Bennett Treriri (MBT) straight wire technique on the content of periostin in gingival crevicular fluid of the maxillary first molar.Methods:Ninety patients with malocclusion who were treated with MBT straight wire technique in Jiaxing Hospital of Traditional Chinese Medicine from February to September 2021 were included in this study. The patients were divided into group A (13-18 years old) and group B (30-35 years old) according to age, with 45 patients in each group. According to the random number table method, patients in group A were divided into 100 g subgroup (group A1, n = 22) and 150 g subgroup (group A2, n = 23), and patients in group B were divided into 100 g subgroup (group B1, n = 22) and 150 g sub group (group B2, n = 23). Effects of age on the content of periostin in gingival crevicular fluid and bite force were observed. The antagonistic effect of periostin in gingival crevicular fluid during the application of different corrective forces was evaluated based on the changes in bite force, bone mineral density and height of the jaw after the application of force. The incidence of complications was calculated. Results:The level of periostin and bite force in group A were (1 249.38 ± 89.29) pmol/L and (1 038.37 ± 79.54) N, respectively, which were significantly higher than (831.54 ± 76.38) pmol /L and (921.45 ± 81.36) N in group B ( t = 23.86, 6.89, both P < 0.05). After 1 and 3 months of treatment, the amplitude of improvement in bite force, jaw bone density, and jaw height in group A2 were greater than those in group A2 ( t = 2.92, 6.39, 0.64, 1.30, 1.07, 2.48, all P < 0.05). After 7 and 14 days of treatment, the level of periostin was increased in both group B1 and B2 and its level in group B2 was significantly higher than that in group B1 ( t = 0.59, 1.89, both P < 0.05). After 1 month of treatment, there were no significant differences in bite force, jaw bone density and jaw height between groups B1 and B2 (all P > 0.05). After 3 months of treatment, the amplitude of improvement in bite force, jaw bone density and jaw height were greater in group B2 than those in group B1 ( t = 0.27, 4.02, 3.07, 1.52, 0.06, 1.57, P < 0.05). There were 3 patients with loose teeth, 2 patients with pulp reaction, 1 patient with mucosal ulcer, and 2 patients with secondary dental caries during treatment. The incidence of complications was 8.89%. Conclusion:MBT straight wire technique is effective and safe in the treatment of patients with dental deformities. The level of periostin in gingival crevicular fluid of the maxillary first molar and bite force decrease with age. The corrective force can increase and activate the expression of periostin, thereby promoting periodontal wound healing and regeneration, and increasing patients' bite force, jaw bone density and height.

Association of the estrogen receptor gene with oral health-related quality of life in patients with dentofacial deformities

Abstract This study aimed to evaluate the associations between oral health-related quality of life (OHRQoL) and patient-associated factors and polymorphisms in the estrogen receptor 1 (ESR1) and 2 (ESR2) genes in patients with dentofacial deformities (DFD). This cross-sectional study included 234 adult individuals. Data such as age, sex, and the type of facial profile (I, II, or III), were collected, and the short-form oral health impact profile 14 (OHIP-14) questionnaire was used to assess their OHRQoL. DNA was collected from oral mucosa cells, and the polymorphisms in ESR1 (rs2234693 and rs9340799) and ESR2 (rs1256049 and rs4986938) were evaluated using real-time polymerase chain reaction. The data were subjected to statistical analysis at a significance level of 5%. Individuals over 28 years of age exhibited worse OHRQoL (p = 0.003) than individuals aged less than or equal to 28 years. Women had worse OHRQoL than men (p < 0.001). Profile II individuals had worse OHRQoL in the social disability domain than profile III individuals (p = 0.030). Genetic analysis showed that rs9340799 was associated with OHRQoL in the functional limitation domain, and GG individuals exhibited worse OHRQoL than individuals carrying the AA/AG genotypes (p < 0.030). In the social handicap domain, individuals with GG genotype in rs9340799 exhibited worse OHRQoL than AG individuals (p < 0.043). Collectively, our results reveal that factors including age, sex, and type of facial profile, are associated with OHRQoL in patients with DFD. In addition, individuals with the GG genotype in rs9340799 (ESR1) may experience a negative impact on OHRQoL in the functional limitation and social handicap domains.

