The Use of Facial Fillers in Clinical Practice: The Level of Patient Satisfaction and an Overview of Common Clinical Complications. / [Artículo traducido] Uso de rellenos faciales en la práctica clínica: nivel de satisfacción del paciente y visión general de las complicaciones clínicas comunes.

BACKGROUND: Patient esthetic satisfaction following facial fillers is an essential topic that should be studied as the number of individuals seeking treatment increases. The face is an essential component of the human body that is frequently associated with beauty, youthfulness, and health. Individuals may seek facial augmentation with fillers for a variety of reasons, such as congenital, acquired by means of aging or disease, or current aesthetic trends. OBJECTIVE: The aim is to assess patient's aesthetic satisfaction and description of common clinical complications in relation to the facial filler injections. METHOD: A cross sectional survey using a questionnaire derived from the global aesthetic improvement scale and WHO quality of life scale, convenience sampling was used to recruit patients attending cosmetic clinics, descriptive analysis and Chi-square methods were used to analyze the data. RESULTS: In the study, 500 female participants, with an average age of 28.48 years, were included. Over 90% reported improvement after filler treatment, ranging from improved to very much improved. A statistically significant correlation was observed between patient satisfaction and the number of filler treatments and the anatomical injection site. However, no statistically significant correlation was found when considering age groups. Local side effects, such as swelling and redness at the injection site, were common but generally mild and of short duration. CONCLUSION: Although the satisfaction level is currently high, practitioners in the field need to pay more attention to this important outcome, since understanding the patient's motivation and expectation before proceeding with the procedure is very important and can contribute significantly in determining patient satisfaction with the result.

The Use of Facial Fillers in Clinical Practice: The Level of Patient Satisfaction and an Overview of Common Clinical Complications.

BACKGROUND: Patient esthetic satisfaction following facial fillers is an essential topic that should be studied as the number of individuals seeking treatment increases. The face is an essential component of the human body that is frequently associated with beauty, youthfulness, and health. Individuals may seek facial augmentation with fillers for a variety of reasons, such as congenital, acquired by means of aging or disease, or current aesthetic trends. OBJECTIVE: The aim is to assess patient's aesthetic satisfaction and description of common clinical complications in relation to the facial filler injections. METHOD: A cross sectional survey using a questionnaire derived from the global aesthetic improvement scale and WHO quality of life scale, convenience sampling was used to recruit patients attending cosmetic clinics, descriptive analysis and Chi-square methods were used to analyze the data. RESULTS: In the study, 500 female participants, with an average age of 28.48 years, were included. Over 90% reported improvement after filler treatment, ranging from improved to very much improved. A statistically significant correlation was observed between patient satisfaction and the number of filler treatments and the anatomical injection site. However, no statistically significant correlation was found when considering age groups. Local side effects, such as swelling and redness at the injection site, were common but generally mild and of short duration. CONCLUSION: Although the satisfaction level is currently high, practitioners in the field need to pay more attention to this important outcome, since understanding the patient's motivation and expectation before proceeding with the procedure is very important and can contribute significantly in determining patient satisfaction with the result.

Complicaciones Asociadas a la Remoción Estética del Cuerpo Adiposo de la Boca (de Bichat) - Revisión Narrativa / Complications Associated with Aesthetic Removal of the Buccal Adipose Body (Bichat's fat-pad) - Narrative Review

