Interdisciplinariedad en el diagnóstico del síndrome de clase III esquelético de Moyers / Interdisciplinarity in the diagnosis of Moyers skeletal class III syndrome

RESUMEN Fundamento: Dentro de las anomalías de la oclusión que provocan afectación estética y funcional en los pacientes, se destaca el síndrome de clase III esqueletal de Moyers, cuyo diagnóstico debe ser preciso y precoz. Objetivo: Cuantificar la concordancia entre los criterios diagnósticos ortodóncicos y médicos en los portadores del síndrome de clase III esquelético de Moyers. Metodología: Se realizó un estudio observacional, descriptivo y transversal en la Clínica Estomatológica Provincial Docente "Mártires del Moncada" de Santiago de Cuba desde enero de 2018 hasta enero de 2020. Se estudiaron, por Ortodoncia y diferentes especialidades médicas seleccionadas, 15 pacientes de 8 a 18 años de edad diagnosticados clínica y cefalométricamente con clase III esqueletal de Moyers. Resultados: El nivel de acuerdo entre ortodoncia y las diferentes especialidades médicas fue leve con Oftalmología (Kappa=0.10), casi perfecta con Ortopedia (Kappa=1.00), pobre por Gastroenterología y por Otorrinolaringología (Kappa de 0.09 y 0.10 respectivamente), resultados estadísticamente significativos solo con Ortopedia. Conclusiones: Es evidente la marcada concordancia entre los diagnósticos ortodóncicos y ortopédicos en el síndrome de clase III esquelético, a diferencia del resto de las especialidades médicas; probablemente asociado a la no estandarización de las evaluaciones clínicas.

ABSTRACT Background: Among the occlusion anomalies that cause esthetic and functional affectation in patients, Moyers skeletal class III syndrome stands out, its diagnosis should be accurate and early. Objective: To quantify the concordance between orthodontic and medical diagnostic criteria in patients with Moyers skeletal class III syndrome. Methodology: An observational, descriptive and cross-sectional study was conducted at the "Mártires del Moncada" Provincial Teaching Dental Care Clinic of Santiago de Cuba from January 2018 to January 2020. 15 patients aged 8 to 18 years clinically and cephalometrically diagnosed with Moyers skeletal class III were studied by Orthodontics and different selected medical specialties. Results: The level of agreement between Orthodontics and the different medical specialties was slight for Ophthalmology (Kappa=0.10), almost perfect for Orthopedics (Kappa=1.00), poor for Gastroenterology and Otolaryngology (Kappa of 0.09 and 0.10 respectively), statistically significant results only for Orthopedics. Conclusions: The manifest concordance between orthodontic and orthopedic diagnoses in skeletal class III syndrome is evident, unlike the rest of the medical specialties; probably associated with non-standard clinical evaluations.

Correlation between different types of malocclusions and body image issues in college students / 中国学校卫生

Objective@#To explore the correlation between malocclusion and body image issues in college students.@*Methods@#A total of 1 851 students in three universities in Jingmen were selected by using stratified cluster sampling method. Angle s classification of malocclusion was used to determine the number of three types of malocclusions. Body image issues were self reported and its relationship with different types of malocclusions was explored.@*Results@#The proportions of Classes Ⅰ, Ⅱ and Ⅲ malocclusion in college students with malocclusion were 71.21%, 16.32%, and 12.47%, respectively. The detection rates of body image issues among students with Classes Ⅰ,Ⅱ and III malocclusions were 36.64%, 54.78% and 65.83%, respectively. No significant difference were found in the detection rates of sexual organ issues and gender issues in college students with different types of malocclusions( χ 2= 0.75, 0.53, P >0.05). There were significant differences in the detection rates of appearance troubles (27.59%, 33.12%, 50.83% ) and stature troubles ( 24.09% , 31.21%, 44.17%) in students with Classes Ⅰ, Ⅱ and Ⅲ malocclusions( χ 2=5.62, 2.89, P <0.05).@*Conclusion@#The prevalence of body image issues in college students increases with severity of malocclusions. Appearance and stature troubles are issues mostly concerned among college students. Psychological evaluation for students with Class Ⅲ malocclusion should be especially emphasized when administrating orthodontic treatment.

