Effects of open rhinoplasty on upper lip position in profile and frontal views.

Examining the upper lip position is a key indicator of facial beauty. This study aimed to examine the upper lip position following cosmetic rhinoplasty at the frontal and profile views. The medical records of 67 patients who underwent rhinoplasty with no history of any facial skeletal surgery were obtained from archives. Complete preoperative and postoperative photos including the profile view at rest and the frontal view at rest, were prepared and analysed using Adobe Photoshop CC 2015 software. Interpupillary distances of two eyes in frontal views and Glabella to Pogonion (POG) distance in profile views were considered as fixed landmarks to calibrate the preoperative and postoperative photos. Upper lip length, subnasal area, and vermilion points were marked and compared between preoperative and postoperative photos. Data analysis was carried out using one-sample t-test and p<0.05% was considered as the significant level. Lip length (frontal view) was increased in 46 subjects. There were changes in the profile view of vermilion and subnasal positions in 56 patients and 53 patients, respectively. In surgical procedures on columella strut, maxillary augment, alar resection, spreader graft, columella retraction, and depressor septi muscle release, vermilion and subnasal protrusion in the profile view was statistically significant and lip length increased significantly in the frontal view. In tip rotation surgery techniques, the vermilion and subnasal position showed also significant protrusion. The depressor septi muscle cutting methods had only led to a significant protrusion of the vermilion position and upper lip length. Despite all covariants interfering in rhinoplasty, this cosmetic surgery most often may increases maxillary lip length and helps that maxilla look more protruded.

Clinical outcomes of dental implants after use of tenting for bony augmentation: a systematic review.

The reconstruction of severely atrophic ridges is often challenging and complicated. We searched the Medline, Embase, and Cochrane databases for articles up to October 2015 that reported the success of all types of tenting for bony regeneration. We extracted data on the size and site of the defect, the number of patients, vertical and horizontal augmentation, survival of dental implants, and complications. Thirteen studies were included, which yielded data on 423 patients with 1111 dental implants. Follow-up periods were more than five years, severely resorbed mandibles were augmented vertically by up to 10mm, and the survival rate of the implants was over 97%. The mean (SD) gain in horizontal width by screw tenting was 3 (0.63)mm, and over 97.6% of dental implants in cortical tenting investigations survived. A tenting approach may reduce the need for large autogenous bone grafts in the reconstruction of severely atrophic ridges and local bony defects, and improves the survival of implants.

Assessment of compression and strength of divergent screws mounted on miniplates for fixation of mandibular fractures: an in vitro experimental study.

An efficient band of tension is critical for the adequate fixation of mandibular fractures, so fixation devices that compress are helpful. We aimed to evaluate the possibility of creating compression using screws inserted divergently into miniplates placed in the tension zone of mandibular fractures and record the effects on the strength of fixation. For this in vitro experimental study we prepared 20 sheep hemimandibles. After angle fractures had been created, the specimens were divided into standard and study groups (n=10 in each). In the standard group the tension zones were fixed in the standard manner with 4-hole miniplates and 4 parallel screws. Those in the study group were fixed as for the standard group but with 4×45° divergent screws. The differences in the gap in the fracture line before and after fixation were measured as indicators of compression. The strength of fixation was also assessed with a universal testing machine in vitro. The amount of compression was significant only in the study group (p<0.001), and there was no difference in the strength of fixation between the two groups (p=0.7). We conclude that divergent drilling and insertion of screws creates more horizontal force when miniplates are used, and results in reduction in the size of the probable gap in the fracture line. Insertion of divergent screws in miniplates may create compression between fractured segments without jeopardising the strength of fixation.