Associação de hábitos parafuncionais e DTM em pacientes classe II / Association of parafunctional habits and TMD class II patients

Introdução: A Disfunção Temporomandibular (DTM) é a dor orofacial crônica mais comum, encontrada por dentistas e outros profissionais de saúde. Sua etiologia tem caráter multifatorial, e pode envolver, desde fatores hereditários, hábitos parafuncionais, maloclusões, até ansiedade e estresse. Objetivo: Este estudo investigou a frequência da DTM e a sua relação entre hábitos parafuncionais em uma população de pacientes classe II esquelética. Método: Uma amostra composta por pacientes classe II esquelética foi selecionada de forma não probabilística. Setenta e três indivíduos concordaram em participar da pesquisa, se submetendo ao exame físico que consistia na aplicação do Eixo I do (RDC/TMD). Resultados: Quarenta e seis por cento dos pacientes examinados apresentaram diagnóstico positivo. A média de idade dos pacientes foi de 27 anos+ 8,73 anos, 82% do gênero feminino e 80% brancos. Trinta e quatro pacientes referiram alguma atividade parafuncional. Desses a onicofagia representou o grupo com maior frequência, seguido pelo bruxismo, interposição de objetos entre os dentes e por último o apertamento. As variáveis não apresentaram associação estatisticamente significante com o desfecho primário estudado. Conclusão: Na amostra estudada não se observou associação entre a ocorrência de DTM e hábitos parafuncionais em pacientes classe II esquelética... (AU)

Introduction: Temporomandibular disorder (TMD) is the most common chronic orofacial pain, found by dentists and other health professionals. Its etiology has a multifactorial character, and may involve, from hereditary factors, parafunctional habits, malocclusions, to anxiety and stress. Objective: This study investigated the TMD frequency and its relationship among parafunctional habits in a population of skeletal class II patients. Method: A sample composed by a class II patients was selected in a non probabilistic manner. Seventy-three members agreed to participate in the research, submitting themselves to a physical examination that consists in the application of Axis I (RDC/TMD). Results: Forty-six percent of patients diagnosed with a positive diagnosis. The average age of the patients was 27 years ± 8.73 years, 82% female and 80% white. Thirty-four patients reported some parafunctional activity. Of these, biting nail represented the group most frequently, followed by bruxism, interposition of objects between the teeth and lastly clenching. As variables did not present a statistically significant association with the primary outcome studied. Conclusion: In the sample studied, it is observed that there is no association between TMD occurrence and parafunctional habits in skeletal class II patients... (AU)

Comprehensive correction of maxillofacial bone deformity-consideration and combined application of orthognathic surgery and facial contouring surgery / 华西口腔医学杂志

The maxillofacial skeleton is the basis of the contour of the face. Orthognathic surgery and facial contouring surgery change jaw tissue and affect facial appearance in different manners. Orthognathic surgery is the main method to correct dental and maxillofacial deformities. It changes the shape of the jaw and improves the occlusal relationship by changing the three-dimensional position of the jaw. Facial contouring surgery mainly adopts the method of "bone reduction", which changes the "amount"of the jawbone by cutting a part of the bone tissue to improve the facial appearance, generally without changing oral function. The combined use of orthognathic surgery and facial contouring surgery is becoming increasingly common in clinical practice. This also requires oral and maxillofacial surgeons to have a holistic consideration of the comprehensive correction of maxillofacial bone deformity, and to perform comprehensive analysis of jaw deformities and jaw plastic surgery to achieve the most ideal results. The author's team has been engaged in the clinical work of orthognathic surgery and facial contouring surgery and accumulated rich clinical experience in the comprehensive correction of maxillofacial bone deformity. In this article, the indications, treatment goals, treatment modes, treatment methods, and key points in the surgical operations of comprehensive maxillofacial bone surgery were summarized.