El cuerpo adiposo de la boca (CAB) es un componente adiposo multilobulado bien delimitado, localizado de manera bilateral en la región facial íntimamente relacionado a estructuras nerviosas y vasculares. La remoción de CAB es un procedimiento ampliamente estudiado en el campo de la cirugía maxilofacial, utilizado principalmente para cubrir defectos. Su influencia en la estética facial ha iniciado una popularización de la remoción de la extensión bucal de CAB para obtener un rostro más estilizado, intervención difundida como poco invasiva y sin complicaciones. El objetivo de este estudio fue recopilar y evaluar estudios que reporten y evalúen complicaciones asociadas a la remoción por razones estéticas de CAB. Se revisó la evidencia en las bases de datos Medline vía PubMed, Epistemonikos, Scopus y Google Scholar, utilizando términos predefinidos, seleccionando estudios primarios de reportes de casos. Se incluyeron 7 artículos con un total de 10 pacientes; de estos, ocho pacientes se realizaron este procedimiento en Brasil, uno en Estados Unidos y uno en Chile. La distribución de la población fue de 3:7 entre hombres y mujeres con edad promedio de 35 años y un rango entre los 23 a los 49 años. En relación a las complicaciones reportadas, 100 % de los pacientes presentaron asimetría facial, un 80 % presentó edema facial, 30 % manifestaron sialocele, Trismus 20 %, 40 % presentó hematoma, 20 % compromiso del estado general, 20 % presentaron disfagia, en los casos de hipoestesia, parestesia, absceso, seroma, parálisis facial, odinofagia, fiebre se expresaron en 10 % de la población estudiada. En todos los estudios se describió una reintervención quirúrgica posterior a la remoción estética del cuerpo adiposo de bichat. La escasa literatura y la baja calidad de esta, no permite estimar el porcentaje real de posibles complicaciones, tampoco es posible determinar sus resultados a largo plazo ya que no existe en la evidencia un seguimiento apropiado para estos pacientes.

The buccal adipose body (BAB) is a well- defined multilobulated adipose component, located bilaterally in the facial region, closely related to nervous and vascular structures. BAB removal is a widely studied procedure in the field of maxillofacial surgery, used mainly to cover defects. Its influence on facial aesthetics has started to popularize the removal of the BAB buccal extension to obtain a more stylized face, an intervention widely known as minimally invasive and without complications. The objective of this study was to collect and evaluate studies that report and evaluate complications associated with the removal of BAB for cosmetic reasons. The evidence was reviewed in the Medline databases via PubMed, Epistemonikos, Scopus, and Google Scholar, using predefined terms, selecting primary studies from case reports. 7 articles with a total of 10 patients were included; Of these, eight patients underwent this procedure in Brazil, one in the United States, and one in Chile. The distribution of the population was 3:7 between men and women with an average age of 35 years and a range between 23 to 49 years. In relation to the reported complications, 100 % of the patients presented facial asymmetry, 80 % presented facial edema, 30 % manifested sialocele, trismus 20 %, 40 % presented hematoma, 20 % compromised general state, 20 % presented dysphagia, in the cases of hypoesthesia, paresthesia, abscess, seroma, facial paralysis, odynophagia, fever were expressed in 10 % of the studied population. All the studies described a surgical reintervention after cosmetic removal of the bichat adipose body. The scarce literature and its low quality do not allow estimating the real percentage of possible complications, nor is it possible to determine their long-term results since there is no evidence of appropriate follow-up for these patients.

Estética y patrones craneofaciales en la Ortodoncia / Aesthetics and craniofacial patterns in Orthodontics

RESUMEN La belleza se puede definir como una combinación de cualidades que dan placer a los sentidos o a la mente. En Ortodoncia, la mayoría de los pacientes acuden a consulta para mejorar su estética. Las características faciales y esqueléticas determinan el desarrollo del patrón facial, este puede ser descrito y cuantificado y es resultado del crecimiento. Dicho aspecto, ofrece, además, las bases para el diagnóstico correcto de la anomalía dentomaxilofacial y es un requisito para lograr una estética y una función adecuadas. Se realizó un estudio de los diferentes conceptos de estética y los análisis craneofaciales tomados en cuenta a lo largo de la historia de la Ortodoncia para definir tratamientos y diagnósticos en los pacientes. Si bien existen numerosos estudios que avalan la importancia de estos datos para llegar a la armonía facial, es evidente la ausencia de un acercamiento a la realidad cubana y su diversidad de razas.