Utilización del botón de Nance modificado para la propulsión mandibular / Utilization of the modified Nance button for mandibular propulsion

RESUMEN Introducción: En sus inicios la mayoría de los aparatos funcionales fueron removibles, pero cada día más se incrementan los fijos. Su combinación puede incrementar la eficacia en el tratamiento del retrognatimo mandibular. Objetivo: Presentar los resultados del tratamiento con el botón de Nance modificado en una paciente con retrognatismo mandibular. Caso clínico: Paciente femenina de 13 años de edad, que presenta perfil convexo, disfunción neuromuscular, dentición permanente en ambos maxilares con presencia de ligero apiñamiento anterior, relación molar bilateral de distoclusión de ½ unidad, resalte y sobrepase incisivos de 6 mm, mala relación intermaxilar causada por retrognatismo de la mandíbula y escaso remanente de crecimiento mandibular activo. La primera etapa del tratamiento, incluyó psicoterapia, mioterapia y avance mandibular con un aparato funcional fijo (botón de Nance modificado para la propulsión mandibular). A los nueve meses de iniciar el tratamiento se comprobó el cambio en las relaciones intermaxilares en sentido antero-posterior, con disminución del ángulo ANB hasta 20 e incremento del SNB a 78, como reflejo de una buena relación de las bases ósea por crecimiento mandibular. Conclusiones: El tratamiento realizado a la paciente con el botón de Nance modificado para la propulsión mandibular, permitió la obtención de relaciones intermaxilares favorables.

ABSTRACT Introduction: In the beginning, most of the functional appliances were removable, but the fixed ones are increasing every day. Their combination can increase the effectiveness in the treatment of mandibular retrognathymus. Objective: To present the results of the treatment of a patient with mandibular retrognathism treated with the modified Nance button. Case report: A 13-year-old female patient with convex profile, neuromuscular dysfunction, permanent dentition in both jaws with the presence of slight anterior crowding, bilateral distoclusion molar ratio of ½ unit, incisor protrusion and overhang of 6 mm, poor intermaxillary relationship caused by retrognathism of the mandible and little remnant of active mandibular growth. The first stage of treatment included psychotherapy, myotherapy and mandibular advancement with a fixed functional appliance (modified Nance button for mandibular propulsion). Nine months after starting the treatment, the change in the intermaxillary relationships in the anteroposterior direction was verified, with a decrease in the ANB angle to 20 and an increase in the SNB to 78, as a reflection of a good relationship of the bone bases due to mandibular growth. Conclusions: One year after treatment with the modified Nance button for mandibular propulsion, a correct relationship of the patient's bone bases was achieved.

Cambios mandibulares después de una expansión maxilar rápida. Revisión de la literatura / Mandibular changes after rapid maxillary expansion. Literature review

El objetivo de esta revisión de literatura es reportar los cambios dentoalveolares y esqueléticos del arco mandibular después de una expansión maxilar rápida (EMR) en denticiones mixtas. Se realizó una búsqueda electrónica en las siguientes bases de datos: Medline/PubMed, Scopus, LILACS y búsqueda manual en las principales revistas de ortodoncia (American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontics, Seminars in Orthodontics) y en Google Scholar. Los criterios de elegibilidad incluyeron todos los estudios relacionados al tema de la revisión, en inglés y español, sin restricción del año de publicación. De un total de 62 artículos encontrados, se eligieron 10 para ser analizados. Diversos autores coinciden en la presencia de cambios esqueléticos y dentoalveolares espontáneos clínicamente significativos en el arco dental mandibular a corto y largo plazo después de la EMR. Durante el período posterior a la EMR, se pudo observar un desplazamiento anterior mandibular debido a la sobreexpansión del maxilar, además, se registraron cambios dentoalveolares y aumento en el ancho de las arcadas dentarias.

