How the lower face soft tissue changes after mandibular advancement or setback.

To contribute as an auxiliary tool for orthodontic and orthognathic planning and treatment, short-term changes on the lower face soft and hard tissues were investigated. All subjects presented adequate maxillary relation with the cranial base. The treatment was done by mandibular advancement in patients with skeletal class II or setback in skeletal class III, by the same oral surgeon, using the same technique, and rigid internal fixation. Lateral cephalograms were traced at the following intervals: T0--immediately before the surgical procedure, T1--6 months after surgery, and T2--1 year after surgery. The postoperative data of the lower face revealed highly significant changes for the soft tissue pogonion and lower lip, in the mandible advancement cases, whereas the underlying bone and dental structures remained constant. For the mandible setback cases, just the hard tissue pogonion variable displayed a statistically significant change.

Our experience with virtual craniomaxillofacial surgery: planning, transference and validation.

Clinical application of virtual craniomaxillofacial surgery (VCMS) planning is demonstrated with four typical cases. An integral component to success is transferring the surgical plan to the operating environment within a reasonable time frame through the design and fabrication of surgical guides and implants.

Cranial base angulation in Brazilian patients seeking orthodontic treatment.

The relationship between cranial base flexion and facial prognathism has been of interest to orthodontists, orthognathic maxillofacial surgeons, and plastic surgeons. This study aimed to identify the cranial base flexion of adults with anteroposterior skeletal disharmony. Because the sample was representing a mixed racial population, the authors performed an investigation to confirm an association with other researches performed in different parts of the world. The results revealed an increase in the cranial base flexion in cases diagnosed as class II skeletal pattern and reduction in the group with class III skeletal pattern. These findings suggested that the characteristics of the Brazilian cases did not differ from some other studies despite various influences of different ethnicities in that population.

Treatment protocol to control Streptococcus mutans level in an orthodontic patient with high caries risk.

The purpose of this article is to report a protocol for treating an orthodontic patient with a high risk of developing caries. The salivary level of Streptococcus mutans was evaluated during various stages of orthodontic treatment. It was significantly high before professional application of 1% chlorhexidine collagen gel, daily mouth rinsing with 0.05% sodium fluoride solution, and bonding of the bands and brackets. Although there were no other changes in hygiene habits, microbiologic tests showed that the microbiota was in balance during the follow-up periods. At the end of orthodontic treatment, periodontal health was observed, and enamel surfaces showed signs of remineralization.

Three-dimensional computerized orthognathic surgical treatment planning.

Three-dimensional volumetric imaging allows better visualization of the morphologic deformity, planning the surgical approach, and evaluating the response not visualized previously with two-dimensional dentofacial records. This in time will replace conventional two-dimensional cephalometric planning and plaster cast model surgery. Three-dimensional craniofacial imaging requires application of various techniques from applied mathematics, computer sciences, and bioengineering. Although it is today in its infancy, it has the potential to accurately simulate the operative experience for surgical planning, with improved morphologic outcomes, patient-specific biomechanical modeling to allow functional assessment of the various outcomes, and accurate simulation for surgical resident training.