ABSTRACT Beauty can be defined as a combination of qualities that give pleasure to the senses or to the mind. In Orthodontics, most patients come for consultation to improve their aesthetics. Facial and skeletal characteristics determine facial pattern development, which can be described and quantified and is the result of growth. It also provides the basis for the correct diagnosis of dentomaxillofacial anomalies and is a prerequisite for adequate function and aesthetics. A study of the different aesthetics concepts and the craniofacial analysis, throughout the history of Orthodontics, was made to define treatments and diagnoses in patients. Although there are numerous studies that endorse the importance of these data to achieve facial harmony, it is evident that there is no an approach to the Cuban reality and its racial diversity.

Evaluation of dental school student's satisfaction regarding their own smile esthetics and facial profile

Introduction: Facial aesthetics is especially important in a person's life. However,what is considered aesthetic by the orthodontist does not always correspond withthe patient's opinion, since aesthetics is very subjective. Thus, the aim of this studyis to evaluate the perception of dentalgraduate students in relation to their ownsmile and facial profile, analyzing if there would be any difference between thisself-evaluation associated with the year students are attending in dental schooland the technical knowledge progressively acquired. Materials and methods: Atransverse observational study was performed, in which a questionnaire wasapplied to all dentistry students at the State University of Rio de Janeiro. Thequestionnaire inquired about: student's current semester, age, gender, nationality,and previous history of orthodontic treatment. It also contained a Likert scale ofsatisfaction about their smile, the aesthetic component of the Index of OrthodonticTreatment Need (IOTN) for students to compare with their smile, and a scale forfacial profile comparison. The chi-squared test was applied using the SPSS 13.0software and all analyzes were performed with 95% confidence (p < 0.05). Results:A total of 253 questionnaires were distributed and 166 were filled out. Amongthose, 103 people reported having had orthodontic treatment before. The level ofsatisfaction with their own smile was high, reaching 78% in the first year of thecourse, 63% in the second, 87% in the third, and 72% in the fourth year. There wasa preference for a slightly convex profile for both genders. It is observed that 62%of the sample reported having been submitted to orthodontic treatment beforeand the percentage of white students who had received previous orthodontictreatment was substantially higher than other ethnicities. The qui-square testfound a significant statistical difference in ethnicity among students that hadreceived previous orthodontic treatment (p=0.008). Conclusion: There was nodifference in the aesthetic perception of the smile and profile in relation to theyear attended by dental school students, with the level of satisfaction with theirown smile being high.

Introdução: A estética facial apresenta grande importância na vida dos indivíduos. Entretanto, nem sempre o considerado estético pelo ortodontista corresponde com a opinião do paciente, visto que a estética é subjetiva. Assim,objetivou-se avaliar a percepção de graduandos da faculdade de Odontologia, em relação ao próprio sorriso e perfil facial, analisando se haveria diferença nesta percepção em relação ao período que cursariam e à medida que os conhecimentos são adquiridos. Materiais e Métodos: Desenvolveu-se este estudo observacional transversal, no qual distribuiu-se um questionário para todos os alunos do curso de Odontologia da Universidade do Estado do Rio de Janeiro. O questionário continha perguntas sobre o período cursado, idade, sexo, naturalidade, história prévia de tratamento ortodôntico, satisfação com o sorriso, índice de Necessidade de Tratamento Ortodôntico (IOTN) para ser comparado com o sorriso, além de escala para comparação do perfil facial. O teste do qui-quadrado foi aplicado no software SPSS 13.0 e todas as análises foram realizadas com 95% de confiança (p<0,05). Resultados: Foram preenchidos 166 dos 253 questionários distribuídos. Destes, 103 alunos relataram tratamento ortodôntico prévio. O grau de satisfação com o próprio sorriso foi alto, sendo de 78% no primeiro ano de faculdade, 63% no segundo, 87% no terceiro e 72% no quarto ano. Houve preferência pelo perfil levemente convexo para ambos os gêneros. Foi observado que 62% da amostra já havia feito tratamento ortodôntico, sendo a maioria da etnia branca. O teste qui-quadrado encontrou diferença estatisticamente significativa na etnia dos estudantes que receberam tratamento ortodôntico prévio (p=0,008). Conclusão: Não houve diferença na percepção estética do próprio sorriso e perfil em relação ao período cursado, sendo o grau de satisfação com o próprio sorriso bastante alto.