The objective of this literature review is to report dentoalveolar and skeletal changes of the mandibular arch after rapid maxillary expansion (RMS) in mixed dentitions. An electronic search was carried out in the following databases: Medline/PubMed, Scopus, LILACS as well as manual search in the main orthodontic journals (American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontics, Seminars in Orthodontics) and Google Scholar. The eligibility criteria included all studies related to the topic being reviewed, in English and Spanish, without restrictions on the year of publication. Of a total of 62 articles found, 10 were chosen to be analyzed. Quite a few authors agree on the presence of clinically significant spontaneous skeletal and dentoalveolar changes, in the mandibular dental arch in short and long term after RMS. During the aftermath of the RMS, an anterior mandibular displacement could be observed due to the overexpansion of the maxilla, in addition, dentoalveolar changes and an increase in the width of the dental arches were recorded.

3D Assessment of the Correlation between Neonatal Morphology and Occlusal Outcomes in 5-Year-Old Patients with Complete Unilateral Cleft Lip and Palate

ABSTRACT Objective: To exploit 3D measurement technology to determine any correlation between neonatal palate morphology and occlusal outcomes at five years in patients receiving surgery for unilateral cleft lip and palate (CLP). Material and Methods: Twenty-nine neonatal and 5-year models treated by the same surgeon using the same protocol for CLP correction were scanned using a high-resolution structured-light scanner and stored in stl format. Dedicated software was used to make linear and surface area measurements on the neonatal models, and each digitized 5-year model was assigned a Five-Year-Old (5YO) index score on three separate occasions by the same investigator. Results: Minimum, maximum, mean, standard deviation and standard error were calculated for each variable considered, and the Pearson coefficient was used to identify any correlations between neonatal variables and 5YO scores. Linear regression analysis showed that the only variable to approach significance was the posterior width of the cleft, which showed an R2 equal to 0.111, indicating that it accounts for 11% of the variability of the 5YO index. There was no other appreciable correlation between linear measurements, surface areas, or their inter-relationships. Conclusion: There is no correlation between neonatal morphological characteristics and occlusal outcomes at 5 years in CLP patients treated via the surgical protocol considered.

Skeletal Class III malocclusion treatment using mandibular and maxillary skeletal anchorage and intermaxillary elastics: a case report

ABSTRACT Introduction: Skeletal Class III malocclusion is one of the most challenging malocclusions to treat. In around 40% of Class III patients, maxillary retrognathia is the main cause of the problem and in most patients, orthopedic/surgical treatments includes some type of maxillary protraction. Objective: The aim of this case report was to describe a treatment method for a patient with maxillary retrognathia and Class III skeletal discrepancy using mandibular and maxillary skeletal anchorage with intermaxillary elastics. Case report: A 13-year-old boy with maxillary retrognathia and mandibular prognathism was treated using bilateral miniplates. Two miniplates were inserted in the mandibular canine area and two other miniplates were placed in the infrazygomatic crests of the maxilla. Class III intermaxillary elastics were used between the miniplates. Results: After eight months of orthopedic therapy, ANB angle increased by 4.1 degrees and ideal overjet and overbite were achieved. Mandibular plane angle was increased by 2.1 degrees and the palatal plane was rotated counterclockwise by 4.8 degrees. Conclusion: This case showed that the skeletal anchorage treatment method may be a viable option for treating patients with Class III skeletal malocclusion.

RESUMO Introdução: a Classe III esquelética é considerada uma das más oclusões mais difíceis de se tratar. Em cerca de 40% dos pacientes afligidos por ela, a principal causa do problema é o retrognatismo maxilar e, na maioria desses pacientes, o tratamento ortopédico/cirúrgico inclui algum tipo de protração da maxila. Objetivo: o objetivo do presente relato de caso é descrever o método de tratamento de um paciente Classe III com discrepância esquelética e retrognatismo maxilar, usando elásticos intermaxilares e ancoragem esquelética superior e inferior. Relato de caso: paciente de 13 anos de idade, com retrognatismo maxilar e prognatismo mandibular, tratado com miniplacas inseridas bilateralmente. Duas miniplacas foram instaladas na região dos caninos inferiores, e outras duas miniplacas foram inseridas na região da crista infrazigomática maxilar. Elásticos intermaxilares de Classe III foram conectados às miniplacas. Resultados: após 8 meses de tratamento ortopédico, o ângulo ANB aumentou 4,1o e obteve-se sobressaliência e sobremordida ideais. O ângulo do plano mandibular aumentou 2,1o e o plano palatal girou 4,8o no sentido anti-horário. Conclusão: esse caso clínico demonstrou que o método de tratamento com ancoragem esquelética pode ser uma opção válida para pacientes com má oclusão de Classe III esquelética.

