Does Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) reflect the impact of malocclusion on facial aesthetics?

ABSTRACT Introduction: Malocclusion is presumed to have adverse effects on dental and facial attractiveness, leading to deleterious psychosocial impact and Quality of life(QoL) of the individual. The Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) has proved to be effective for assessment of psychosocial impact of malocclusion on dental aesthetics, but it's effectiveness for assessing facial aesthetics is unknown. Objective: The aim of the present study was to assess the effectiveness of PIDAQ on its ability to reflect the psychosocial impact of malocclusion on facial attractiveness, using the Facial Aesthetic index (FAI) after its translation and validation in the regional language. Methods: The 23-item PIDAQ, after translation process, cross-cultural adaptation and pilot testing, was administered to 330 subjects (62.5 % females and 37.5 % males; age range 18-30 years) with varying degrees of severity of malocclusion, assessed by the two components of the Index of Orthodontic Treatment Need (Dental Health Component, IOTN-DHC, for normative need; and self-administered Aesthetic Component, IOTN-AC, for subjective need) and FAI. Results: The internal consistency and test-retest reliability were good (Cronbach's alpha = 0.859 - 0.958; Intraclass correlation coefficient =0.984). FAI, IOTN-DHC and IOTN-AC scores showed highly significant correlation with PIDAQ scores, depicting strong convergent validity (p< 0.001). One-way analysis of variance (ANOVA) and Bonferroni post-hoc test showed highly significant correlations (p-value < 0.001) for all comparisons. There were no significant differences between responses of males and females. The regional version of PIDAQ had excellent reliability. Conclusions: PIDAQ showed good psychometric properties and was able to effectively reflect the psychosocial impact of malocclusion on altered facial aesthetics.

RESUMO Introdução: Acredita-se que a má oclusão tenha efeitos adversos na estética dentária e facial, levando a um impacto psicossocial e na qualidade de vida (QV) do indivíduo. O questionário PIDAQ (Psychosocial Impact of Dental Aesthetic Questionnaire) provou ser eficaz para avaliação do impacto psicossocial da má oclusão na estética dental, mas sua eficácia para avaliar a estética facial é desconhecida. Objetivo: O objetivo do presente estudo foi avaliar a eficácia do PIDAQ em refletir o impacto psicossocial da má oclusão na atratividade facial, usando o Índice de Estética Facial (FAI) após sua tradução e validação na linguagem regional. Métodos: O PIDAQ com 23 itens, após o processo de tradução, adaptação transcultural e teste piloto, foi administrado a 330 indivíduos (62,5% do sexo feminino e 37,5% do sexo masculino; faixa etária de 18 a 30 anos) com má oclusão de gravidade variada, avaliados pelos dois componentes do Índice de Necessidade de Tratamento Ortodôntico (Componente de Saúde Dentária, IOTN-DHC, para necessidade normativa; e Componente Estético auto-administrado, IOTN-AC, para necessidade subjetiva) e pelo FAI. Resultados: A consistência interna e a confiabilidade teste-reteste foram boas (alfa de Cronbach = 0,859-0,958; coeficiente de correlação intraclasse = 0,984). Os escores FAI, IOTN-DHC e IOTN-AC mostraram correlação altamente significativa com os escores do PIDAQ, representando forte validade convergente (p< 0.001). A análise de variância (ANOVA) de uma via e o teste post-hoc de Bonferroni mostraram correlações altamente significativas (p < 0,001) para todas as comparações. Não houve diferenças significativas entre as respostas de homens e mulheres. A versão regional do PIDAQ apresentou excelente confiabilidade. Conclusões: O PIDAQ mostrou boas propriedades psicométricas e foi capaz de refletir efetivamente o impacto psicossocial da má oclusão na estética facial alterada.

Prospective study of the aesthetic effect of botulinum toxin a when injected into the muscles of facial expression

Botulinum neurotoxin A (BoNT-A) causes an anticholinergic effect on neuronal fibers, which control muscle contraction and autonomic disorders. Thus, it has been widely used in facial aesthetics, decreasing the action of motor muscles and consequent wrinkles. This preliminary study evaluated the effect of BoNT-A in 77 patients, the treatment satisfaction index was defined in percentage (from 0% to 100%). The evaluation was carried out on 15th, 30th, 60th, 90th, and 180th days after BoNT. The data were analyzed using the Friedman, Student t, Mann-Whitney test with t (alpha=0.05). The results showed that at 15th and 30th days the scores were similar in all muscles with high level of satisfaction and until 90th days the scores decreased significantly for Corrugator supercilii 79.38%, Occipitofrontalis 71.46%, Orbicularis oculi 70.43%; but the satisfaction was good. At 180 days, there was a drop in effectiveness in all treated muscles since the scores decreased significantly, showing low satisfaction by the participants. This study demonstrated that the BoNT-A had attested satisfaction effect by participants for up to 90th days, but at 180th days the satisfaction was low. In the comparative analyzes between women under 40 and over 40 years of age, there was no significant differences.