Effect of orthodontic treatment on adult severe periodontal disease / 中华医学美学美容杂志

Objective:To investigate the orthodontic treatment of adult severe periodontal disease.Methods:Twenty patients with periodontal disease requiring orthodontic treatment from 2015 to 2017 were selected for systemic periodontal treatment before orthodontic treatment. There were 6 male and 14 female patients aged from 55 to 68 years with average of 62 years.Results:After the orthodontic treatment for 20 to 28 months, the relaxation of the teeth were improved, and the periodontal pocket was disappeared, and the periodontal tissue and alveolar bone conditions were significantly improved, and the biting was better, and the profile of the patients were more satisfactory than before.Conclusion:The orthodontic treatment significantly improves the health of the periodontal tissue, which is a very effective treatment method.

Resultados posoperatorios y satisfacción en pacientes operados de cirugía ortognática durante los años 2011-2018 en Hospital San José, Chile

Resumen Introducción: Las dismorfosis dentofaciales (DDF) corresponden a un conjunto de alteraciones en la forma, posición o tamaño de los huesos maxilares. La cirugía ortognática es el tratamiento quirúrgico de elección para tratar este tipo de alteraciones, permitiendo la reposición de los maxilares y restitución de las funciones masticatorias, fonéticas y respiratorias, así como la estética facial. Objetivo: Describir resultados posoperatorios y el grado de satisfacción de los pacientes que optaron por la cirugía ortognática durante los años 2011-2018 por el equipo de Cirugía Maxilofacial del Hospital San José. Material y Método: Estudio retrospectivo, se evaluaron los protocolos operatorios de 44 pacientes operados de cirugía ortognática. Criterio de inclusión: pacientes mayores de 15 años con diagnóstico de DDF clases II y III no asociado a síndrome craneofacial. Se aplicó una encuesta a estos pacientes para conocer el grado de satisfacción con respecto a la cirugía ortognática efectuada, presencia de pérdida de sensibilidad neurológica y localización anatómica de ésta si la hubiese. Posteriormente, se relacionaron las variables género, edad del paciente al momento de la cirugía, pérdida de sensibilidad neurológica, tiempo de evolución posoperatorio y clase esqueletal con el nivel de satisfacción del paciente respecto a la cirugía ortognática. Resultados: Un 90,9% de los pacientes está satisfecho con los resultados de la cirugía. No existe una relación estadísticamente significativa entre el grado de satisfacción con la cirugía ortognática y las variables, sexo, edad de operación, pérdida de sensibilidad neurológica (del nervio mentoniano, que da inervación sensitiva al tejido blando del mentón, labio inferior, encía por vestibular de incisivos, canino y primer premolar inferior), tiempo de evolución posterior a la cirugía y clase esqueletal. Conclusión: Existe un alto nivel de satisfacción en los pacientes intervenidos mediante cirugía ortognática. Las cinco variables analizadas no influyen en el nivel de satisfacción de los pacientes posterior a la cirugía ortognática.

Abstract Introduction: Dentofacial deformities are a set of alterations in the shape, position or size of the maxillary bones. Orthognathic surgery is the surgical treatment of choice for this type of alterations, allowing the replacement of the maxillary and restitution of masticatory, phonetic and respiratory functions, as well as facial aesthetics. Aim: Describe post-operative results and level of satisfaction in patients who opted for orthognathic surgery during the years 2011-2018 by the Maxillofacial Surgery team of San José Hospital. Material and Method: Retrospective study, the surgical protocols of 44 patients who underwent orthognathic surgery were evaluated. Inclusion criteria: patients over 15 years old with diagnosis of DDF class II and III not associated with any craniofacial syndrome. A survey was applied to these patients to know the degree of satisfaction with respect to the orthognathic surgery carried out, the presence of loss of neurological sensitivity and its anatomical location, if any. Subsequently, the variables gender, patient age at the time of surgery, loss of neurological sensitivity, time of postoperative evolution and skeletal class were related to the level of satisfaction of patients with orthognathic surgery. Results: 90.9% of patients are satisfied with the results of the surgery. There is no statistically significant relationship between the level of satisfaction patients with orthognathic surgery and the variables, gender, age at the time of surgery, loss of neurological sensitivity (of the mentonian nerve, that gives sensitive innervation to the soft tissue of the chin, lower lip, gum by vestibular of incisors, canine and first lower premolar), time of postoperative evolution and skeletal class. Conclusion: There is a high level of satisfaction in patients undergoing orthognathic surgery. The five variables analyzed do not influence the level of patient satisfaction after orthognathic surgery.