Tratamiento de la clase II división 1 con el activador abierto elástico de Klammt / Treatment of class II division 1 with the elastic open activator of Klammt

RESUMEN Introducción: el activador abierto elástico de Klammt es un aparato funcional que permite la corrección de las anomalías de posición mandibular al aprovechar la fuerza generada por la musculatura. Objetivo: evaluar los resultados del tratamiento de la clase II división 1 con el activador abierto elástico de Klammt. Método: se realizó un estudio cuasi-experimental modalidad antes y después sin grupo control en 15 pacientes que fueron ingresados en la consulta de ortodoncia de la Clínica Universitaria de Especialidades Estomatológicas "Manuel Cedeño", y se atendieron en el período de febrero de 2016 a febrero de 2018. Resultados: la población objeto de estudio estuvo representada por 73,33 % de las edades entre siete a nueve años y el sexo femenino el más representativo con el 60,00 %. La clase II división 1 se corrigió en el 80,00 % de los pacientes al igual que la relación molar, y la estética mejoró luego del tratamiento en el 73,33 % de los pacientes. Conclusiones: con el empleo del activador abierto elástico de Klammt se alcanzan resultados favorables en el tratamiento de la clase II división 1 lo cual favorece un equilibrio funcional y estético del sistema estomatognático.

ABSTRACT Introduction: the Klammt open elastic activator is a functional device that allows the correction of mandibular position anomalies by taking advantage of the force generated by the musculature. Objective: the objective of the investigation was to evaluate the results of treatment of class II division 1 with the elastic open activator of Klammt. Method: we performed a quasi-experimental modality before and after without a control group in 15 patients who were admitted to the orthodontic clinic of the University Clinic of Stomatological Specialties "Manuel Cedeño", and attended in the period from February 2016 to February 2018. Results: the study population was represented by 73.33% of the ages between seven to nine years and the female sex was the most representative with 60.00%. Class II division 1 was corrected in 80.00% of patients as well as the molar ratio, and aesthetics improved after treatment in 73.33% of patients. Conclusions: with the use of Klammt elastic open activator favorable results are achieved in the treatment of class II division 1 which favors a functional and aesthetic balance of the stomatognathic system.

Treatment Outcome Based on GOSLON Score of Multiple Factors in Unilateral Cleft Lip and Palate Children of Four Different Ethnic

Objective: To evaluate and compare the effect of each congenital and postnatal treatment factors in treatment outcome based on dental arch relationship (DAR) of four different populations at a time using GOSLON yardstick. Material and Methods: 432 unilateral cleft lip and palate subjects (Japanese, Malay ethnic group, Bangladeshi and Pakistani populations) age 5 to 12 years were taken before orthodontic treatment and alveolar bone grafting. The DAR was assessed by GOSLON Yardstick. Independent t-test was performed to compare the GOSLON score for each factors. A multiple comparison (Anova) was also conducted between the GOSLON score of four different populations. The significance level was set at p<0.05. Results: Statistically no significant different was found among the congenital factors. However, the family history of Class III malocclusion showed most likely to associate with, though there was no significant difference (p=0.069). Significant difference revealed between two techniques of cheiloplasty in both Malay ethnic group and Pakistani population (p=0.038 and p=0.000, respectively). Gender and Techniques of palatoplasty also showed significant difference in Pakistani population (p=0.026 and p=0.000, respectively). Japanese and Bangladeshi population showed no significant differences. Also no significant differences found between the GOSLON score and different countries. Conclusion: The treatment outcome based on DAR significantly varies in individual population [Malay ethnic group (cheiloplasty); Pakistan (gender, cheiloplasty and palatoplasty)].