About chin (genioplasty) surgery / Sobre cirugía del mentón (genioplastía)

Facial harmony is the consequence of a proper balance between all facial structures. The identification and classification of morphologic characteristics that detract from facial harmony is most effectively accomplished by clinical examination. The maintenance of the ratios between the facial thirds, correct spatial bone position and soft tissues accommodation are all factors that directly contribute in a balanced facial profile. The chin, likewise, contributes significantly in facial balance, mainly in the profile view. Expressive changes on chin position are associated with the perception of strong or delicate characters. Thus, over the years, a series of studies has been constructed focusing on mandibular osteotomies techniques that enable changes in chin position: advances, setback, extrusion, intrusion, widening, narrowing and asymmetry. This study aims to address historical and technical aspects of genioplasty; associating patient's condition with the surgical techniques that can be applied for correction of chin deformities.

La armonía facial es la consecuencia del balance entre las estructuras facial. La identificación y clasificación de las características morfológicas que están acompañando la armonía facial son mas efectivas al realizar un estudio de análisis facial. La obtención de promedios entre los tercios, corrección especial de la posición del hueso y la acomodación de los tejidos blandos son factores directamente involucrados en el balance del perfil. El mentón, contribuye significativamente en este balance. Cambios expresivos en la posición del mentón son asociados con la percepción de características fuertes o delicadas. Durante los años, una serie de estudios han sido desarrollados enfocándose en las osteotomías mandibulares y técnicas capaces de alcanzar los cambios en la posición del mentón: avances, retrocesos, extrusiones, ensanchamientos, estrechamientos y asimetrías. Este estudio pretende orientar las condiciones históricas y técnicas respecto de la genioplastia; la asociación de las características del paciente con la técnica quirúrgica pueden ser aplicadas para la corrección de las deformidades.

Assessment of facial analysis measurements by golden proportion / Avaliação das medidas de análise facial pela proporção áurea

Abstract Introduction: The face is the most important factor affecting the physical appearance of a person. In facial aesthetics, there is a specific mathematical proportion, which is called golden proportion, used to measure and analyse facial aesthetic qualities in population. Objectives: The aim of this study was to measure the facial soft tissue proportions which would help to constitute a standard for facial beauty and diagnose facial differences and anomalies and to compare these proportions to the golden proportion. Methods: One hundred and thirty-three (133) Turkish patients 18-40 years of age (61 females, 72 males) were involved in the study. Analysis of the photographs was performed by the same physician, and a software programme was used (NIH Image, version 1.62). Facial proportions were measured and differences from the golden proportions were recorded and grouped as normal (1.6-1.699), short (<1.6) and long (>1.699). Results: According to the facial analysis results, the trichion-gnathion/right zygoma-left zygoma was assessed: 33.1% of the patients were in normal facial morphology, 36.8% were in long facial morphology and 30.1% were in short facial morphology, according to this proportion. The trichion-gnathion/right zygoma-left zygoma proportion was significantly higher in males than females (p < 0.001). Statistically significant difference was noted in gender groups, according to the trichion-gnathion/right zygoma-left zygoma and the right lateral canthus-left lateral canthus/right cheilion-left cheilion proportions (p = 0.001, p = 0.028). Conclusion: Facial proportion assessments in relation to the golden proportion showed that a statistically significant difference was observed between gender groups. Long facial morphology was observed more in males (51.4%); normal (41%) and short (39.3%) facial morphology were more common in females. The measurements and proportions for facial balance in our study population showed that the facial width and height proportions deviated from the golden proportion.

