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

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

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

Changes in the airway after mentoplasty (genioplasty): systematic review / Cambios en la vía aérea después de una mentoplastia (genioplastia): una revisión sistemática

SUMMARY: The aim of this research was to evaluate the changes obtained with the mentoplasty technique in the increase of the airway imaging. A systemic review was performed using the parameters of the prism matrix, in the PubMed, Science Direct, Redalyc database, covering the years 1984 to 2019 with the use of defined inclusion criteria. The authors independently applied the selected parameter of data extraction, study selection and risk-to-bias assessment. A total of 1,251 articles were obtained among the 3 databases, of which 10 met the inclusion criteria. The variables studied were: type of research, sample size, sex, age, dento-skeletal diagnosis, airway classification, diagnosis of obstructive sleep apnea syndrome (OSAS), type of imaging evaluation, variables evaluated in the image, pre and post-operative values, surgical technique and type of fixation used, other surgical procedures applied, and complications. In the cases of linear evaluation with cephalometric analysis (9 articles) they used PAS (posterior airspace), MP-H (mandibular plane to the hyoid) and SNB (saddle-nasion-point B), and SCSA (section area as the most relevant points, smallest cross section) and VT (total volume) in the volumetric evaluations (2 articles). The average change in posterior airspace achieved by the cited authors is 4.2 mm with standard deviation of 1.4 mm with the use of advancement mentoplasty. The most widely used technique was mentoplasty with a horizontal osteotomy by 5 authors. Based on the research there is a positive relationship between the increase in the airway and the advancement mentoplasty procedure, however, more standardized studies associated with the way of measuring and evaluating the relationship between advancement and the airway are necessary.

RESUMEN: El objetivo de esta investigación fue evaluar los cambios obtenidos con la técnica de mentoplastia en el incremento de la via aérea. Una revisión sistemática fue realizada utilizando parámetros de la matriz prisma, en PubMed, Science Direct, Redalyc database, cubriendo los años 1984 a 2019 con criterios de inclusión definidos. Los autores aplicaron de forma independiente los parámetros de selección y extracción de datos, selección de estudios y riesgos de sesgo. Un total de 1251 artículos fueron obtenidos de las 3 bases de dato, donde 10 artículos cumplieron los criterios de inclusión. Las variables estudiadas fueron: tipo de investigación, tamaño de la muestra, genero, edad, diagnóstico dento esqueletal, clasificación de la vía aérea, diagnostico de síndrome de apnea del sueño (SAOS), tipo de evaluación de la imagen, variables evaluadas en la imagen en pre y postoperatorio, técnica quirúrgica y tipo de fijación utilizada, otros procedimientos quirúrgicos y complicaciones. En el caso de la evaluación linear con cefalometria (9 artículos), usaron PAS (posterior airspace), MP-H (plano mandibular hacia el hueso hioide) y SNB (silla turca-nasion- punto B) y SCSA (sección de puntos mas relevantes, menores transfversales) y el VT (volumen total) en las evaluaciones volumétricas (2 artículos). El promedio de cambio posterior de la vía aérea citado por autores fue de 4,2 mm con una desviación estándar de 1,4 mm con el uso de la mentoplastia de avance. La técnica mas habitual fue la mentoplastia con osteotomía horizontal (5 autores). Basados en esta investigación existe una relación positiva entre el incremento de la vía aérea y el avance con genioplastia; sin embargo, mas estudios estandarizados junto con medidas definidas y la evaluación correcta del avance y la vía área son necesarios.

Morfología cefalométrica de la sínfisis del mentón en individuos jóvenes de la ciudad de Quito-Ecuador / Cephalometric morphology of chin symphysis in young individuals from the city of Quito-Ecuador

Resumen Introducción: La sínfisis del mentón aporta equilibrio, simetría y armonía al rostro. Por ser una estructura anatómica mandibular muy importante y altamente modificable en cirugía estética, se considera indispensable conocer su morfología y así obtener una correcta interacción en el diagnóstico, pronóstico y terapéutica médico-odontológica. Objetivo: Determinar la morfología sínfisis del mentón en jóvenes adultos de la ciudad de Quito- Ecuador, año 2019, mediante la identificación de las longitudes sagitales y coronales. Metodología: Este estudio tuvo un enfoque cuantitativo, tipo descriptivo-observacional, con temporalidad retrospectiva. Se calibraron, analizaron y trazaron 384 radiografías digitales laterales de adultos jóvenes de la ciudad de Quito-Ecuador, año 2019 en el software AutoCAD-2019. Resultados: Existió una elevada frecuencia de la forma geométrica cuadrada (60%) con respecto a la rectangular (40%), adicionalmente se identificó que la figura cuadrada es más frecuente en individuos de sexo femenino y sujetos clase I (56%) y II (70%), además de todos los patrones de crecimiento vertical hipodivergentes (58%), normodivergentes (64%) e hiperdivergentes (57%). Conclusiones: La forma cuadrada de la sínfisis del mentón es mayor que la forma rectangular. Por la originalidad de los resultados, se sugiere realizar nuevos estudios que correlacionen la morfología mentoniana con las diferentes estructuras cráneo-maxilofaciales.