Non-familial Cherubism – Report of a case / Querubim não familiar - Relatório de caso

The Cherubism is a rare disease that affects the middle and lower third of the facein individuals at the time of childhood. It is a rarehereditary benign bone disease with an autosomal dominant inheritance. The familial distribution may affect different generations and isolated nonfamilial cases have also been reported in literature. Lesions appear as cystic multilocular radiolucencies, histologically, they resemble central giant cell granluloma and hyperpara thyroidism brown tumorwith numerous randomly distributed multinuclea tedgiant cells and vascular spaces within a fibrous connective tissue stroma. Objective: The aim of this study is to report the importance of the diagnosis of this pathology and the variety of treatments availablein the literature, thus guiding to an individualized treatment. Case Report: Caucasian 8 years-oldfemale, in good general condition, was referred to Service of Oral and Maxillofacial Surgery of Erasto Gaertner Hospital (EGH), Curitiba – PR, Brazil, complaining of bilateral swelling of the maxilla and mandible since 4 years-old. Apparently, the girl isthe first one who developed the genetic pathologyin at least 4 generations of her family. After biopsy, cherubism diagnosis was confirmed and the treatment of choice was periodic monitoring. Discussion: Cherubism studies with long-term follow-up with clinical and radiographic documentation indicate that the spontaneous resolution of bone lesions israre. Treatment of cherubism is controversial and various modalities have been reported as the use of calcitonin, osseous plasty surgery, curettage, orthognathic surgery, liposuction and palliative treatments. Conclusion: cherubism is a rarecondition that affects individuals in childhood that lead to some facial alterations, those patients need an special care and an well trained team to treat these disease more carefully and wisely noting that exist a series of option of new treatments in this cases...

Introdução: O Querubismo é uma doença rara que afeta o terço médio e inferior da face em indivíduos no momento da infância. É uma doença óssea hereditária benigna com herança autossômica dominante sendo que a distribuição familial pode afetar diferentes gerações, todavia casos não-familiares isolados também foram relatados na literatura. As lesões apresentam se radiograficamente como cistos multiloculados radiolúcidos e histologicamente se assemelham ao granuloma central de células gigantes e ao tumor marrom do hiper paratireoidismo com numerosas células gigantes multinucleadas distribuídos aleatoriamente e espaços vasculares dentro de um estroma de tecido conjuntivo fibroso. Objetivos: O objetivo deste estudo é relatar a importância do diagnóstico desta patologia e da variedade de tratamentos disponíveis na literatura, orientando dessa maneira a um tratamento individualizado. Relato de Caso: Mulher, caucasiana, 8 anos de idade, em bom estado geral. Foi encaminhada ao Serviço de Cirurgia Bucomaxilofacial do Hospital Erasto Gaertner (EGH), Curitiba - PR, Brasil, com queixa de inchaço bilateral da maxila e da mandíbula desde os 4 anos de idade. Em avaliação notou-se que menina é a primeira pessoa que desenvolveu a patologia empelo menos quatro gerações de sua família. Após biópsia o diagnóstico de cherubism foi confirmado e o tratamento de escolha foi a monitorização periódica. Discussão: estudos de cherubism a longo prazo de follow-up com documentação clínica e radiográficas indicam que a resolução espontânea das lesões ósseas são raras. O tratamento do cherubism é controverso e diversas modalidades têm sido relatados como o uso de calcitonina, a cirurgia de plastia óssea, curetagem cirurgia ortognática, lipoaspiração e tratamentos paliativos...