Resumo Introdução: A face é o aspecto mais importante da aparência física de uma pessoa. Na estética facial, existe uma proporção matemática específica, chamada de proporção áurea. A proporção áurea é usada para medir e analisar as qualidades estéticas da face na população. Objetivo: Medir as proporções dos tecidos moles faciais que contribuem para o padrão da beleza facial, auxiliar a percepção e o diagnóstico das diferenças e anomalias faciais e comparar essas proporções com a proporção áurea. Método: Foram incluídos no estudo 133 pacientes turcos com 18 a 40 anos (61 mulheres, 72 homens). A análise das fotografias foi realizada pelo mesmo médico e um programa de software foi usado (NIH Image, versão 1.62). As proporções faciais foram medidas e as diferenças das proporções áureas foram registradas e agrupadas como normais (1,6-1,699), curtas (< 1,6) e longas (> 1,699). Resultados: De acordo com os resultados da análise facial, avaliou-se a proporção do tríquion-gnátio/zigoma direito-zigoma esquerdo e 33,1% dos pacientes apresentaram morfologia facial normal, enquanto 36,8% tinham morfologia facial longa e 30,1% morfologia facial curta, segundo essa proporção. A proporção do tríquion-gnátio/zigoma direito-zigoma esquerdo foi significantemente maior em homens do que em mulheres (p < 0,001). Uma diferença estatisticamente significante foi observada entre os sexos, de acordo com a proporção do tríquion-gnátio/zigoma direito-zigoma esquerdo e do canto lateral direito-canto lateral esquerdo/ângulo cantal direito- ângulo cantal esquerdo (p = 0,001, p = 0,028). Conclusão: A avaliação da proporção facial em relação à proporção áurea mostrou que houve diferença estatisticamente significante entre os sexos. A morfologia facial longa foi mais observada no sexo masculino (51,4%), a morfologia facial normal (41%) e a curta (39,3%) foram mais comuns no sexo feminino. As medidas e proporções para o equilíbrio facial em nossa população estudada mostraram que as proporções de largura e altura faciais se desviaram da proporção áurea.

Prevalence of Actinic Keratosis on a Facial Aesthetic Unit / 대한피부과학회지

No abstract available.

Important aspects to consider in facial analysis for Orthognatic Surgery / Aspectos importantes a considerar en el análisis facial para la Cirugía Ortognática

The process of facial analysis for orthognathic surgery has become of utmost importance over the last several decades, many studies show that the correction of occlusion in a dentofacial deformity does not always reach the desired facial proportions. There is no face completely symmetrical; However, the absence of some asymmetry is essential for an aesthetic outcome. Moreover, the perfect understanding of the face balance prior to treatment is critical to obtain the success of the treatment plan. Thus, the search for facial harmony requires an organized process of facial evaluation; which we intend to address in this article.

El proceso de análisis facial para la cirugía ortognática se ha vuelto de suma importancia en las últimas décadas, muchos estudios muestran que la corrección de la oclusión en una deformidad dentofacial no siempre alcanza las proporciones faciales deseadas. No hay rostro completamente simétrico; sin embargo, la ausencia de alguna asimetría es esencial para un resultado estético. Además, la comprensión perfecta del equilibrio facial antes del tratamiento es fundamental para obtener el éxito del plan de tratamiento. Por lo tanto, la búsqueda de armonía facial requiere un proceso organizado de evaluación facial; que intentamos abordar en este artículo.

Análisis de los criterios médico legales para la valoración del perjuicio estético en el rostro en la clínica médico forense: estudio de casos penales en el año 2011 / Analysis of legal medical criteria for the assessment of disfigurement on the face in forensic medical clinic: study of criminal cases in 2011

El presente trabajo busca responder a la necesidad de contar con un estudio actualizado sobre valoración del perjuicio estético en el rostro en el campo de la medicina legal en Costa Rica. Para este estudio se utilizó una población de 239 casos valorados por secuelas de lesiones en el rostro extraídos de los expedientes de la Sección de Clínica Médico Forense del Departamento de Medicina Legal en el año 2011. Se utilizaron variables sociodemográficas y variables utilizadas en la caracterización y valoración del perjuicio estético en el rostro. dentro de los resultados más relevantes del estudio se evidenció un predominio de casos del sexo masculino y en el grupo de edad de los 20 a 29 años, las lesiones encontradas, en la mayoría de los casos, fueron producidas con un objeto contundente. El tipo de perjuicio estético más encontrado fueron las cicatrices, en más de la mitad de los casos no se indicó si las cicatrices producían alteración de la armonía facial o si eran retráctiles y en una tercera parte tampoco se mencionaba si producían alteración de la mímica facial. La mayoría de las cicatrices se describieron como hipocrómicas y planas. En cuanto a la visibilidad más de la tercera parte de los casos presentaban lesiones descritas como visibles a distancia de conversación y un 20% se describieron como visibles a distancia social. Solamente la quinta parte de los casos valorados, se catalogaron como con marca indeleble. En cerca de un 70% de los casos no se estableció porcentaje de incapacidad permanente. El presente estudio refleja la importancia de la valoración del perjuicio estético en la actualidad así como la necesidad de contar con criterios estandarizados para realizar este tipo de valoraciones así como para determinar la presencia de marca indeleble en el rostro.