Abstract Introduction: The chin symphysis contributes to the balance, symmetry and harmony of the face. Since it is an important anatomical jaw structure and highly modifiable in aesthetic surgery, it is considered crucial to know its morphology and, thus, obtain a correct interaction in the diagnosis, prognosis and medical-dental therapy. Objective: To determine the symphysis morphology of the chin in young adults in the city of Quito, Ecuador, in the year 2019, through the identification of sagittal and coronal lengths. Methodology: This study had a quantitative approach, descriptive-observational type, with retrospective temporality. We calibrated, analyzed and plotted 384 lateral digital radiographs of young adults from the city of Quito-Ecuador, year 2019 in the software AutoCAD-2019. Results: There was a high frequency of the square geometric shape (60%) in comparison to the rectangular one (40%). Additionally, it was identified that the square figure is more frequent in female individuals and class I (56%) and II (70%) subjects, in addition to all the hypodivergent (58%), normodivergent (64%) and hyperdivergent (57%) vertical growth patterns. Conclusions: The square shape of the chin symphysis is larger than the rectangular shape. Due to the originality of the results, it is suggested to carry out new studies that correlate chin morphology with the different cranio-maxillofacial structures.

Factors associated with the morphology of the mandibular symphysis and soft tissue chin

ABSTRACT Objectives: This study aimed to (I) assess the morphology of the symphysis and soft tissue chin associated with sex, age and sagittal/vertical skeletal patterns, and (II) identify the individual and combined contributions of these variables to different portions of the symphysis. Methods: This cross-sectional study included 195 lateral cephalometric radiographs from untreated adults. Alveolar, basal, and soft tissue of the symphysis were measured by an X/Y cranial base coordinate system, and divided in accordance to four predictor variables: sex, age, and sagittal/vertical skeletal patterns. Parametric tests were conducted for comparison and correlation purposes, while multiple regression analysis was performed to explore combined interactions. Results: Alveolar inclination is related to sagittal and vertical patterns, and both explained 71.4% of the variations. Alveolar thickness is weakly predicted and poorly influenced by age. Symphysis height was 10% higher in males, and associated with a vertical skeletal pattern and sex, and both explained 43.6% of variations. Basal symphyseal shows an individual thickness, is larger in males, and vertically short-positioned with age. Soft tissue chin is not necessarily related to the size of the underling skeletal pattern, and enlarges with age, even in adulthood. Conclusions: The symphysis and surrounding tissues are influenced by sex, age, and sagittal and vertical patterns, acting differently on the alveolar, basal and soft tissue portions. Sagittal and vertical skeletal patterns are the strongest association on alveolar symphysis inclination, whereas sex and age acts on the vertical symphysis position and soft tissues thickness.

RESUMO Introdução: O presente estudo objetivou: 1) avaliar a morfologia da sínfise mandibular e dos tecidos tegumentares do mento, associada ao sexo, idade, padrões sagital e vertical; e 2) identificar as contribuições dessas variáveis, individualmente ou combinadas, às diferentes regiões da sínfise. Métodos: Este estudo transversal incluiu 195 radiografias cefalométricas laterais de adultos não tratados ortodonticamente. Os tecidos alveolar, basal e mole da sínfise foram medidos por um sistema de coordenadas x, y e z da base do crânio e divididos de acordo com quatro variáveis preditoras: sexo, idade e padrões esqueléticos sagitais e verticais. Testes paramétricos foram conduzidos para fins de comparação e correlação, enquanto a análise de regressão múltipla foi realizada para explorar as interações combinadas. Resultados: A inclinação alveolar está relacionada aos padrões sagitais e verticais, e ambos explicaram 71,4% das variações. A espessura alveolar é fracamente prevista e pouco influenciada pela idade. A altura da sínfise foi 10% maior no sexo masculino e esteve associada ao padrão esquelético vertical e ao sexo, sendo que ambos explicaram 43,6% das variações. A sínfise basal mostra espessura individual, é maior no sexo masculino e verticalmente curta com a idade. O tecido mole do mento não está necessariamente relacionado ao tamanho do padrão esquelético subjacente e aumenta com a idade, mesmo na idade adulta. Conclusões: A sínfise e os tecidos circundantes são influenciados pelo sexo, idade e padrões sagitais e verticais, que atuam de forma diferenciada nas porções alveolar, basal e de tecidos tegumentares. Os padrões esqueléticos sagitais e verticais são a associação mais forte na inclinação da sínfise alveolar, enquanto o sexo e a idade atuam na posição vertical da sínfise e na espessura dos tecidos tegumentares.

La vertical verdadera al punto A´(blando), al Pg´(blando), al Labrale superior y al Labrale inferior en posición ideal asistida de la cabeza (PIAC) / The true vertical from point A´(soft), to Pg´ (soft), to superior Labrale and inferior Labrale in Ideal Assisted Head Position (PIAC)

El 81,3% de una encuesta realizada a 96 ortodoncistas y ortopedistas calificados y técnicos radiólogos consultados informan que ubican la cabeza del paciente en una posición ideal, subjetiva del profesional instruido que lo asiste, ya que muchas de sus fotografías y telerradiografías no son posiciones naturales de la cabeza genuinas. Se ha utilizado la vertical verdadera como parámetro para mediciones, todas angulares, para definir la disposición ánteroposterior del punto A´ (de construcción) para el cuerpo del labio superior, el punto Pg´para el mentón, el Labrale superior y el Labrale inferior para el bermellón de cada labio, con la finalidad de planificar correcciones ortopédicas, ortodóncicas u ortodóncicas-quirúrgicas de acuerdo a la anomalía detectada (AU)

