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Objective: To validate and ascertain the reliability of the Orofacial Esthetic Scale specifically within the context of prosthodontic patients, aiming to establish it as a credible and standardized tool for evaluating orofacial esthetics in this specialized cohort. Methods: The systematic analysis adhered to the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search using four databases PubMed /Medline, Web of Science, Scopus, Science Direct along with manual and grey literature (ProQuest and Google scholar) till 30 October 2023 was performed. The risk of biasness was assessed using Joanna Briggs Institute (JBI) critical appraisal checklist followed by validity analysis. For meta-analysis, psychometric values (Cronbach alpha and Intra class correlation coefficient) were used through MedCalc software. Results: The overall ICC value was 0.95 (95% CI: 0.94 to 0.96) and the overall Cronbach alpha value was 0.94 (95% CI: 0.92 to 0.96). There was evidence of high heterogeneity and no publication bias among the studies included. Conclusion: This study underscores the pivotal role of orofacial esthetics in prosthodontic care, introducing the Orofacial Esthetic Scale as a validated tool to quantitatively assess subjective perceptions. This will highlight its potential for tailored treatment planning and improved patient outcomes.

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Background: For medium/small size breast, breast conserving surgery (BCS) is usually associated to poor cosmetic results. The objective of the study is to evaluate oncological safety and cosmetic results comparing the "Crescent" and the "J" mammoplasty technique and to develop an algorithm for the treatment of breast cancer located in lower quadrants in medium/small breast. Methods: We retrospectively analysed all consecutive patients who underwent a "J" mammoplasty or a "Crescent" technique at AUSL IRCCS Reggio Emilia between 2016 and 2021. Fifty-eight patients were enrolled, the first group including 29 "Crescent" technique procedures and the second one including 29 patients who underwent the "J" mammoplasty technique. Oncological safety and surgical minor and major complications were evaluated. Aesthetic results were evaluated by two senior breast surgeons, independently, at least 6 months after radiotherapy (RT). Results: At follow-up of 36 months, no recurrences and no major complications were observed in both groups. Minor complications were observed in two (6.9%) "J" group cases and in six (20.7%) "Crescent" ones (P<0.05). The 96.6% of "Crescent" and the 73.5% of "J" cases were judged excellent/good. One (3.4%) "Crescent" was judged fair versus six (20.7%) "J" mammoplasty. Two (6.9%) "J" cases were judged poor, requiring ipsilateral re-operation. Conclusions: When a favourable ratio between tumor size and breast volume is present, BCS can be performed for tumors located in the lower quadrants. Evaluating patients' anthropometric characteristics, skin involvement and tumor features is the key to select the right technique and to obtain both great cosmetic result and low rate of complications.

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Background: Patient satisfaction is a crucial indicator of a successful dental implant treatment. Attainment of an aesthetically acceptable final result is central to this success. Hence, the primary objective of this systematic review was to identify aesthetic concerns linked to dental implants within the aesthetic zone. Methods: An electronic search was conducted on different databases such as PubMed, Medline, and Google Scholar using the key terms "tooth implant," "anterior implant," "dental implantation in the aesthetic zone," and "aesthetic area implant. Following the elimination of duplicate articles and adherence to the inclusion criteria, 14 articles (five randomized clinical trials, four prospective clinical trials, four case series, and one pilot study) published between 2007 and 2020 were deemed suitable for this review. Results: The selected studies highlighted several aesthetic issues, such as recession, marginal bone loss, gingival loss, and pink aesthetic scores related to dental implants placed in the aesthetic zone. Conclusion: Addressing these challenges necessitates meticulous treatment planning, effective soft tissue management, regular follow-ups, patient education, expectation management, and collaborative efforts among specialists. A limitation of this systematic review is that it focused solely on studies conducted within a relatively short timeframe (2007-2020). However, it is essential to recognize that significant changes occurred in the treatment procedures and materials within the field during this period. These changes have resulted in notable variances in the treatment protocols utilized across studies, potentially affecting the generalizability of the findings.

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Sarcoidosis and complications related to fillers have been reported following the COVID-19 vaccination. Additionally, cutaneous sarcoidosis has been observed around polymethyl methacrylate (PMMA) injection sites. Foreign-body reactions to PMMA can occur simultaneously with systemic sarcoidosis, suggesting a shared pathogenic mechanism between both conditions. To report a case of sarcoidosis and PMMA granulomas following COVID-19 vaccination (ChAdOx11), successfully treated with tofacitinib. We present a 59-year-old woman who developed systemic sarcoidosis and a granulomatous reaction to PMMA filler following the COVID-19 vaccination (ChAdOx11). Notably, both PMMA and the vaccine were potential triggers for sarcoidosis. Treatment with tofacitinib produced marked improvement in both the cutaneous and pulmonary involvement of sarcoidosis and the granulomatous reaction to PMMA. This successful outcome suggests tofacitinib, a pan-JAK inhibitor, an alternative treatment for cutaneous and systemic sarcoidosis, as well as a potential therapy for granulomatous complications of dermal fillers, such as PMMA.