The present study aims to answer the need to have an up to date study related to facial aesthetic damage assessment in the field of legal medicine in Costa Rica. For this study it was used a population of 239 cases evaluated for facial injury sequels extracted from the files of the Clinical Forensic Medicine Section of the Legal Medicine Department in Costa Rica during the year 2011. Variables used include socio demographic and others used in characterization and evaluation of facial aesthetic damage. Among the most relevant results of this study it was evidenced a predominance of masculine cases and in the group of 20 to 29 years, the injuries, in the majority of cases, were produced by a blunt object. The most frequent type of aesthetic damage encountered were the scars, in more than half of the cases it was not indicated if the scars produced alteration of the facial harmony or if they were retractable and in a third of cases it was not mention if there was facial mimic alteration. The majority of the scars were described as hipocromic and flat. In regard to visibility, in more than a third of the cases the alterations were described as visible in conversation distance and 20% as visible in social distance. Only a fifth part of the cases were cataloged as indelible mark. In nearly a 70% of the cases no percentage of permanent impairment were established The present study reflects the importance of the evaluation of the aesthetic damage nowadays and also the need to have standardized criteria to perform this kind of assessment and to determine the presence of facial indelible mark.

Conceito tridimensional: nova tendência no tratamento estético facial / Three-dimentional treatment: new trends in aesthetic procedures

A maneira de se aplicar toxina botulínica e preenchedores com ácido hialurônico vem modificando-se ao longo dos últimos anos. A proposta deste artigo é apontar algumas das mais prováveis causas que levaram a estas modificações e apontá-las, indicando as novas tendências no tratamento estético facial.

Reposición maxilar y reconstrucción con injerto de cresta lliaca: parte 1: indicaciones y técnica quirúrgica / Maxillary repositioning and reconstruction with lliac crest graft: part 1: indications and surgical technique

Las técnicas de implantología actuales, no se limitan a evaluar la instalación de implantes y la rehabilitación protésica, sino que deben abocarse a resolver los problemas integrales de nuestros pacientes. De esta forma, devolver armonía facial perdida debe ser un criterio trascendente en la elección de los tratamientos. Con este principio, la estética se establece como un punto de inicio de nuestras terapias, lo cual lleva obligatoriamente a interrelacionarla con la función del sistema estomatognático. Este artículo tiene como objetivo discutir algunos conceptos asociados a la reconstrucción de maxilares atróficos y establecer su relación con fenómenos de deficiencias dentofaciales. Desarrollamos una revisión de aspectos que consideramos relevantes a la hora de escoger determinados tratamientos y presentamos uno de nuestros casos para ejemplificarlo.

Despite solve the implant installation and prosthesis rehabilitation the actual implant are also used to solve other disorders. This way, restore the facial symmetry lost has to be transcendent criteria when choosing a treatment. With this principle, aesthetic becomes a major point in our therapy, correlating it with the stomatognathic system function. The meaning of the present article is discuss some concepts associated with the reconstruction of the atrophic maxillas and established its relation with dentofacial deformities. It was performed a literature review of some points that we consider relevant when choosing a treatment planning and showing one of ours clinical case to exemplify.

Distribution of Histologic Subtypes of Basal Cell Carcinoma by Facial Aesthetic Unit and Subunit / 대한피부과학회지

BACKGROUND: Surgical removal and reconstruction in basal cell carcinoma(BCC) located in the face is important both functionally and cosmetically, however, evaluation of clinical and histological characteristics of BCC in view of dermatologic surgery is not enough. OBJECTIVE: To assess the anatomic distribution of primary and recurrent BCCs, and of histological subtypes based on facial aesthetic units and subunits. And to establish their importance and their application to the dermatologic surgery field. METHODS: We reviewed patients' charts to extract clinical data and reexamined their histologic patterns on the excised specimen, classifying then into 5 categories and mapped the anatomical location of the histologic subtype on schematic drawings of the facial the aesthetic unit and subunit. RESULTS: The location of occurrence in BCCs were on the junctional lines, nose, periorbital area respectively. Of 60 cases occurred in H-zone, 48 cases(80%) occurred in T-zone, and of 9 recurrent cancers occurred in H-zone, 7 cases occurred in T-zone. Among the 5 histologic subtypes, the nodular type was the most common on each of the aesthetic units. And in the junctional lines, the nodular type occurred in almost all cases. The nodulomorpheic type occurred relatively more on forehead, nose and infraorbital area of the cheek. CONCLUSION: We confirmed the relationship between the clinical, histological characteristics and facial aesthetic unit and subunit. And we also proved that T-zone was the most dangerous zone.