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.

Planificación en ortodoncia a partir del incisivo superior: una propuesta de VTO / Planning in orthodontics from the upper incisor: a VTO proposal

Para adecuarnos a los objetivos estéticos de la ortodoncia actual, y con el fin de lograr una planificación más eficiente, hemos propuesto una modificación al objetivo visual de tratamiento (VTO) tradicional de Ricketts. En este método, sugerimos comenzar la planificación ortodóncica evaluando la estética de los tejidos blandos y la sonrisa del paciente, de forma individualizada para cada caso según su arquetipo facial, tomando como punto de partida la posición deseada del incisivo superior, dando importancia a las posibilidades de modificación del plano oclusal, de la altura del tercio inferior de la cara y de la proyección del mentón a partir de la autorrotación mandibular. Durante este proceso se utilizan, además de la telerradiografía de perfil, las fotos del paciente de frente y de perfil para planear cambios de forma visual, a través del efecto morphing, todo esto facilitado por el uso de un software de diseño(AU)

For adapting us to the aesthetics objectives of today's orthodontics, and in order to achieve a more efficient planning, we have proposed a modification to the traditional Ricketts' visual treatment objective - VTO. In this method, we suggest starting orthodontic planning by evaluating the aesthetics of soft tissues and the smile of the pacient, in a customized way for each case according to facial archetype, taking as a starting point the desired position of the upper incisor, giving importance to the possibilities for occlusal plane changing, to the height of the lower third of the face and to the projection of the chin from the mandibular autorotation. During this process, in addition to profile teleradiography, full-face and profile pictures of the patient are used to plan visual changes through morphing, all of this was facilitated by the use of design software(AU)

Tratamiento de la clase III esquelética máxilo-mandibular con twin block / Treatment of skeletal Class III maxillo-mandibular relationship with the twin block appliance

RESUMEN Introducción: la clase III esquelética máxilo-mandibular se caracteriza por la relación no fisiológica de los arcos dentarios, perfil cóncavo, discrepancia sagital máxilo-mandibular y alteraciones funcionales que perturban el funcionamiento del sistema estomatognático. En la literatura nacional e internacional no existe evidencia de la eficacia del tratamiento con twin block de la clase III esquelética máxilo-mandibular. Objetivo: evaluar el tratamiento de la clase III esquelética máxilo-mandibular con el uso de twin block. Material y Métodos: se realizó un estudio de intervención de tipo cuasi-experimental, en 43 pacientes con clase III esquelética máxilo-mandibular, en la Clínica Universitaria de Especialidades Estomatológicas "Manuel Cedeño", en el período de enero de 2018 a junio de 2019. Se estudiaron las variables: relación de oclusión, clasificación esquelética máxilo-mandibular, disfunción de la articulación temporomandibular y estética facial. A todos los pacientes se les aplicó el twin block como parte del tratamiento ortopédico-funcional. Resultados: inicialmente el 86,04% de los pacientes tenían una mesioclusión, la que se modificó a neutroclusión en el 81,39%. La clasificación esquelética se corrigió en el 88,37% de los casos. La disfunción de la articulación temporomandibular mejoró, a leve, en el 51,16% de los pacientes. La estética facial resultó no afectada en el 83,72%. Conclusiones: Con el uso de twin block se corrige la relación de oclusión dentaria y la clase III esquelética máxilo-mandibular, además de ser una opción terapéutica que mejora la disfunción de la articulación temporomandibular y la estética facial en pacientes con esta anomalía dentomaxilofacial.