Severidad, estética e impacto psicosocial de anomalías dentomaxilofaciales en niños y adolescentes / Severity, aesthetics and psychosocial impact of dentomaxillofacial anomalies in children and adolescents

RESUMEN Fundamento: la apariencia dental simboliza un papel básico en la toma de decisiones de los pacientes con necesidad de tratamiento ortodóncico. Al mismo tiempo, la motivación para emprender una mejora estética, posee un trasfondo más profundo de origen psicosocial que hace imposible separar ambos factores en el análisis. Es por ello, que la comunidad ortodóncica debe desplegar acciones que sirvan de premisa para dar prioridad al tratamiento, sobre todo, en aquellos individuos donde la autoimagen y autoestima despiertan gran interés, entiéndase niños y adolescentes. Objetivo: analizar la relación entre la severidad, estética e impacto psicosocial de anomalías dentomaxilofaciales para la atención ortodóncica en niños y adolescentes. Métodos: se realizó un estudio descriptivo transversal en niños y adolescentes de la clínica estomatológica del Policlínico Docente Tula Aguilera, desde septiembre 2017 a septiembre 2018. Se utilizaron índices epidemiológicos, a saber: índice de estética dental, índice de necesidad de tratamiento ortodóncico y el cuestionario de impacto psicosocial de la estética dental. Se verificó la importancia otorgada por los adolescentes a la estética dental según la severidad de la misma. Resultados: más de la cuarta parte de los adolescentes indicaron que las anomalías dentomaxilofaciales tienen un impacto significativo en su vida, desde la perspectiva psicosocial. El grado de afectación estética moderado predominó según la percepción de los pacientes, en especial el de las féminas. Conclusiones: existió una relación entre la severidad de las anomalías, la afectación estética e impacto psicosocial, comportándose de manera significativa en algunos casos.

ABSTRACT Background: the dental appearance symbolizes a basic role in the decision-making of patients in need of orthodontic treatment. At the same time, the motivation to undertake an aesthetic improvement has a deeper psychosocial background that makes it impossible to separate the two factors in the analysis. That is why; the orthodontic community must deploy actions that serve as a premise to give priority to treatment, especially in those individuals where self-image and self-esteem arouse great interest, children and adolescents. Objective: to analyze the relationship between the severity, aesthetics and psychosocial impact of dentomaxillofacial anomalies for orthodontic care in children and adolescents. Methods: a descriptive cross-sectional study was carried out in children and adolescents of the dental clinic of the Tula Aguilera teaching polyclinic, in the period from September 2017 to September 2018. Epidemiological indexes were used, namely: Index of Dental Aesthetics, Index of Need for Treatment Orthodontic and the Psychosocial Impact Questionnaire of Dental Aesthetics. The importance given by adolescents to dental aesthetics was verified according to its severity. Results: more than a quarter of adolescents indicated that dentomaxillofacial anomalies have a significant impact on their life, from a psychosocial perspective. The moderate degree of aesthetic involvement predominated according to the perception of the patients, especially that of the females. Conclusions: there was a relationship between the severity of the anomalies, the aesthetic affectation and the psychosocial impact, behaving significantly in some cases.

Planejamento virtual em cirurgia ortognática para tratamento de assimetria: relato de caso / Virtual planning in orthognathicsurgey for assimetrytreatment: case report

Introdução: Os casos de assimetria facial são um desafio para a cirurgia Bucomaxilofacial, devido a alterações craniofaciais nos três planos do espaço (Pitch, Yaw e Roll). Estes termos são utilizados para o planejamento da cirurgia ortognática e são essenciais para o planejamento virtual. A utilização da tecnologia neste sentido vem sendo cada vez mais empregada devido a sua previsibilidade de resultado tanto nos casos convencionais como nos mais desafiadores como os das assimetrias faciais. Relato de caso: Paciente do sexo masculino, 30 anos, leucoderma possuía como queixa principal assimetria na face. O procedimento consistiu em planejamento virtual através da cirurgia ortognática para correção de assimetria facial, propiciando maior previsibilidade e estabilidade ao tratamento. Considerações finais: Atualmente a correção das assimetrias possui como padrão ouro o planejamento virtual, pois através dele é possível fazer uma correlação importante entre os achados clínicos com as impressões do planejamento virtual, para alcançar uma boa previsibilidade... (AU)