Morphological characteristics of soft tissue profile of Angle's class II division i malocclusion before and after orthodontic treatment / Características morfológicas del perfil de tejido blando de la clase II de la división I de maloclusión de ángulo antes y después del tratamiento de ortodoncia

SUMMARY: By analysing cephalometrics before and after the treatment of Angle's class II division 1 malocclusion, soft tissue profile changes were observed, and to explore whether there was a correlation between the change of posterior occlusal plane (OP-P) and soft tissue profile. The study aimed to provide a theoretical reference in the clinical diagnosis and orthodontic treatment of early permanent dentition of Angle class II division 1 malocclusion patients. We randomly selected 20 cases of orthodontics in Shanxi Medical University orthodontics patients (aged 12-18 years) of the lateral cephalograms, Winceph 8.0 software was used to measure the posterior occlusal plane (OP-P), TUL-EP, TLL-EP, nasolabial angle, upper lip base thickness, upper lip tension, lower lip H line distance, chin soft tissue thickness and Z angle. And SPSS 22.0 software was used to analyze the correlation between OP-P and other measurement indexes. The change of posterior occlusal plane was positively related to the distance from upper lip to the esthetic plane, the distance from lower lip to the esthetic plane, the tension of the upper lip and distance from lower lip to H line, and the change of posterior occlusal plane was negatively related to nasolabial angle and Z angle. The change of posterior occlusal plane had no significant correlation with upper lip base thickness and soft tissue chin thickness. The change of posterior occlusal plane has an important guiding significance for orthodontic treatment,by focusing on the change of the posterior occlusal plane to achieve the purpose of changing the soft tissue profile.

RESUMEN: Se realizó un estudio cefalométrico antes y después del tratamiento de ortodoncia en pacientes portadores de maloclusión clase II división 1 de Angle. Se observaron cambios en el perfil de los tejidos blandos y se exploró si había una correlación entre el cambio del plano oclusal posterior (OP-P) y el perfil de los tejidos blandos. El objetivo de este estudio fue otorgar una referencia teórica en el diagnóstico clínico y el tratamiento de ortodoncia de los pacientes con dentición permanente temprana con maloclusión clase II división 1 de Angle. Seleccionamos al azar 20 casos cefalometrías de pacientes de ortodoncia de la Universidad Médica de Shanxi (entre 12 y18 años). Para ello, se utilizó el software Winceph 8.0 para medir el plano oclusal posterior (OP-P), TUL-EP, TLL-EP, ángulo nasolabial, grosor de la base del labio superior, tensión del labio superior, distancia entre líneas del labio inferior H, grosor del tejido blando del mentón y ángulo Z. Se utilizó el software SPSS 22.0 para analizar la correlación entre OP-P y otros índices. El cambio del plano oclusal posterior tuvo una correlación positiva con la distancia desde el labio superior al plano estético, la distancia desde el labio inferior hasta el plano estético, la tensión del labio superior y distancia del labio inferior a la línea H. El cambio del plano oclusal posterior tuvo una correlación negativa con el ángulo nasolabial y el ángulo Z. El cambio del plano oclusal posterior no tuvo una correlación significativa con el grosor de la base del labio superior y la barbilla de tejido blando. El cambio del plano oclusal posterior tiene un importante significado de orientación para el tratamiento de ortodoncia, de tal manera que al cambiar el plano oclusal posterior se podrá lograr el propósito de cambiar el perfil del tejido blando.

Comparative evaluation of soft tissue changes in Class I borderline patients treated with extraction and nonextraction modalities

Abstract Objective: To compare soft tissue changes in Class I borderline cases treated with extraction and nonextraction modalities. Methods: A parent sample of 150 patients with Class I dental and skeletal malocclusion (89 patients treated with premolar extraction and 61 patients without extraction) was randomly selected and subjected to discriminant analysis which identified the borderline sample of 44 patients (22 extraction and 22 nonextraction patients). Pretreatment and post-treatment cephalograms of the borderline subsample were analyzed using 22 soft tissue parameters. Results: Upper and lower lips were more retracted and thickness of the upper lip increased more in the borderline extraction cases (p < 0.01). The nasolabial angle became more obtuse and the interlabial gap was reduced in the borderline extraction cases (p < 0.01). Lower lip, interlabial gap and nasolabial angle showed no changes in the borderline nonextraction cases. Conclusion: The soft tissue parameters which can be used as guideline in decision making to choose either extraction or nonextraction in Class I borderline cases are upper and lower lip protrusion in relation to the E-plane and Sn-Pg' line, lower lip protrusion in relation to the true vertical line (TVL), upper lip thickness, nasolabial angle and interlabial gap.

RESUMO Objetivo: comparar as alterações sofridas nos tecidos moles em casos limítrofes de Classe I tratados com extrações e sem extrações. Métodos: uma amostra inicial de 150 pacientes com má oclusão esquelética e dentária de Classe I (89 pacientes tratados com extrações de pré-molares e 61 pacientes tratados sem extrações) foi aleatoriamente selecionada e submetida a uma análise discriminante, a qual permitiu selecionar uma amostra de 44 pacientes limítrofes (22 tratados com extrações e 22 tratados sem extrações). Telerradiografias obtidas antes e depois do tratamento dessa subamostra de pacientes limítrofes foram analisadas, utilizando-se 22 grandezas em tecidos moles. Resultados: nos casos limítrofes tratados com extrações, houve maior retração dos lábios superior e inferior e um maior aumento na espessura do lábio superior (p < 0,01); bem como o ângulo nasolabial tornou-se mais obtuso e o espaço interlabial sofreu redução (p < 0,01). Já nos casos limítrofes tratados sem extrações, o lábio inferior, o espaço interlabial e o ângulo nasolabial não apresentaram alterações significativas. Conclusão: as grandezas em tecidos moles que podem ajudar na tomada de decisão entre o tratamento com e sem extrações nos casos limítrofes de Classe I são: protrusão dos lábios superior e inferior em relação ao plano E e em relação à linha Sn-Pg', protrusão do lábio inferior em relação à linha vertical verdadeira (LVV), a espessura do lábio superior, o ângulo nasolabial e o espaço interlabial.