ABSTRACT Introduction: Skeletal Class III maxillo-mandibular relationship is characterized by the non-physiological relationship between the dental arches, concave profile, maxillo-mandibular sagittal discrepancy and functional alterations that disturb the functioning of the stomatognathic system. In the national and international literature, there is no evidence of the effectiveness of treatment of Skeletal Class III maxillo-mandibular relationship with the use of twin block appliance. Objective: To evaluate the treatment of skeletal Class III maxillo-mandibular relationship with the use of twin block appliance. Material and Methods: A quasi-experimental intervention study was conducted in 43 patients with skeletal Class III maxillo-mandibular relationship at Manuel Cedeño Dental Specialties University Clinic during the period between January 2018 and June 2019. The study variables were: occlusion ratio, maxillo-mandibular skeletal classification, temporomandibular joint dysfunction and facial esthetics. The twin block appliance was applied to all patients as part of the orthopedic functional treatment. Results: Initially, 86,04 % of the patients had a mesioclusion, which was modified to neutroclusion in 81,39 %. Skeletal classification was corrected in 88,37 % of cases. Temporomandibular joint dysfunction improved to mild in 51,16 % of patients. Facial esthetics was not affected in 83,72 %. Conclusions: The ratio of dental occlusion and class III maxillo-mandibular skeletal relationship are corrected with the use of a twin block appliance, besides being a therapeutic choice that improves dysfunction of the temporomandibular joint and facial esthetics in patients with this dentomaxillofacial anomaly.

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.

Assessment of facial analysis measurements by golden proportion.

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.

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.

El envejecimiento facial, una mirada desde la Ortodoncia

Introducción: El envejecimiento es un proceso continuo y multifactorial que puede ser considerado como la acumulación de diferentes cambios perjudiciales en las células y en los tejidos.Objetivo: Profundizar en el conocimiento sobre la relación entre el envejecimiento facial y la Ortodoncia.Métodos: Se realizó un estudio de revisión de literatura de artículos publicados en la Universidad de Ciencias Médicas de Sancti Spíritus entre enero y marzo del 2017. Se emplearon métodos del nivel teórico: analítico-sintético e histórico-lógico y del nivel empírico: análisis documental. Se evaluaron revistas de impacto de la Web of Sciencies relacionadas con este tema. En la búsqueda se priorizaron los artículos publicados en los últimos 5 años, así como los artículos clásicos del tema que habían sido citados por otros autores en sus estudios. Se consultaron las bases de datos de sistemas referativos MEDLINE, PubMed, Google Académico; Science Direct y SciELO se encontraron con los descriptores y fueron revisados 36 bibliografías 33 revistas y 3 libros.Conclusiones: Para los profesionales de la Ortodoncia es esencial profundizar en el conocimiento del envejecimiento facial para establecer un correcto diagnóstico y planificación del tratamiento bajo la visión futura del envejecimiento, donde los resultados no influyan negativamente en la futura estética facial del paciente [AU]

Subcutaneous lateral brow lift, an option with local anesthesia / Levantamiento de cejas lateral con acceso subcutáneo, una opción con anestesia local

The aim of this article is to present a case series of subcutaneous lateral brow lifts withlocal anesthesia. The case series includes 9 subjects operated on between 2014 and 2016, with an averageage of 57 years and with no limitations on ethnic group or gender. The surgery was done bilaterally entirelyunder local anesthesia. After a minimum follow-up of 3 months, no major complications were observed, onlypartial suture dehiscence at two surgical sites that did not require surgical management of the zone. Goodresults were established, being fast, economical and with low morbidity. It is concluded that the subcutaneousbrow lift with local anesthesia can be applied with a low rate of complications and good results.

El objetivo de este articulo es presentar una serie de casos operados para levantamiento lateral de cejas, con disección subcutánea y con uso de anestesia local. Se diseño un estudio de serie de casos, incluyendo 9 sujetos operados entre el año 2014 y 2016, con una edad promedio de 57 años y sin restricción de etnia o sexo. Se realizó la cirugía totalmente bajo anestesia local de forma bilateral. Después de un seguimiento mínimo de 3 meses, no se observaron complicaciones mayores, presentado solo dehiscencia parcial de sutura en dos sitios quirúrgico que no requirieron manejo quirúrgico de la zona; se establecieron buenos resultados, siendo ellos rápidos, de baja morbilidad y de bajo costo. Se concluye que la técnica de levantamiento de cejas con disección subcutánea y anestesia local puede ser aplicado con bajo índice de complicaciones y buenos resultados.