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The aim of this study is to evaluate the changes in nasolabial soft tissues following Le Fort I osteotomies, focusing on the impact of maxillary vertical repositioning. This retrospective study included 39 patients with a history of Le Fort 1 osteotomy between 2013 and 2021. Patients were grouped based on their maxillary movement into three categories: pure advancement (group A), advancement with impaction (group B), and advancement with downward repositioning (group C). Preoperative and postoperative CBCT (Cone Beam Computed Tomography) data were analyzed to measure the changes in nasolabial soft tissues. The current study utilized Mimics Suite 20.0 for measuring linear and angular variables. The evaluated variables included intercanthal distance, nasal dorsal length, tip protrusion, mouth width, alar width, upper lip height, nostril dimensions, and angles of nasolabial, alar base, and upper lip. Among them intercanthal distance, nasal dorsal length, or tip protrusion showed no statistical difference (p > 0,05). Mouth width, alar width, alar base angle were increased and upper lip angle was decreased significantly (p < 0.001). Changes in upper lip height and nasolabial angle differed among the groups of the study. While upper lip height increased significantly in groups A and C (p < 0.05), there was a slight decrease in Group B with no significance (p > 0.05). Nasolabial angle decrased significantly on Groups A and B (p < 0.05). The results of this study revealed changes in several soft tissue parameters, some of which occurred regardless of vertical repositioning of the maxilla. Within the limitations of the study, maxillary advancement surgery can affect the aesthetics of the nasolabial region and cause specific changes in related soft tissues. Understanding these changes is essential to establish realistic patient expectations and achieve optimal functional and aesthetic outcomes.

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Aesthetic medicine has grown exponentially in recent decades, becoming a key part of healthcare and wellness, with distinct generational demands shaping its landscape. Baby Boomers seek youthful rejuvenation, preferring noninvasive treatments like botulinum toxin injections and dermal fillers. Generation X favors natural, minimally invasive enhancements, often influenced by authentic testimonials. Millennials, driven by social media and self-care trends, prioritize preventive and enhancement procedures, sharing their experiences online. Generation Z, influenced by social media and digital beauty standards, focuses on prejuvenation and temporary enhancements. For industry professionals, understanding these generational dynamics and leveraging social media is essential to meet diverse patient expectations and enhance engagement.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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Congenital aplasia cutis (CAC) is a rare neonatal condition characterized by the absence of skin at birth, often associated with diverse underlying conditions. We report the case of a newborn male admitted on the second day of life with a skin defect on the anterior abdominal wall and a lesion on the left thigh. The mother was treated with carbimazole for hyperthyroidism. Notably, there were no similar cases in the family history. The patient showed favorable progress and normal development following a successful dermo-epidermal allograft. Particular attention was given to managing the risk of infection and ensuring optimal healing through tailored wound care protocols. This case underscores the complexity of CAC, highlighting the importance of early diagnosis, multidisciplinary care, and ongoing research to understand better and effectively treat this rare condition.

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BACKGROUND: Cellulite is a cosmetic defect of multifactorial etiology that affects over 90% of women worldwide. Cellulite-induced skin changes are undesirable and negatively affect self-esteem. Despite a plethora of cellulite-reducing treatments, we still lack objective tools to enable accurate diagnosis and treatment efficacy assessment. The aim of this study was to determine whether high-frequency ultrasound can be helpful in assessing cellulite and whether there is an association between ultrasound-derived measurements, parameters ascertained clinically, and cellulite assessment scale scores. METHODS: The study group consisted of 114 women with cellulite in their posterior thighs, assessed using the Nürnberger-Müller scale. Two types of ultrasound devices were used in this study: a conventional scanner with a linear transducer and a skin-dedicated scanner equipped with a mechanical transducer. We used high-frequency ultrasonography to determine epidermal thickness, dermal thickness, the surface area of fat protrusions at the dermal subcutaneous junction, and the thickness and stiffness of the subcutaneous tissue (ultrasound elastography). RESULTS: There was a correlation between cellulite severity and subcutaneous tissue thickness (r = 0.63), the surface area of fat protrusions at the dermal subcutaneous junction (r = 0.64), and the elastographic strain ratio (r = 0.51). An association was also demonstrated between thigh circumference and subcutaneous tissue thickness (r = 0.48). There was a significant difference in the assessed parameters between the subgroups identified by cellulite severity scores. CONCLUSIONS: Ultrasound-determined surface area of fat protrusions at the dermal subcutaneous junction as well as the thickness and stiffness of the subcutaneous tissue seem useful in cellulite assessment. Thus, ultrasonography has the potential to become a common tool in aesthetic medicine and cosmetology.