Facial height in Japanese-Brazilian descendants with normal occlusion

OBJECTIVE: The aim of this study was to determine the standards of facial height in 30 young (14-year-old) Japanese-Brazilian descendants with normal occlusion, and assess whether sexual dimorphism is evident. METHODS: The cephalometric measurements used followed the analyses by Wylie-Johnson, Siriwat-Jarabak, Gebeck, Merrifield and Horn. RESULTS: Results showed dimorphism for total anterior facial height (TAFH), lower anterior facial height (LAFH), anterior facial height (AFH), total posterior facial height (TPFH) and upper posterior facial height (UPFH) measurements. CONCLUSIONS: The standards of facial heights in young Japanese-Brazilian descendants with normal occlusion were observed. Sexual dimorphism was identified in five out of thirteen evaluated variables at this age range. .

INTRODUÇÃO: o objetivo desse estudo foi obter os valores médios de normalidade das alturas faciais anterior e posterior de 30 jovens mestiços nipo-brasileiros, descendentes de xantodermas e leucodermas, com oclusão normal, com idade média de 14 anos, e verificar a presença ou ausência de dimorfismo entre os sexos. MÉTODOS: elaborou-se um estudo cefalométrico com as mensurações advindas das análises de Wylie e Johnson, Siriwat e Jarabak, Gebeck, Merrifield e Horn. RESULTADOS: os resultados revelaram a presença de dimorfismo entre os sexos para as variáveis AFAT, AFAI, AFA, AFPT e AFPS. CONCLUSÕES: um padrão cefalométrico específico, das alturas faciais anterior e posterior, para os jovens mestiços nipo-brasileiros com oclusão normal, descendentes de xantodermas e leucodermas, foi apresentado e um dimorfismo entre os sexos para cinco das treze variáveis avaliadas foi verificado nessa faixa etária média. .

Relationship between facial morphology, anterior open bite and non-nutritive sucking habits during the primary dentition stage

INTRODUCTION: Non-nutritive sucking habits (NNSHs) can cause occlusal alterations, including anterior open bite (AOB). However, not all patients develop this malocclusion. Therefore, the emergence of AOB does not depend on deleterious habits, only. OBJECTIVE: Investigate a potential association between non-nutritive sucking habits (NNSHs), anterior open bite (AOB) and facial morphology (FM). METHODS: 176 children in the primary dentition stage were selected. Intra and extraoral clinical examinations were performed and the children's legal guardians were asked to respond to a questionnaire comprising issues related to non-nutritive sucking habits (NNSHs). RESULTS: A statistically significant relationship was found between non-nutritive sucking habits (NNSHs) and anterior open bite (AOB). However, no association was found between these factors and children's facial morphology (FM). CONCLUSIONS: Non-nutritive sucking habits (NNSHs) during the primary dentition stage play a key role in determining anterior open bite (AOB) malocclusion regardless of patient's morphological facial pattern (FM). .

INTRODUÇÃO: os hábitos de sucção não nutritiva podem causar alterações oclusais, como, por exemplo, a mordida aberta anterior (MAA). No entanto, nem todos os pacientes desenvolvem essa má oclusão. Sendo assim, a instalação da MAA não depende apenas da ocorrência do hábito. OBJETIVO: avaliar a possível associação entre hábito de sucção não nutritiva, mordida aberta anterior e morfologia facial. MÉTODOS: foram selecionadas 176 crianças na fase de dentição decídua completa. Exames clínicos intra- e extrabucais foram realizados, e um questionário, com aspectos relacionados aos hábitos de sucção não nutritiva, foi aplicado aos responsáveis. RESULTADOS: encontrou-se uma relação estatisticamente significativa entre as variáveis hábito de sucção não nutritiva e MAA. Entretanto, não houve associação desses fatores com a morfologia facial da criança. CONCLUSÃO: a presença dos hábitos de sucção não nutritiva tem associação para a determinação da má oclusão de MAA, independentemente do padrão facial morfológico na dentição decídua. .