Principales causas relacionadas con el abandono del tratamiento ortodóncico por escolares y adultos jóvenes según tipos de aparatos utilizados / Main causes related to the orthodontics treatment cessation by school children and young adults according to types of braces used

Se realizó un estudio epidemiológico analítico, de casos y controles, para identificar los principales factores asociados al abandono del tratamiento ortodóncico en el Servicio de Ortodoncia de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, en el período comprendido desde septiembre de 2010 hasta julio de 2013. Para ello se crearon 2 grupos: el de los casos, integrado por 193 pacientes de uno u otro sexo, que habiendo iniciado el tratamiento ortodóncico en 2008 por presentar maloclusiones, lo abandonaron en 2010; y el de los controles, conformado por 193 que lo comenzaron también en 2008, pero lo finalizaron en 2010 o 2011. Se determinaron los odds ratio y los intervalos de confianza al 95 por ciento para los factores, en tanto mostraron la mayor fuerza de asociación al abandono del tratamiento: sexo masculino, 6 y más consultas no asistidas y 6 y más consultas pérdidas por falta de recursos. Los principales factores que se asociaron causalmente al abandono del tratamiento ortodóncico fueron los escolares, el sexo masculino, el menor nivel de escolaridad, aparatos removibles y funcionales, aparatos removibles rotos y/o perdidos, consultas entre el ingreso y la instalación de los aparatos y las consultas perdidas por falta de recursos

An analytic epidemiological cases and controls study was carried out, to identify the main factors associated with the orthodonctics treatment cessation in the Orthodontics Service of "Mártires del Moncada" Teaching Provincial Stomatological Clinic in Santiago de Cuba, from September, 2010 to July, 2013. Two groups were created: the cases group, integrated by 193 patients from both sexes that began the orthodontics treatment in 2008 due to malocclusions, and quit it in 2010; and the controls group, conformed by 193 that also began in 2008, but they concluded it in 2010 or 2011. The odds ratio and confidence intervals were determined at 95 percent for the factors, as long as they showed the highest force of association when quitting the treatment: the male sex, 6 and more missed visits and 6 and more lost visits due to lack of resources. The main factors that were causally associated with the orthodontics treatment cessation were the school children, the male sex, the lowest school level, removable and functional braces, broken and/or lost removable braces, visits between admission and teeth bracing and lost visits due to lack of resources

Principales causas relacionadas con el abandono del tratamiento ortodóncico por escolares y adultos jóvenes según tipos de aparatos utilizados / Main causes related to the orthodontics treatment cessation by school children and young adults according to types of braces used

Se realizó un estudio epidemiológico analítico, de casos y controles, para identificar los principales factores asociados al abandono del tratamiento ortodóncico en el Servicio de Ortodoncia de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, en el período comprendido desde septiembre de 2010 hasta julio de 2013. Para ello se crearon 2 grupos: el de los casos, integrado por 193 pacientes de uno u otro sexo, que habiendo iniciado el tratamiento ortodóncico en 2008 por presentar maloclusiones, lo abandonaron en 2010; y el de los controles, conformado por 193 que lo comenzaron también en 2008, pero lo finalizaron en 2010 o 2011. Se determinaron los odds ratio y los intervalos de confianza al 95 por ciento para los factores, en tanto mostraron la mayor fuerza de asociación al abandono del tratamiento: sexo masculino, 6 y más consultas no asistidas y 6 y más consultas pérdidas por falta de recursos. Los principales factores que se asociaron causalmente al abandono del tratamiento ortodóncico fueron los escolares, el sexo masculino, el menor nivel de escolaridad, aparatos removibles y funcionales, aparatos removibles rotos y/o perdidos, consultas entre el ingreso y la instalación de los aparatos y las consultas perdidas por falta de recursos(AU)