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Across all sports, there has been increasing realization that mental health symptoms and disorders in athletes are common. More specifically, there has been increasing study of differences in mental health between individual and team sport athletes. However, this topic is still under-developed, and no comprehensive review on the topic has been undertaken. This manuscript aims to provide a narrative review of mental health symptoms and disorders, spanning depression, anxiety, eating disorders, and substance use and other addictive disorders, in individual versus team sports. Findings revealed that individual sports may be associated with relatively more negative mental health than team sports. This includes depression, anxiety, eating disorders, and concepts related to exercise addiction. Substance misuse and use disorders may be an exception to this pattern, with team sport athletes exhibiting higher rates of problematic alcohol use, use of certain forms of nicotine, and possibly use of illicit substances such as marijuana. Reasons for the greater overall mental health risk in individual versus team sports may include relatively more negative self-attribution after failure and less social cohesion/support. Steps can be taken to improve the sporting environment for all athletes-across individual and team sports-in order to optimize mental health outcomes.

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Buildings are an integral part of our physical environment and have aesthetic significance with respect to the organizational integrity of architectural elements. While Gestalt principles are essential in design education, their relationship with architectural features remains understudied. The present study explored how Gestalt principles and complexity levels influence evaluations of building façades through the use of questionnaires and eye tracking. Twenty-four two-dimensional black and white façade drawings, manipulated using selected Gestalt principles (similarity and proximity) to achieve different levels of complexity (low, medium & high), were presented to 79 participants. The results suggested a negative linear relationship between aesthetic ratings and complexity levels across selected Gestalt principles. In addition, as expected, participants had the highest number of fixations, shortest fixation durations, and lowest aesthetic ratings for higher levels of complexity. Results involving Gestalt principles revealed that proximity-based designs received higher aesthetic ratings, demanded less time, elicited lower number of fixations, and resulted in shorter fixation durations. Conversely, similarity-based designs received lower aesthetic ratings, demanded more time, elicited higher number of fixations, and resulted in longer fixation durations. These findings offer insights into architectural aesthetic experiences and inform future research directions.

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BACKGROUND: This study aimed to evaluate the utility of a novel neck lift technique based on fixation of superolateral platysma flap to the mastoid fascia in terms of postoperative aesthetic outcome and patient satisfaction within an 18-month follow-up period. METHODS: A total of 145 female patients who underwent isolated neck lift operation with the superolateral platysma flap technique were included. Global Aesthetic Improvement Scale (GAIS) scores (by the investigator) and the patient reported outcomes were recorded in terms of improvement in the cervicofacial angle, jowls, platysmal bands and malpositioned cervical fats, at 6 and 18 months, postoperatively. The complications were recorded at early postoperative period and at 1, 6 and 18 months, postoperatively. RESULTS: The median duration of follow-up was 18 months (range, 6-48 months). GAIS scores at 18th months, revealed exceptional improvement in the cervicofacial angle (82.8%), the jowls (93.1%), platysmal bands (93.1%) and malpositioned cervical fat (97.2%). Majority of patients were very satisfied with the treatment in terms of the aesthetic improvement. Complications involved the minor ecchymosis (17.2%) and minor skin circulatory problem (11.7%) in the early postoperative period, suture exposure (12.4%) in the postoperative 1st month, and cervical band reformation in the 6th (0.7%) and 18th (1.4%) months. CONCLUSION: In conclusion, lateral displacement and fixation of superolateral platysma flap to the mastoid fascia seems to be a useful neck lift technique for correction of platysma- and skin-derived aging sings with minor and manageable complications, immediate return to everyday activities and a high patient satisfaction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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BACKGROUND: Neuromodulator injections in the US increased by 24% from 2021 to 2022. This rise is attributed to new products and growing acceptance of minimally invasive aesthetic treatments. Recent studies emphasize the importance of facial anatomy for precision and, consequently, a higher efficacy of neuromodulator treatments. This study aims to evaluate the clinical efficacy of a novel previously proposed injection technique targeting the depressor anguli oris (DAO) muscle to improve oral commissure position. This clinical, prospective study included 34 volunteers from the Shinobu Clinic, São Paulo, Brazil. Patients received 3 units of onabotulinumtoxinA per side, injected mid-distance between the oral commissure and jawline, following the labiomandibular sulcus (LMS). Standardized photographs and assessments using the Oral Commissure Severity Scale (OCSS) and Global Aesthetic Improvement Scale (GAIS) were conducted before and 30 days post-treatment. Statistical analyses included t-tests, Wilcoxon Signed Rank test, and generalized linear models. The average increase in commissural height was 5.22% (p < 0.001). OCSS ratings improved significantly from baseline (clinician: 1.21 to 0.72, p < 0.001; patient: 0.93 to 0.69, p < 0.001). However, GAIS scores indicated no significant change (patient: 0.32, observer: 0.38; p = 0.491). The proposed injection technique improves perioral aesthetics objectively and subjectively. However, the lack of significant change in GAIS scores suggests that perceived improvements may not be clinically meaningful to patients. Future studies should focus on patient-centered evaluation methods to better assess aesthetic outcomes.