Photometric analysis of esthetically pleasant and unpleasant facial profile

Objective: To identify which linear, angular and proportionality measures could influence a profile to be considered esthetically pleasant or unpleasant, and to assess sexual dimorphism. Methods: 150 standardized facial profile photographs of dental students of both sexes were obtained and printed on photographic paper. Ten plastic surgeons, ten orthodontists and ten layperson answered a questionnaire characterizing each profile as pleasant, acceptable or unpleasant. With the use of a score system, the 15 most pleasant and unpleasant profiles of each sex were selected. The photographs were scanned into AutoCAD computer software. Linear, angular and proportion measurements were obtained using the software tools. The average values between groups were compared by the Student's t-test and the Mann-Whitney test at 5%. Results: The linear measures LL-S, LL-H, LL-E, LL-B and Pn-H showed statistically significant differences (p < 0.05). Statistical differences were also found in the angular measures G'.Pn.Pg', G'.Sn.Pg' and Sn.Me'.C and in the proportions G'-Sn:Sn-Me' and Sn-Gn':Gn'-C (p < 0.05). Differences between sexes were found for the linear measure Ala-Pn, angles G'-Pg'.N-Pn, Sn.Me'.C, and proportions Gn'-Sn:Sn-Me' and Ala-Pn:N'-Sn. (p < 0.05). Conclusion: The anteroposterior position of the lower lip, the amount of nose that influences the profile, facial convexity, total vertical proportion and lip-chin proportion appear to influence pleasantness of facial profile. Sexual dimorphism was identified in nasal length, nasofacial and lower third of the face angles, total vertical and nasal height/length proportions. .

Objetivo: identificar quais medidas lineares, angulares e de proporcionalidade influenciam para um perfil ser considerado agradável ou desagradável, e avaliar o dimorfismo sexual. Métodos: foram obtidas e impressas em papel fotográfico 150 fotografias padronizadas do perfil facial de acadêmicos de Odontologia de ambos os sexos. Dez cirurgiões-plásticos, dez ortodontistas e dez leigos responderam um questionário caracterizando cada perfil em agradável, aceitável ou desagradável. Com a utilização de um sistema de escore, foram selecionadas as fotografias dos 15 perfis mais agradáveis e dos 15 mais desagradáveis de cada sexo. As fotografias foram digitalizadas para o programa de computador AutoCAD, e medidas lineares, angulares e de proporcionalidade foram mensuradas utilizando-se ferramentas do programa. As médias obtidas entre os grupos foram comparadas pelos testes t de Student e de Mann-Whitney a 5%. Resultados: as medidas lineares Li-S, Li-H, Li-E, Li-B e Pn-H apresentaram diferenças estatisticamente significativas (p < 0,05). Os ângulos G'.Pn.Pg', G'.Sn.Pg' e Sn.Me'.C e as medidas de proporcionalidade G'-Sn:Sn-Me' e Sn-Gn':Gn'-C também apresentaram diferenças significativas (p < 0,05). Diferenças significativas entre os sexos foram identificadas na medida linear Ala-Pn, nos ângulos G'-Pg'.N'-Pn, Sn.Me'.C e proporções Gn'-Sn:Sn-Me' e Ala-Pn:N'-Sn (p < 0,05). Conclusão: o posicionamento anteroposterior do lábio inferior, a quantidade do nariz que influencia o perfil, a convexidade facial, a proporção vertical total e lábio-queixo parecem influenciar a agradabilidade do perfil facial. Dimorfismo sexual foi identificado na medida linear comprimento nasal, nos ângulos nasofacial e terço inferior da face e nas proporções vertical total e comprimento/altura nasal. .

Cone beam tomographic study of facial structures characteristics at rest and wide smile, and their correlation with the facial types

OBJECTIVE: To determine the characteristics of facial soft tissues at rest and wide smile, and their possible relation to the facial type. METHODS: We analyzed a sample of forty-eight young female adults, aged between 10, 19 and 40 years old, with a mean age of 30.9 years, who had balanced profile and passive lip seal. Cone beam computed tomographies were performed at rest and wide smile postures on the entire sample which was divided into three groups according to individual facial types. Soft tissue features analysis of the lips, nose, zygoma and chin were done in sagittal, axial and frontal axis tomographic views. RESULTS: No differences were observed in any of the facial type variables for the static analysis of facial structures at both rest and wide smile postures. Dynamic analysis showed that brachifacial types are more sensitive to movement, presenting greater sagittal lip contraction. However, the lip movement produced by this type of face results in a narrow smile, with smaller tooth exposure area when compared with other facial types. CONCLUSION: Findings pointed out that the position of the upper lip should be ahead of the lower lip, and the latter, ahead of the pogonion. It was also found that the facial type does not impact the positioning of these structures. Additionally, the use of cone beam computed tomography may be a valuable method to study craniofacial features.

OBJETIVOS: determinar as características dos tecidos moles faciais nas fases em repouso e em sorriso amplo, e sua possível relação com o tipo facial. MÉTODOS: foi analisada uma amostra de 48 adultos jovens, com idade variando entre 19,10 e 40 anos, com média de 30,9 anos, do sexo feminino, apresentando faces equilibradas e selamento labial passivo. Tomografias computadorizadas de feixe cônico em repouso e em sorriso amplo foram efetuadas em toda a amostra, que foi segmentada em três grupos de acordo com o tipo facial. A análise das características tegumentares de lábios, nariz, malar e mento foi feita em cortes tomográficos sagitais, axiais e em vista frontal. RESULTADOS: na análise estática das estruturas faciais, em repouso e em sorriso amplo, não houve diferenciação entre os tipos faciais em nenhuma das variáveis estudadas. A análise dinâmica evidenciou que o tipo braquifacial é mais sensível à movimentação, apresentando maior contração sagital do lábio superior, porém, o deslocamento labial apresentado por esse tipo facial produz um sorriso pouco amplo, com menor área de exposição dentária quando comparado aos demais tipos faciais. CONCLUSÃO: constatou-se que, em uma face equilibrada, a posição do lábio superior deve ser à frente do lábio inferior, e esse à frente do pogônio, e que o tipo facial não exerce influência sobre o posicionamento dessas estruturas. Observamos que a utilização de tomografias computadorizadas de feixe cônico pode ser de grande valia para o estudo de características craniofaciais.

