Tratamento orto-cirúrgico de paciente com sorriso gengival e padrão face longa ­ relato de caso / Orto-surgical treatment of patient with gummy smile and long face pattern ­ case report

Resumo Introdução: O padrão Face Longa é uma deformidade facial com aumento da altura facial anterior. Nesse padrão, verifica-se incompetência labial com contração da musculatura perioral. O crescimento dentoalveolar vertical excessivo provoca exposição gengival durante o sorriso, o que constitui a principal queixa do paciente. A prevalência do padrão Face Longa varia de 1,5% a 14,6% na população adulta e aproximadamente metade desses pacientes necessitam de intervenção cirúrgica. Objetivo: relatar o caso clínico de paciente com padrão Face Longa severo tratado com a abordagem ortodôntico-cirúrgica. Métodos: Após um breve tratamento ortodôntico pré-cirúrgico, o paciente foi submetido à cirurgia ortognática. Foi realizada impacção maxilar de 10mm com rotação de plano oclusal e mentoplastia. A tecnologia digital, com imagens tridimensionais, foi aplicada para planejar o tratamento e imprimir guias cirúrgicas. Resultados: O tratamento promoveu selamento labial passivo com exposição gengival adequada no sorriso e um perfil facial reto. A paciente mostrou-se muito satisfeita com os resultados estéticos e funcionais. Conclusão: O tratamento orto-cirúrgico em pacientes com padrão de crescimento vertical é uma excelente alternativa para corrigir a desarmonia esquelética e melhorar a estética facial e do sorriso, além disso, promove forte impacto positivo na qualidade de vida dos indivíduos. Essa abordagem, quando devidamente planejada por um profissional experiente e com o auxílio da tecnologia digital pode aumentar a previsibilidade e a estabilidade a longo prazo.(AU)

Abstract Introduction: The Long Face pattern is a facial deformity with increased anterior total facial height. In this pattern, there is lip incompetence, and when the lip seals, contraction of the perioral musculature can be evidenced. Excessive dentoalveolar growth leads to gingival overexposure during smile, which is the patient's main complaint. The prevalence of Long Face pattern ranges from 1,5% to 14,6% in adult population and approximately half of these patients require surgical intervention. Objective: to report a clinical case of a patient with severe Long Face pattern treated with an orthodontic-surgical approach. Methods: After a brief pre-surgical orthodontic treatment the patient underwent orthognathic surgery. It was performed a 10mm maxillary impaction with occlusal plane rotation and mentoplasty. The digital technology with three-dimensional images was ­ to plan the treatment and print surgical splints. Results: Treatment promoted passive lip seal with adequate smiling gingival exposure and a straight profile. Patient became very satisfied with the aesthetical and functional results. Conclusion: Ortho-surgical treatment in patients with vertical growth pattern is an excellent alternative to correct skeletal disharmony and improve facial and smile aesthetics, besides that it promotes a strong positive impact on the quality of life of individuals. This approach when properly planned by an experienced professional and with the aid of digital technology may increase predictability and long-term stability.(AU)

Evaluation of the Post Orthognathic Surgery Satisfaction: a Comparative Cross-Sectional Study of Patients Class II and III.

The aim of this study was to analyze the degree of postoperative satisfaction regarding facial and dental esthetics, masticatory and respiratory function, and psychosocial factors in patients with dentofacial deformity Class II compared with Class III. The patients were divided into 2 groups with 50 patients in Group 1 (Class II) and 30 patients in Group 2 (Class III). Assessing the degree of postoperative satisfaction, the authors did not observe a significant difference between the groups in terms of improvements in the aesthetic and functional aspects and the psychological impact of the treatment. It can be concluded that regardless of the type of dentofacial changes, the treatment well indicated and conducted, results in significant positive effects on patients lives, both aesthetically and in the function, and psychosocial great benefit.