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The aim of this case report was to present an alternative therapeutic combination involving lip repositioning (LR) in the correction of gummy smile (GS). This treatment is less invasive than orthognathic surgery and is highly acceptable to patients, using a modified technique that combines myotomy with the insertion of polyester threads as a physical barrier against relapse.

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Traumatic injuries of anterior teeth can seriously affect a person's smile, which contributes significantly to an individual's overall personality and sense of self. Hence, various efforts have been made over the years to develop techniques that enable clinicians to replicate the natural tooth anatomy while being practical enough to allow its use in clinical practice. The putty index technique helps to make significant progress in achieving such goals by forming a template against which composite material can be placed for restoration of various modalities - in this case, Ellis class I and II. The prepared index replicates the palatal anatomy of the wax build-up done on the patient's cast. This reduces the chair time while improving the predictability of the final restoration.

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Platelet-rich plasma (PRP) has emerged as a promising treatment in aesthetic dermatology. This systematic review aims to evaluate the current evidence for PRP applications in skin rejuvenation, hair restoration, wound healing, and fat grafting. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across multiple databases and 13 studies meeting the inclusion criteria were selected for review. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of included studies. The reviewed studies consistently reported positive outcomes for PRP across various applications. In skin rejuvenation, significant improvements in collagen density and overall skin appearance were observed. For hair restoration, studies showed mean increases of 18-27.7 hairs/cm² in treated areas. PRP demonstrated efficacy in accelerating wound healing across various wound types, including chronic ulcers. In fat grafting, PRP was associated with improved graft survival and integration. Patient satisfaction was generally high across all applications. However, there was significant heterogeneity in PRP preparation methods and treatment protocols among studies. This systematic review provides evidence supporting the efficacy of PRP in aesthetic dermatology, particularly in skin rejuvenation, hair restoration, wound healing, and fat grafting. PRP demonstrates a favorable safety profile across applications. However, the variability in study designs and PRP protocols highlights the need for standardization. Future research should focus on large-scale randomized controlled trials with standardized protocols and longer follow-up periods to solidify the evidence base for PRP in aesthetic dermatology.