Presencia y morfometría de forámenes y canales en relación a las espinas mentonianas / Presence and morphometry of foramina and canals in relation to mental spines

Los procedimientos quirúrgicos desarrollados en la porción anterior del cuerpo mandibular, como por ejemplo la instalación de implantes oseointegrados, genioplastias, profundizaciones de flanco lingual, fracturas, etc. pueden presentar complicaciones de importancia cuando estas invaden estructuras vasculares, con la consecuente hemorragia y formación de hematomas sublinguales. Dentro de estos elementos anatómicos se encuentran forámenes y canales que se ubican en relación a las espinas mentonianas. El objetivo de este estudio fue cuantificar la ubicación, diámetro y longitud de los forámenes y canales presentes por superior, inferior y entre las espinas mentonianas superiores e inferiores en 71 mandíbulas secas de la Unidad de Morfología de la Universidad de los Andes las que fueron fotografiadas. Analizando las fotografías con el programa Photoshop® Cs 3 extended, se midieron en pixeles el diámetro y longitud de los forámenes y canales para luego transformarlos en mm. El 97 por ciento de las mandíbulas observadas presentaron al menos un foramen, el 45 por ciento presentó dos y el 31 por ciento tres. En relación a su ubicación el 82 por ciento de las mandíbulas presentó forámenes por superior a las espinas y el 76 por ciento por inferior. El diámetro promedio fue de 0,73 mm para los de ubicación superior y de 0,71 mm para los de ubicación inferior. La longitud promedio de los canales fue de 6,77 mm para los ubicados por superior y de 5,5 mm para los de ubicación inferior a las espinas mentonianas. Debido a la alta prevalencia de forámenes y canales en nuestra muestra es recomendable tenerlos siempre en cuenta en la planificación de intervenciones quirúrgicas que involucren ya sea el flanco lingual mediano mandibular o el cuerpo mandibular en la zona de la sínfisis.

Surgical procedures developed in the anterior mandibular body, such as the installation of osseointegrated implants, genioplasties, lingual edge insights, fractures, etc. may produce mayor complications when these invade vascular structures, with consequent bleeding and sublingual hematoma formation. Within these anatomical elements we find foramina and canals that are located in relation to the mental spine. The objective of this study was to quantify the location, diameter and length of the foramina and canals present superior, inferior and between the upper and lower mental spine in 71 dry mandibles from the Morphology Unit, Universidad de los Andes, which were photographed. Analyzing the pictures with Photoshop ® Cs 3 extended program, the diameter and length of the foramina and canals were measured in pixels and then transformed into mm. 97 percent of the jaws observed had at least one foramen, 45 percent had two and 31 percent three. In relation to location 82 percent of the mandibles showed foramina in the bones superior and inferior 76 percent. The average diameter was 0.73 mm for superior placement and 0.71 mm for inferior placement. The average length of the superior canals was 6.77 mm and 5.5 mm for those inferior to the mental spine. Due to the high prevalence of foramina and canals in our sample its recommended to keep always in mind when planning surgical procedures that involve either medium mandibular lingual flank as the mandibular body at the symphysis area.

Role of buccal corridor in smile esthetics and its correlation with underlying skeletal and dental structures.

Purpose: This study was designed to evaluate the buccal corridor in smile esthetics and to correlate it with underlying hard tissues. Materials and Methods: Posed smiling frontal photographs, digital posterior-anterior (PA) cephalograms, and study models of 25 males and 25 females in age range of 18-25 years were taken. Photographs were evaluated for smile esthetics by eight orthodontists, eight plastic surgeons, eight beauticians and eight lay people to group them into three groups with least attractive, average and attractive smile and buccal corridor width was measured. Digital PA cephalograms were transferred on Nemo-tech software for frontal facial analysis. Intercanine and intermolar widths were measured on upper study model with the help of a digital calliper. Results: The buccal corridor width was least in attractive smile group and maximum in least attractive smile group. The buccal corridor width had a negligible correlation with hard tissues and a mild to moderate inverse correlation with intercanine and intermolar widths within the groups. Conclusion: As the amount of buccal corridor display was increased, smiling images were scored less attractive by the evaluators. The buccal corridor is not influenced by underlying skeletal hard tissues but have mild to moderate inverse correlation with the intercanine and intermolar width.

comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy

The aim of the present study was to compare the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test [MMT], the ratio of height to thyromental distance [RHTMD] and the Upper-Lip-Bite test [ULBT]. We collected data on 603 consecutive patients scheduled for elective surgery under general anesthesia requiring endotracheal intubation and then evaluated all three factors before surgery. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading [as per Cormack and Lehane's classification]. Sensitivity, specificity, and positive and negative predictive value, Receiver operating characteristic [ROC] Curve and the area under ROC curve [AUC] for each airway predictor in isolation and in combination were determined. Difficult laryngoscopy [Grade 3 or 4] occurred in 41 [6.8%] patients. The main endpoint of the present study, the AUC of the ROC, was significantly lower for the MMT [AUC, 0.511; 95% CI, 0.470-0.552] than the ULBT [AUC, 0.709; 95% CI, 0.671-0.745, P=0.002] and the RHTMD score [AUC, 0.711; 95% CI, 0.673-0.747, P=0.001]. There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score. By using discrimination analysis, the optimal cutoff point for the RHTMD for predicting difficult laryngoscopy was 21.06 [sensitivity, 75.6%; specificity, 58.5%]. The RHTMD is comparable with ULBT for prediction of difficult laryngoscopy in general population