Introduction: The facial asymmetry cases are a challenge for the oral maxillofacial treatment due craniomaxillofacial alterations in the three spatial plans (Pitch, Yaw e Roll). These terms are used for orthognathic surgical plan and are essentials for the virtual planning. The application of this technology in this situation has been increasingly employed due to its predictability of outcome in both conventional and challenging cases such as facial asymmetries. Case report: Male, white patient, 30 years-old had a main complaining of facial asymmetry. The procedure consisted in virtual planning trough the orthognathic surgery for facial asymmetry correction, providing higher predictability and stability to the treatment. Final considerations: Currently the correction of asymmetries has as golden pattern the virtual planning, because trough he it is possible to do an important correlation between the clinical findings with the virtual planning impressions, with the objective to achieve a good predictability... (AU)

Estudio comparativo del espacio aéreo faríngeo según deformidades dentofaciales en radiografías cefalométricas / Comparative study of pharyngeal airway space according to dentofacial deformities in cephalometric radiographs

RESUMEN Objetivo: Comparar la dimensión del espacio aéreo faríngeo superior e inferior en las deformidades esqueléticas clase I, II y III determinadas en radiografías cefalométricas. Material y métodos: Se realizó un estudio de tipo retrospectivo donde se analizó 106 radiografías cefalométricas, tomadas en el centro radiográfico del Centro Universitario de Salud de la Universidad Peruana de Ciencias Aplicadas entre los años 2011 y 2014. A través del programa Nemoceph® se marcaron los puntos y trazados cefalométricos principales para determinar la de-formidad esquelética (según Steiner) y la dimensión de las vías aéreas superior e inferior (según McNamara). Resultados: La mayor dimensión en promedio (17,68 mm), se encontró en el espacio aéreo faríngeo superior (EAFS) con en la deformidad dentofacial clase III (DDF clase III) y la menor dimensión en promedio (13,71 mm) en la DDF clase II. En el espacio aéreo faríngeo inferior (EAFI), el mayor promedio (15,98mm) se presenta en la DDF clase III y el menor promedio (13,19mm) en la DDF clase II. Al comparar la dimensión del espacio faríngeo (EAF) entre las DDF, se encontró que existe diferencias estadísticamente significativas entre el EAFS de las DDF II y III, con un valor de p = 0,001; y en el inferior entre DDF III con DDF I y DDF III con DDFII con valores de p=0,0236 y p=0,0042 respectivamente. Conclusiones: En este estudio se encontró que existe diferencias estadísticamente significativas en el espacio aéreo faríngeo superior e inferior entre las tres clases de deformidades esqueléticas.

SUMMARY Objectives: Compare the dimension of the upper and lower pharyngeal airspace between the skeletal deformities class I, II and III in cephalometric radiographs. Material and methods: A retrospective type of study was made where there were analyzed 106 side radiogra-phies, taken in the X-ray center of the University health Center of the Peruvian University of Applied Sciences UPC between the years 2011 and 2014. Through the program Nemoceph® the main cephalometrics points and tracings were marked to be able to obtain the skeletal deformity (Steiner) and the dimension of the upper and lower airspace (McNamara). Results: In the upper pharyngeal airspace it was found that the highest aver-age dimension was 17.68 mm founded in the dentofacial deformation class III, and the lowest in class II with a value of 13.71 mm. Fort the lower airspace, the highest average was 15.98mm and the lowest 13.19mm, also founded in skeletal deformation Class III and Class II respectively. While comparing the size of the pharyngeal space between classes of deformity, it was found that there is statistically significant difference between the upper airspace of skeletal deformities class II and III with a value of p = 0.001; and in the lower, between classes III - I and III - II with values of p=0.0236 and p=0.0042 respectively. Conclusions: In this study it was found that there is a statistically significant difference in the upper and lower pharingeal airspace between the three dentofacial skeletal deformities.