An analytic epidemiological cases and controls study was carried out, to identify the main factors associated with the orthodonctics treatment cessation in the Orthodontics Service of Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, from September, 2010 to July, 2013. Two groups were created: the cases group, integrated by 193 patients from both sexes that began the orthodontics treatment in 2008 due to malocclusions, and quit it in 2010; and the controls group, conformed by 193 that also began in 2008, but they concluded it in 2010 or 2011. The odds ratio and confidence intervals were determined at 95 percent for the factors, as long as they showed the highest force of association when quitting the treatment: the male sex, 6 and more missed visits and 6 and more lost visits due to lack of resources. The main factors that were causally associated with the orthodontics treatment cessation were the school children, the male sex, the lowest school level, removable and functional braces, broken and/or lost removable braces, visits between admission and teeth bracing and lost visits due to lack of resources(AU)

Principales factores de riesgo relacionados con el abandono del tratamiento ortodóncico por escolares, adolescentes y adultos jóvenes / Main risk factors related to the orthodontics treatment cessation for school children, adolescents and young adults

Se realizó un estudio epidemiológico analítico, de casos y controles, para identificar los principales factores asociados al abandono del tratamiento ortodóncico en el Servicio de Ortodoncia de la Clínica Estomatológica Provincial Docente "Mártires del Moncada" de Santiago de Cuba, en el período comprendido desde septiembre de 2010 hasta julio de 2013. Para ello se crearon 2 grupos: el de los casos, integrado por 193 pacientes de uno u otro sexo, que habiendo iniciado el tratamiento ortodóncico en 2008 por presentar maloclusiones, lo abandonaron en 2010; y el de los controles, conformado por 193 que lo comenzaron también en 2008, pero lo finalizaron en 2010 o 2011. Entre las variables utilizadas figuraron: edad, sexo, escolaridad y consultas no asistidas. Se obtuvo un predominio de los varones (55,4 %), del abandono del tratamiento por los escolares (72,0 %), del menor nivel de escolaridad (88,6 %) y de la asistencia a menos de 6 consultas (54,9 %).

An analytic epidemiological, of cases and controls study, to identify the main factors associated to the orthodontics treatment cessation in the Orthodontics Service of "Martires del Moncada" Teaching Provincial Stomatological Clinic in Santiago de Cuba, was carried out from September, 2010 to July, 2013. Two groups were formed: the cases, integrated by 193 patients from both sexes that began the orthodontics treatment in 2008 due to malocclusions, and quit it in 2010; and the controls group, conformed by 193 that also began in 2008, but they concluded it in 2010 or 2011. Among the used variables there were: age, sex, school level and missed visits. A prevalence of males (55.4 %), school children treatment cessation (72.0 %), the lowest school level (88.6 %) and the attendance to less than 6 visits (54.9 %) was obtained.

Principales factores de riesgo relacionados con el abandono del tratamiento ortodóncico por escolares, adolescentes y adultos jóvenes / Main risk factors related to the orthodontics treatment cessation for school children, adolescents and young adults

Se realizó un estudio epidemiológico analítico, de casos y controles, para identificar los principales factores asociados al abandono del tratamiento ortodóncico en el Servicio de Ortodoncia de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, en el período comprendido desde septiembre de 2010 hasta julio de 2013. Para ello se crearon 2 grupos: el de los casos, integrado por 193 pacientes de uno u otro sexo, que habiendo iniciado el tratamiento ortodóncico en 2008 por presentar maloclusiones, lo abandonaron en 2010; y el de los controles, conformado por 193 que lo comenzaron también en 2008, pero lo finalizaron en 2010 o 2011. Entre las variables utilizadas figuraron: edad, sexo, escolaridad y consultas no asistidas. Se obtuvo un predominio de los varones (55,4 por ciento), del abandono del tratamiento por los escolares (72,0 por ciento), del menor nivel de escolaridad (88,6 por ciento) y de la asistencia a menos de 6 consultas (54,9 por ciento)(AU)

An analytic epidemiological, of cases and controls study, to identify the main factors associated to the orthodontics treatment cessation in the Orthodontics Service of Martires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba, was carried out from September, 2010 to July, 2013. Two groups were formed: the cases, integrated by 193 patients from both sexes that began the orthodontics treatment in 2008 due to malocclusions, and quit it in 2010; and the controls group, conformed by 193 that also began in 2008, but they concluded it in 2010 or 2011. Among the used variables there were: age, sex, school level and missed visits. A prevalence of males (55.4 percent), school children treatment cessation (72.0 percent), the lowest school level (88.6 percent) and the attendance to less than 6 visits (54.9 percent) was obtained(AU)