Morphological and morphometric study of the mental foramen on the M-CP-18 Jiachenjiang point / Estudio morfológico y morfométrico del foramen mental en el punto M-CP-18 Jiachenjiang

The purpose of this work was to study the morphology and morphometry of the mental foramen (MF), as well as to evaluate its morphological configuration; in addition to taking measures of its localization using as a parameter the distances of the foramen to the inferior border of the mandible and at the alveolar ridge. 80 dry mandibles were analyzed using the test of Qui-square and T test, with 5 percent of significance. Its average distance, on the right side, at the inferior edge of the mandible (IEM) was of 12.96( +/-1 .57) mm and of the alveolar ridge (AR) was of 12.82(+/-3.4) mm. On the left side it was found distant of IEM 12.96(+/-1.32) mm and of the AR 12.82(+/- 3.22)mm. The largest horizontal diameter found was of 3.32 (+/- 0.91) mm to the right and 3.25 (+/- 0.86) mm to the left side while the largest vertical diameter was of 2.38 (+/- 0.63) mm on the right and of 2.39 (+/- 0.58) mm on the left side. It was predominantly found in the oval form, on the right side, of which 98.3 percent presented as a larger diameter the horizontal (type I). On the left side, all the oval foramens were classified as of type I. 76 (95 percent) appeared single on both sides. As to the localization related to the mandibular dentition, it was localized in similar statistic proportions between the 1st and 2nd premolars and above the 2nd premolar, in 45.17 percent of the mandibles, on the right side. On the left side it was predominantly found between the 1st and 2nd premolars 48.48 percent of the mandibles. The study of the MF is of vital importance to the acupuncture practice, as well as to modern surgical procedures, like anesthesia, requiring a detailed and precise study of the morphology and morphometry of the area.

El objetivo de este trabajo fue estudiar la morfología y morfometría del foramen mentoniano (FM), así como evaluar su configuración morfológica; tomar las medidas de su localization usando como parámetro la distancia del foramen hacia el borde inferior de la mandíbula y el reborde alveolar. 80 mandíbulas secas se analizaron mediante la prueba de Chi-cuadrado y prueba t, con un 5 por ciento de significancia. Su distancia media, en el lado derecho, hasta el borde inferior de la mandíbula (BIM) fue de 12,96 (+/- 1,57) mm y del reborde alveolar (RA) fue de 12,82 (+/- 3,4) mm. En el lado izquierdo se encuentro una distancia del BIM de 12,96 (+/- 1,32) mm y del RA de 12,82 (+/- 3,22) mm. El mayor diámetro horizontal encontrado fue de 3,32 (+/- 0,91) mm a la derecha y 3,25 (+/- 0,86) mm a la izquierda, mientras que el mayor diámetro vertical fue de 2,38 (+/- 0,63) mm a la derecha y de 2,39 (+/- 0,58) mm en el lado izquierdo. Se encuentra principalmente en forma oval en el lado derecho, de los cuales 98,3 por ciento presenta un diámetro mayor horizontal (tipo I). En el lado izquierdo, todos los forámenes ovales fueron clasificados como de tipo I. 76 (95 por ciento) aparecieron solamente en ambos lados. En cuanto a la localization en relación con la dentición mandibular, fue localizado en la misma proporción estadística entre el 1er y 2d° premolar y por encima del 2ª premolar en el 45,17 por ciento de las mandíbulas en el lado derecho. En el lado izquierdo se encuentran principalmente entre los l ros y 2ros premolares en el 48,48 por ciento de las mandíbulas. El estudio del FM, es de vital importancia para la práctica de la acupuntura, así como para los modernos procedimientos quirúrgicos, como la anestesia, que requieren un estudio detallado y preciso de la morfología y morfometría de la zona.

Comparative study of intermaxillary relationships of manual and swallowing methods

This study compared the mandibular displacement from three methods of centric relation record using an anterior jig associated with (A) chin point guidance, (B) swallowing (control group) and (C) bimanual manipulation. Ten patients aged 25-39 years were selected if they met the following inclusion criteria: complete dentition (up to the second molars), Angle class I and absence of signs and symptoms of temporomandibular disorders and diagnostic casts showing stability in the maximum intercuspation (MI) position. Impressions of maxillary and mandibular arches were made with an irreversible hydrocolloid impression material. Master casts of each patient were obtained, mounted on a microscope table in MI as a reference position and 5 records of each method were made per patient. The mandibular casts were then repositioned with records interposed and new measurements were obtained. The difference between the two readings allowed measuring the displacement of the mandible in the anteroposterior and lateral axes. Data were analyzed statistically by ANOVA and Tukey's test at 5 percent significance level. There was no statistically significant differences (p>0.05) among the three methods for measuring lateral displacement (A=0.38 ± 0.26, B=0.32 ± 0.25 and C=0.32 ± 0.23). For the anteroposterior displacement (A=2.76 ± 1.43, B=2.46 ± 1.48 and C=2.97 ± 1.51), the swallowing method (B) differed significantly from the others (p<0.05), but no significant difference (p>0.05) was found between chin point guidance (A) and bimanual manipulation (C). In conclusion, the swallowing method produced smaller mandibular posterior displacement than the other methods.