Treatment of dentofacial deformities secondary to condylar resorption / 华西口腔医学杂志

Treating dentofacial deformities secondary to condylar resorption is a remarkable clinical challenge. Combined orthodontic treatment and orthognathic surgery is currently the main treatment scheme and is often integrated with temporomandibular joint surgery or conservative treatment according to the severity of condylar resorption. This paper discussed the etiology, clinical features, imaging features, treatment options, and prophylaxis of condylar resorption.

Espectro de dismorfosis dentofaciales: estudio restrospectivo de 23 años en hospital tipo I de alta complejidad Chile / 23 years of dentofacial deformities patients treated in a tertiary referral hospital in chile. retrospective study

RESUMEN: Objetivo: Determinar los tipos de dismorfosis dentofaciales (DDF) operados en el Hospital Clínico San Borja Arriarán, Santiago, Chile (HCSBA) entre los años 1993 - 2015 y su distribución por sexo y edad al momento de la intervención quirúrgica. Material y Método: Estudio retrospectivo, el criterio de inclusión fue diagnóstico de DDF (clases II o III esqueletal) no asociado a síndrome. La edad de los pacientes se describió con promedio y desviación estándar y el sexo con porcentajes. Análisis estadístico se realizó mediante test de Proporciones, T de Student, prueba Exacta de Fisher y modelo multivariado. Se consideró un valor p<0,05 como significativo. Resultados: De 1.008 pacientes operados por el equipo de cirugía oral y máxilofacial entre 1993 - 2015, 570 (56,5%) fueron intervenidos por cirugía ortognática para corrección de DDF. 76 (13,3%) por DDF tipo II y 494 (86,7%) por DDF tipo III. El mayor porcentaje fueron 366 mujeres (64,2%), la edad promedio fue 26,9 (DS 10,8) años en clase II y 22,8 (DS 6,8) años en clase III. Todas estas diferencias fueron estadísticamente significativas. El rango de edad con mayor porcentaje de operaciones fue entre los 20 - 30 años (55,6%). Conclusión: La DDF más frecuentemente operada es la DDF III y el mayor porcentaje son mujeres entre los 20 - 30 años.

ABSTRACT: Objective: To determine main characteristics of dentofacial deformities (DDF) patients treated with orthognathic surgery at San Borja Arriarán Clinical Hospital, Santiago, Chile (HCSBA) during the last 23 years. Materials and methods: This is a retrospective study, the cases are registered in the electronic database of the oral and maxillofacial service of the HCSBA between 1993 - 2015. Inclusion criteria were patients with a diagnosis of DDF (skeletal class II or III) - not associated with syndromes- who went under orthognathic surgery since 1993 to 2015. Characteristics analysed included: type of DDF, sex and age. Results were described using percentage, mean and standard deviation. Proportion, Student's Ttest, Exact Fisher Test and a multivariate model were utilized for statistical analysis. A p-value <0.05 was considered significant. Results: A total of 1.008 patients were surgically treated. During this period 570 (56,5%) patients underwent orthognathic surgery to correct DDF, 76 (13.3%) for DDF type II and 494 (86.7%) for DDF type III. Most patients intervened were women 366 (64.2%). The mean age was of 23.3 years; 26.9 (SD 10.8) years in class II and 22.8 SD (6.8) years in class III. All differences were statistically significant. The age range with the highest percentage of operations was between 20 - 30 years (55.6%). Conclusion: The most frequently operated DDF is type III, the highest percentage being women and young adults between 20 - 30 years.

