ABSTRACT
Botulinum toxin is composed of 7 botulinum toxin antigenic subtypes. It is produced by Clostridium botulinum bacterial fermentation. Several botulinum toxin subtypes are under investigation for clinical use, but only botulinum toxin type A (BTX-A) is currently approved for cosmetic use because of its clinical safety profile and efficacy. The use of BTX-A in cosmetic facial procedures is a reliable way to enhance aesthetics in the face and is becoming commonplace in oral and maxillofacial surgery. This article reports an uncommon complication after Botox injection in the upper lip, for cosmetic reasons, originating a mass in the anterior region of the maxilla, which leads to failure in orthodontic treatment. Knowledge of the site anatomy, pharmacology, and dose of BTX-A before its use in cosmetic surgery should be strengthened.
Subject(s)
Botulinum Toxins, Type A/adverse effects , Cosmetic Techniques/adverse effects , Facial Muscles/drug effects , Foreign-Body Reaction/chemically induced , Neuromuscular Agents/adverse effects , Adult , Diagnosis, Differential , Female , Foreign-Body Reaction/diagnosis , Humans , SmilingABSTRACT
O diagnóstico prévio de patologias envolvendo a articulação temporomandibular é de extrema importancia para o planejamento das cirurgias ortognáticas. Em caso de patologias da articulação temporomandibular que não sejam diagnosticadas ou sejam ignoradas, é esperada a piora do quadro clínico de disfunção temporomandibular ou a recidiva da deformidade dentoesquelética após a cirurgia ortognática. A hiperplasia condilar causa o aumento do tamanho do côndilo mandibular, que se repercute por toda a mandíbula, com consequente deformidade dentofacial. O tratamento da hiperplasia condilar consiste na remoção da área do côndito, responsável por este crescimento excessivo e posterior correção da deformidade facial remanescente. O objetivo deste trabalho é o de relatar um caso clínico de recidiva da assimetria facial devido à falha no diagnóstico e ao tratamento da hiperplasia condilar, ressaltando a importância da articulação temporomandibular na cirurgia ortognática.
The prior diagnosis of pathological conditions of the temporomandibular joint is extremely important for the planning of orthognathic surgery. If such conditions are ignored or not diagnosed, the worsening of the clinical features or postoperative relapse of the dentofacial deformity are to be expected. Condylar dsyplasia leads to an increase in the size of the mandibular condyle with repercussions for the entire jaw and resulting dentofacial deformity. The treatment of condylar hyperplasia consists in the resection of the area of the condyle responsible for this excessive growth and subsequent correction of the remainig facial deformity. The aim of this paper is to report a clinical case of relapse of facial asymmetry due to a failure to diagnose and treat condylar hyperplasia, emphasizing the importance of the temporomandibular joint in orthognathc surgery.