Este estudo comparou o deslocamento mandibular a partir de 3 métodos de registro da relação cêntrica usando um jig anterior associado com: (A) guia da ponta do mento; (B) deglutição grupo controle (C) manipulação bimanual. As moldagens dos arcos maxilares e mandibulares foram feitas com hidrocolóide irreversível. Os modelos de estudo de cada paciente foram obtidos e montados em máxima intercuspidação como uma posição de referência no microscópio. Foram obtidos 5 registros de cada método em 10 pacientes. Os modelos mandibulares foram reposicionados com os registros interpostos e novas medidas foram obtidas. A diferença entre as duas leituras permitiu a medida do deslocamento mandibular nos eixos ântero-posterior e laterais. ANOVA não demonstrou diferença estatisticamente significativa entre os 3 métodos em relação ao registro do deslocamento lateral (A = 0,38 ± 0,26, B = 0,32 ± 0,25 e C = 0,32 ± 0,23). Quanto ao deslocamento anteroposterior, ANOVA e o teste de Tukey (a=0,05) indicaram diferença estatisticamente significante entre os três métodos (A=2,76 ± 1,43, B=2,46 ± 1,48 e C=2,97 ± 1,51). Não houve diferença estatisticamente significante entre A e C. A deglutição propiciou menor deslocamento mandibular posterior que os outros métodos.

Evaluation of the Divine Proportion in the facial profile of young females.

BACKGROUND: Beauty is the phenomenon of experiencing pleasure, through the perception of balance. According to some authors, attractive faces have ideal proportions that are related to the Divine Proportion (1.618:1). AIM: The purpose of this study was to evaluate the Divine Proportion in the human profile and investigate the effects of this ratio on the perception of the beauty of the profile. STUDY AND DESIGN: We conducted a cross-sectional study to determine the mentioned aims. MATERIALS AND METHODS: In this cross-sectional study, fifty females in the age range of 20-25 years, with acceptable profiles were selected. Standardized profile silhouettes were each given a score by 20 judges (consisting of 10 men and 10 women) using the visual analog scale. Five landmarks were determined and five ratios were measured on the silhouettes by using the adobe photoshop program. STATISTICAL ANALYSIS: The Student's t test was used to compare profile proportions of the subjects. RESULTS: Statistical analysis showed none of the proportions had the mean of 1.618, but in subjects having higher esthetic scores, trichion (Te)-soft tissue menton (Me):Tr-subnasale (Sn) and Tr-Me:soft tissue nasion (N)-Me, with the mean of 1.58 were closer to Divine Proportion. CONCLUSIONS: The results suggested the perception of beauty is influenced by the Divine Proportions and Tr-Me:Tr-Sn and Tr-Me:N-Me are the most influential ratios in the perception of the beauty of profile; however, if the Divine Proportion is to be used in treatment planning, it should be used along with other factors.

A study of cephalometric appraisal of the inheritance of craniofacial pattern in Gorkhas.

The phenotypic expression of biologic variability expressed in the craniofacial complex is influenced by constant interplay of heredity and environmental factors. The aim of this study was to observe the pattern of inheritance of cranio-facial complex in Gorkhas. Gorkhas are the original inhabitants of NEPAL in the slopes of HIMALAYAS and they generally marry strictly in their race. 76 individuals from 19 Gorkha families (son, daughter and both parents); were selected. Eight angular (saddle angle, articular angle, gonial angle, N-S-Gn, N-S-Go, SNA, SNB and ANB angles) and four linear (anterior facial height, posterior facial height, overjet and overbite) variables were measured from lateral head cephalograms and the values of the variables were evaluated and compared. It was found that the Inheritance of cranio facial pattern has shown significant coefficient of correlation from mother to offsprings for jarabak ratio, father to son for NS-Gn and NS-Go angle, father to daughter for articular and ANB angles. Different parts of craniofacial complex represents the resultant of morphology and size variation. Each one of these components are in turn influenced by many genetic and environmental factors.

An assessment of the ratio of height to thyromental distance compared to thyromental distance as a predictive test for prediction of difficult tracheal intubation in Thai patients.

BACKGROUND AND RATIONALE: Preoperative evaluation is important in the detection of patients at risk for difficult tracheal intubation. Thyromental distance (TMD) is often used for these purposes, but its value as an indicator for difficult intubation is questionable, as it varies with patient size and body proportions. The purpose of the present study was to evaluate and compare the accuracies of the ratio of patient's height to TMD (ratio of height to TMD = RHTMD) and TMD alone in the prediction of difficult tracheal intubation in Thai patients. MATERIAL AND METHODS: The authors collected data on 382 consecutive patients scheduled to receive general anesthesia requiring endotracheal intubation for elective surgery. Thyromental distance and RHTMD were evaluated preoperatively. Difficult intubation was defined in the present study by Cormack and Lehane grade 3 or 4. The optimal predictive value was chosen using a receiver operating characteristic (ROC) curve. The areas under the ROC curves (AUC) of TMD and RHTMD were compared to determine the performance of the different predictive tests used. The sensitivity, specificity, and positive and negative predictive values of each of the predictive tests were calculated according to standard formulae. RESULTS: Difficult intubation occurred in 42 patients (10.9 %). The predictive advantage of RHTMD has a similar specificity with improved sensitivity in comparison with TMD. The AUC of RHTMD was significantly greater than the AUC of TMD (p = 0.00). The authors concluded that RHTMD had better accuracy in predicting difficult intubation than TMD.