Características respiratórias de indivíduos com deformidade dentofacial / Breathing characteristics of individuals with dentofacial deformity

Objetivo compreender as características respiratórias em indivíduos com deformidades dentofaciais e verificar se há diferenças comparativamente a indivíduos com equilíbrio dentofacial. Métodos participaram 60 indivíduos (18 a 40 anos), 30 portadores de deformidade dentofacial e 30 de um grupo controle. Foi realizada avaliação do Tempo Maximo de Fonação das emissões /a/, /i/, /u/, /s/, /z/ e contagem de números pelo programa Sound Forge (Sony); avaliação da capacidade vital e coordenação pneumofonoarticulatória, pelo espirômetro PonyFx. Os resultados foram comparados pelo teste “t” de Student. Resultados os indivíduos com deformidade dentofacial apresentaram valores de Tempo Maximo de Fonação inferiores aos indivíduos com equilíbrio dentofacial nas emissões: “s” para aqueles com má oclusão esquelética classe II e homens; “z” para indivíduos com má oclusão classe II; contagem de números para os homens. As medidas extraídas pela espirometria foram semelhantes entre os indivíduos com e sem deformidade dentofacial. Conclusão não houve diferenças em relação à capacidade vital e coordenação pneumofonoarticulatória, mas o grupo com deformidade dentofacial apresentou valores reduzidos de Tempo Maximo de Fonação em emissões que contêm fonemas consonantais. .

Purpose comprehend the respiratory characteristics of individuals with dentofacial deformities and verify if there are differences comparatively to individuals with dentofacial balance. Methods participated 60 individuals (18 to 40 years old), 30 with a dentofacial deformities and 30 of a control group. The assessment of the Maximum Phonation Time for the emissions /a/, /i/, /u/, /s/, /z/ and the number counting was evaluated using the program Sound Forge (Sony); the vital capacity and pneumophonic coordination by the PonyFx spirometer. The results were compared by using the “t” Student test. Results the individuals with dentofacial deformities presented lower Maximum Phonation Time values than individuals with dentofacial balance in the emissions: “s” for those with skeletal Class II malocclusion and men; “z” for individuals with Class II malocclusion; number counting for men. The measures extracted by the spirometry were similar between the individuals with and without dentofacial deformities. Conclusion there were no differences regarding the vital capacity and pneumophonic coordination, but the dentofacial deformities group presented lower values of Maximum Phonation Time in the emissions that contain consonant phonemes. .

Congenital syngnathia: a case report

Congenital syngnathia refers to the fusion of bony tissues, a rare disorder with only 41 cases reported in the international literature from 1936 to 2009. The occurrence of syngnathia without any other associated systemic disease or congenital anomaly is extremely rare. This report presents a case of congenital syngnathia with unilateral maxillomandibular bony adhesion without any other oral or maxillofacial anomaly. No recommended protocol for surgery exists due to the rarity of the disorder. There is a very low survival rate for the few patients who have forgone surgical management. This case describes a 74-year-old female patient who was suffering from limitation of mouth opening and was subsequently diagnosed with congenital syngnathia. The surgical staff performed separation surgery and reconstructed the malformed oral vestibule and cheek using the radial forearm free flap operation.

Application of CAD/ CAM techniques in repair of defects and correction of deformity on the jaw bones / 中华创伤杂志

Objective To apply the techniques of CAD/CAM in the repair of defects and correction of deformity on the jaw bones so as to improve the accuracy and controllability of operations.Methods With CAD techniques,3D bone model was reconstructed based on CT images.Then,a repairing model was created with mirror operation on original model.The physical models of original model and repairing model were fabricated through rapid prototyping.Based on physical models,operation plan and model surgery with pre-forming plate could be designed.Results The designed operation plan and pre-forming plate techniques of CAD/CAM were successfully applied in eight patients,with satisfactory results.Conclusions With techniques of CAD/CAM,reconstructing and fabricating the original bone model and mirror repair model are very helpful for designing operation plan for maxillofacial surgery.It also can improve the surgery accuracy and save operation time obviously.