Fonoaudiología y estética facial: experiencia de Brasil en la atención primaria de salud / speech therapy and facial esthetic: experience of Brazil in primary health care

La fonoaudiología es una disciplina relativamente nueva en Chile por lo cual se encuentra en pleno proceso de crecimiento y desarrollo. En este contexto, en el área de Motricidad Orofacial ha surgido hace algunos años una subespecialidad denominada “estética facial” que aborda la musculatura facial y sus alteraciones, ya sean secundarias al proceso natural de envejecimiento y/o a factores externos. Brasil, país pionero en esta práctica, ha desarrollado diversos planes de intervención en salud. A través de la creación de Núcleos de Apoyo a la Salud de la Familia, se ha incluido la estética facial en el contexto de atención primaria de salud. Es así que en la ciudad de Sete Lagoas, Minas Gerais se ha desarrollado un programa de estética facial con el objetivo de fomentar la integración del cuidado físico y mental de los usuarios. La evidencia científica muestra los resultados de la fonoaudiología estética, relajando la musculatura facial, disminuyendo arrugas y líneas de expresión y mejorando la sensación de bienestar de las personas. Se plantea la importancia de ampliar el conocimiento del profesional fonoaudiólogo chileno y desarrollar nuevas áreas de desempeño para contribuir en el beneficio de la población...

Speech Therapy is relatively new discipline in Chile, therefore, it is in the process of growth and development. As part of the orofacial motricity area, a new specialty has began to develop: Facial esthetic. This new area deals with facial muscles and their alterations caused by natural aging processes and/or external factors. Brazil, a pioneer country in this practice, has developed several health intervention plans. In this respect, facial esthetic has been included in the context of primary health care, through the creation of Family Health Support Centers. For instance, a program of facial esthetic has been implemented in the city of Sete Lagoas, Minas Gerais. This program aims to promote the integration of physical and mental care. Scientific evidence shows that esthetic’s speech therapy produce relaxation of facial muscles, reducing wrinkles and fine lines and improving the people’s sense of well-being. Therefore, increasing the knowledge about this area in Chilean speech therapists and developing new areas of professional performance would be important issues to address...

Recuperación de la autoestima en una adulta mayor rehabilitada con prótesis dental / Recovery of self-esteem in a female elderly rehabilitated with dentures

Se describe el caso clínico de una paciente de 67 años de edad, asistida en la Clínica Estomatológica del Policlínico Docente "Camilo Torres Restrepo" de Santiago de Cuba, quien había portado, por más de 10 años, prótesis superior acrílica desajustada, y además refería haber disminuido de peso corporal por la presencia de importantes dificultades masticatorias y dolor ocasional en las articulaciones temporomandibulares; asimismo, la afectada mostraba inconformidad con su estética facial. Todo lo anterior había dañado su autoestima y, consecuentemente, le producía limitaciones sociales en los planos laboral y personal. La paciente fue rehabilitada con prótesis total superior acrílica y parcial inferior acrílica, con lo cual mejoraron su estética y la función masticatoria. Fue remitida a consulta de Fisioterapia para completar el tratamiento del trastorno articular.

The case report of a 67 years patient is described, attended in the Stomatological Clinic from "Camilo Torres Restrepo" Teaching Polyclinic in Santiago de Cuba who had wore maladjusted acrylic upper denture for more than 10 years, and besides she referred to have lost of body weight due to important masticatory difficulties and occasional pain in the temporomandibular joints; likewise, the patient showed disagreement with her facial aesthetics. All the above-mentioned facts had damaged her self-esteem and, consequently, she showed social limitations in the working and personal fields. The patient was rehabilitated with upper total acrylic and partial lower acrylic prosthesis, with which her aesthetics and the masticatory function improved. She was referred to the Physiotherapy department to complete the treatment of the joint dysfunction.