Application of digital technology in diagnosis and treatment of dentofacial deformities / 口腔疾病防治

@#Dento-maxillofacial deformity refers to an abnormal relationship of the volume or shape of the upper and lower jaw bones with the other bones of the craniofacial area. Its correction mainly involves hard tissues, such as the jaws and teeth. In recent years, digital techniques based on virtual surgery, real-time navigation, and 3D printing have developed rapidly in the area of craniomaxillofacial surgery. Digital technology has advantages for preoperative diagnosis, surgical plan formulation, surgical simulation, intraoperative navigation, effect prediction, doctor-patient communication, and young physician training. The Department of Orthognathic and TMJ Surgery of West China Hospital of Stomatology, Sichuan University, has conducted digitized diagnosis and treatment of dento-facial deformities since 2008 and has established a digital center for the treatment of dentofacial deformities based on equipment such as spiral CT, dental arch laser scanners, facial 3D cameras, virtual surgery software, 3D printers, and sleep-breathing monitoring. The result is a diagnostic and treatment protocol for dentofacial deformity specific to the characteristics of the population of West China. This article combines the latest domestic and foreign literature and comprehensively introduces the application of digital technology for the diagnosis and treatment of dental and maxillofacial deformities.

Pressure and resistance of the lips in subjects with and without occlusal change / Pressão e resistência dos lábios em sujeitos com e sem alteração oclusal

ABSTRACT Objective: to evaluate the resistance and pressure of the lips in Class I, II and III Angle's malocclusion subjects, in comparison to reference values and relate them with gender and age. Methods: a quantitative, descriptive and cross-sectional study. Participants included 40 subjects, 20 women and 20 men, average age 26.3 years, separated by occlusal classification. The volunteers answered on the self-reported performance of the stomatognathic functions and were submitted to the evaluation of the mobility and posture of the lips. Pressure and resistance were measured with the Iowa Oral Performance Instrument (IOPI) and the results compared to the reference values described in the instrument´s manual. The data were analyzed descriptively and, for inferential analysis, Pearson's Chi-Square test was used. The significance level was considered 5%. Results: a decrease in pressure and resistance values wasobserved in all patients, including Angle's class I group. There was an inverse relationship between the age of the subjects and the values of pressure of lips with statistical significance (p = 0.02). In general, women had lower pressure values than men. Conclusion: all study subjects had lower pressure of the lips than the reference values described in the literature.

RESUMO Objetivo: avaliar a pressão e resistência dos lábios em sujeitos com má oclusão classe I, II e III de Angle, comparativamente a valores de referência e relacioná-las com sexo e idade. Métodos: estudo quantitativo, descritivo e transversal. Participaram 40 sujeitos, 20 mulheres e 20 homens, idade média 26,3 anos, separados pela classificação oclusal. Os voluntários responderam sobre queixa autorreferida de desempenho das funções estomatognáticas e foram submetidos à avaliação da mobilidade e postura dos lábios. Pressão e resistência foram aferidas com Iowa Oral Performance Instrument(IOPI) e os resultados comparados aos valores de referência descritos no manual do referido equipamento. Os dados foram analisados descritivamente e, para análise inferencial, utilizou-se o teste Qui-Quadrado de Pearson. Considerou-se nível de significância de 5%. Resultados: foi possível observar diminuição dos valores de pressão e resistência em todos os participantes, inclusive no grupo classe I de Angle. Foi encontrada uma relação inversa entre a idade dos sujeitos e os valores de pressão de lábios com significância estatística (p=0,02). De uma maneira geral, as mulheres apresentaram valores de pressão mais baixos que os homens. Conclusão: todos os sujeitos do estudo apresentaram valores de pressão labialinferiores aos de referência, descritos na literatura.

Cirugía ortognática para el tratamiento de las anomalías dentoesqueletales / Orthognathic surgery for the treatment of dentoskeletal abnormalities

Las anomalías dentoesqueletales se presentan en el 2-3% de la población. Las mismas afectan el complejo maxilomandibular como también la relación entre las arcadas dentarias. Estas alteraciones producen problemas fonéticos, deglutorios, respiratorios y estéticos. Existe una tendencia en corregir las alteraciones dentarias sin tratar las discrepancias esqueletales, dificultando la corrección quirúrgica, si esta fuera necesaria. Actualmente, la cirugía ortognática ha tenido mayor aceptación como el tratamiento ideal para pacientes con estas anomalías. Se presentará una revisión de la literatura sobre las características que esta alteración presenta, junto a la resolución de casos clínicos (AU)