Sob as barbas do Imperador D. Pedro II: o prognatismo dos Habsburgos / Under the beard of the Emperor D. Pedro II: the Habsburg prognathism

Os autores descrevem a evolução histórica que levou à precoce coroação do D. Pedro deAlcântara como Imperador do Brasil e a concomitante discussão sobre o uso precoce debarba em que se mesclava a influência do prognatismo hereditário do qual era portador e anecessidade naquele momento histórico de ter um aparência mais envelhecida para imporo respeito do seu cargo. Os autores fazem uma revisão dos antecedentes hereditários do D.Pedro II, ligando a família dos Habsburgos reconhecida portadora de prognatismo hereditário.Citam e discutem os casos mais reconhecidos desta afecção nos Habsburgos.

The authors describe the historical evolution of the Pedro de Alcântara precocious coronationas Emperor of Brasil and the discussion about the need of the use of beard even he was soyoung. This debate included the influence of its hereditary prognathism and the necessityto show an older and respectable Emperor. The authors review the inheritance of D. PedroII linking to the Habsburg family recognized as a carrier of the hereditary prognathism.

Padronização de avaliação em cirurgia ortognática / Standardization of the evaluation in orthognathic surgery

Em cirurgia ortognática, o diagnóstico e o tratamento proposto são baseados em diferentes parâmetros, os quais devem ser precisamente documentados para que se possa atingir o melhor resultado possível. O Grupo de Cirurgia Craniomaxilofacial da Divisão de Cirurgia Plástica e Queimaduras da Faculdade de Medicina da Universidade de São Paulo desenvolveu um protocolo de documentação dos casos de cirurgia ortognática com o objetivo de definir a queixa do paciente com suas alterações funcionais e estéticas, delinear o melhor tratamento e avaliar a correspondência entre a cirurgia proposta, o procedimento cirúrgico realizado e o resultado obtido.

In orthognathic surgery, diagnosis and treatment proposed are based on different parameters which should be recorded precisely for the best possible treatment. The Craniomaxillofacial Surgery Unit of the Plastic Surgery and Burn Division of São Paulo University Medical School developed a recording data protocol for the orthognathic cases aiming to define the patient’s complaint including its functional and aesthetics alterations, to outline the best treatment and to evaluate the correspondence between the surgery proposed, the procedure carried out and the result achieved.

Evaluate the reliability of standardized facial photographs in assessment of mandibular asymmetry case / 中国医师杂志

Objective To assess the reliability and validity of standardized facial photographs under natural head position (NHP) in assessment of mandibular asymmetry cases. Methods Standardized facial photographs (SFP) and posteroanterior cephalometry (PAC) were taken under natural head position from 25 mandibular asymmetry eases (14 boys and 11 girls), aged 14 to 29 years old. Distances from 8 landmarks to the vertical reference line were measured. The difference and the asymmetry ratio of two sides were calculated respectively. The relationship between the measurements of SFP and PAC were compared, and the repeatability of landmarks was assessed. Results Six measurements were significant different between two sides, 3 from SFP and 3 from PAC. Measurements from two ways were correlated a cer-tain extent. The repeatability of landmarks was satisfied. Conclusion Measurements from standardized facial photographs under NHP pres-ent a clinical useful method to quantify mandibular asymmetry.

Intraoral distraction osteogenesis for maxillary and mandibular deformities / 实用口腔医学杂志

Objective:To describe the application of intraoral di st raction osteogenesis for correction of maxillofacial and mandibular deformities . Methods: 5 cases with serious maxillofacial or mandibula r deformities underwent distraction by using 2 types of intraoral distraction d evice.Mandibular lengthening and maxillary widening for micrognathia and maxilla ty constriction was performed in 1 case with Treacher Collions syndromes. M axillary distraction osteogenesis for maxillary hypoplasia in 2 cases.Simultaneo us maxillary and mandibular distraction in 1 case with hemifacial microsomia. T ransport distraction for mandibular body rectangle defect in 1 case. Results: Satisfactory morphologic results were achieved in all patients with good facial symmetry, ad equate occlusal relationship without any complication.Conclusions: Intraoral distraction osteogenesis provides a safe and effective treatment for the reconstruction of facial morphologic and occlusal relationshi p.