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AIMS: This long-term study assessed satisfaction and pain levels following facial aesthetic procedures. The study also aimed to correlate expectations, and psychological and social well-being immediately and after one month, describe perceived age, and assess differences in satisfaction between injectable fillers and other Orofacial Harmonization procedures such as hyaluronic acid treatments (for dark circles, nasolabial fold lips, malar, jaw), botulinum toxin injections, enzymatic lipolysis of the double chin, micro-needling, and PDO threads. METHODS: Data were collected immediately after the procedures and then again 30 days later. Among the participants, 159 (92.4%) were females and 13 (7.6%) were males, who completed FACE-Q questionnaires addressing perceived age, expectations, psychological and social well-being, satisfaction, and facial appearance, as well as the visual pain scale. RESULTS: The average age of the patients treated in the Dental Clinics in Brazil was 40.4 years (SD± 12.7), with 48.8% of participants perceiving themselves as older immediately after the procedures, decreasing to 47.7% after 30 days, and pain intensity was reported as low. The total number of Orofacial Harmonization procedures performed was 256. Satisfaction after 30 days was high, especially among those who received fillers. The psychological and social function scales were positively correlated with satisfaction with the decision, result, and appearance scales. Fillers showed a significant improvement in perceived age appearance, with half of the patients feeling younger after 30 days. The patients exhibited high satisfaction levels in one-month post-aesthetic orofacial harmonization procedures. Despite initially high expectations, patients reported enhanced psychological and social well-being, along with minimal pain during interventions CONCLUSION: Positive correlations were observed between satisfaction, decision-making, result perception, and appearance. Injectable fillers notably improved perceived aging, with a significant portion of patients initially perceiving themselves as older than their actual age, but later feeling younger post-procedure. Fillers also yielded superior satisfaction and pain relief compared to alternative interventions. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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O avanço tecnológico revolucionou a prática odontológica, com os alinhadores ortodônticos emergindo como uma escolha altamente popular entre pacientes que buscam tratamentos estéticos e confortáveis. No entanto, apesar de sua crescente demanda, permanecem questões cruciais relacionadas à eficácia e análise dimensional desses dispositivos. Este artigo oferece uma análise abrangente das características químicas, físicas e mecânicas dos alinhadores ortodônticos, iluminando a influência vital do processo de termoformação e da espessura nas propriedades desses materiais. Compreender profundamente essas características é essencial para aprimorar a eficácia e a durabilidade dos alinhadores ortodônticos, contribuindo, assim, para o sucesso e a evolução dos tratamentos ortodônticos modernos. Neste estudo, exploraremos: 1) as propriedades químicas dos materiais e como elas afetam a biocompatibilidade e a resistência à degradação; 2) as características físicas, incluindo textura de superfície, transparência e sua influência na adaptação bucal e no conforto do paciente; 3) as propriedades mecânicas, como flexibilidade e rigidez, e como essas características afetam a distribuição de forças de movimentação dentária; 4) a influência do processo de termoformação na precisão e reprodutibilidade dos alinhadores, bem como sua relação com a qualidade do tratamento; 5) a análise crítica da espessura dos alinhadores e seu papel na capacidade de aplicar forças adequadas para a movimentação dentária. Ao abordar esses aspectos, este artigo visa oferecer uma visão holística das complexidades envolvidas na fabricação e uso de alinhadores ortodônticos. Esperamos que esta revisão contribua para uma compreensão mais profunda desses dispositivos e promova avanços significativos na ortodontia, beneficiando tanto os profissionais quanto os pacientes.

Technological advancement has revolutionized dental practice, with orthodontic aligners emerging as a trendy choice among patients seeking aesthetic and comfortable treatments. However, despite their growing demand, crucial questions remain regarding these devices' effectiveness and dimensional analysis. This article offers a comprehensive analysis of the chemical, physical, and mechanical characteristics of orthodontic aligners, illuminating the vital influence of the thermoforming process and thickness on the properties of these materials. Understanding these characteristics in depth is essential to improving the effectiveness and durability of orthodontic aligners, thus contributing to the success and evolution of modern orthodontic treatments. In this study, we will explore 1) the chemical properties of materials and how these properties affect biocompatibility and resistance to degradation; 2) the physical characteristics, including surface texture, transparency and their influence on oral adaptation and patient comfort; 3) mechanical properties, such as flexibility and stiffness, and how these characteristics affect the distribution of tooth movement forces; 4) the influence of the thermoforming process on the precision and reproducibility of the aligners, as well as its relationship with the quality of the treatment; 5) critical analysis of aligner thickness and its role in the ability to apply adequate forces for tooth movement. By addressing these aspects, this article aims to offer a holistic view of the complexities involved in manufacturing and using orthodontic aligners. We hope this review will contribute to a deeper understanding of these devices and promote significant advances in orthodontics, benefiting professionals and patients.

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Processing fluency has been shown to affect how people aesthetically evaluate stimuli. While this effect is well documented for visual stimuli, the evidence accumulated for auditory stimuli has not yet been integrated. Our aim was to examine the relevant research on how processing fluency affects the aesthetic appreciation of auditory stimuli and to identify the extant knowledge gaps in this body of evidence. This scoping review of 19 studies reported across 13 articles found that, similarly to visual stimuli, fluency has a positive effect on liking of auditory stimuli. Additionally, we identified certain elements that impede the generalizability of the current research on the relationship between fluency and aesthetic reactions to auditory stimuli, such as a lack of consistency in the number of repeated exposures, the tendency to omit the affective component and the failure to account for personal variables such as musical abilities developed through musical training or the participants' personality or preferences. These results offer a starting point in developing novel and proper processing fluency manipulations of auditory stimuli and suggest several avenues for future research aiming to clarify the impact and importance of processing fluency and disfluency in this domain.