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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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INTRODUCTION: As part of the International Society of Aesthetic Plastic Surgery, we present an analysis of our global aesthetic statistics, fulfilling the role of a worldwide organization of plastic surgeons with a clear mission to disseminate aesthetic education worldwide, promote patient safety, protect high ethical standards, and communicate. MATERIAL AND METHODS: A retrospective analysis of the ISAPS Global Aesthetic Statistics was conducted annually from 2010 to 2023. The design and analysis of each survey was carefully developed and validated by Industry Insights, Inc. prior to distribution. Participants were recruited using an anonymous online questionnaire that focused primarily on the number of surgical and nonsurgical procedures performed in the previous year, as well as questions related to surgeon demographics and the prevalence of medical tourism. ISAPS invited all physicians in their data base who were board-certified plastic surgeons or equivalent and suggested National Societies to encourage their members to participate. RESULTS: The latest survey reported a global increase in 3.4%, including 34.9 million surgical and nonsurgical aesthetic procedures performed by plastic surgeons in 2023. More than 15.8 million surgical procedures and more than 19.1 million nonsurgical procedures were performed worldwide. During the past decade, a steady increase in aesthetic procedures has been observed, which has been more pronounced since 2021. In the last 4 years, the overall increase in procedures was 40%. SURGICAL PROCEDURES: The top five surgical procedures were liposuction, breast augmentation, eyelid surgery, abdominoplasty, and rhinoplasty. This trend has been stable for 14 years, with the exception of 2022, when breast lift surgery temporarily replaced rhinoplasty. FACE AND HEAD PROCEDURES: These procedures continue to be the most popular. This group included brow lift, ear surgery, eyelid surgery, facelift, facial bone contouring, facial fat grafting, lip augmentation or frontal surgery, neck lift, and rhinoplasty. BODY AND EXTREMITIES PROCEDURES: This group included abdominoplasty, buttock augmentation, buttock lift, liposuction, lower body lift, thigh lift, arm lift, upper body lift, labiaplasty, and vaginal rejuvenation. Over the past 14 years, body and extremity procedures have increased, with more than 5.1 million procedures in 2023 compared to 2.6 million in 2009. NONSURGICAL PROCEDURES: The five most popular nonsurgical procedures are botulinum toxin, hyaluronic acid, hair removal, chemical peels, and nonsurgical fat reduction. In 2022, chemical peels will replace nonsurgical skin tightening in the top five. MALE AESTHETIC SURGERY: Procedures performed on men continue to grow, with minimally invasive procedures dominating. The most recent survey reported that they represented 14.5% of the total. The top five surgical procedures were eyelid surgery, gynecomastia, liposuction, rhinoplasty, and facial fat grafting. The most popular nonsurgical procedures for men were botulinum toxin, hyaluronic acid, hair removal, nonsurgical skin tightening, and nonsurgical fat reduction. This trend has held steady for more than a decade. DISCUSSION: This study analyzes the most recent data and experience of board-certified aesthetic plastic surgeons in surgical and nonsurgical procedures worldwide over 14 years and provides insight into future trends. More than 60 years have passed since the introduction of liposuction, being one of the most performed aesthetic procedures worldwide over the past 14 years and currently number one procedure performed by plastic surgeons. New trends and technologies have evolved over the years, however, plastic surgeons must be cautious, as history has shown that risks increase when new technologies are introduced. With the popularity of liposuction, other body contouring procedures began to gain interest, and in 2015, gluteal lipoinjections were added to the ISAPS global aesthetic statistics and with them complications arise. In 2018 and 2019, the major patient safety societies, ISAPS, ASERF, ASPS, and ASAPS, began a systematic educational campaign to inform their members about the inherent risks of performing gluteal fat transfer surgery and what techniques or equipment can be used to minimize risks. Another procedure added to the ISAPS statistics in 2010 was vaginal aesthetic surgery. With the new trend of vaginal aesthetics, many believed that they were just changing the appearance of the area, but today it is clear that they are here for much more, to truly empower women with their sexuality. Breast augmentation showed a decline for the first-time last year. However, breast augmentation and liposuction have been the most performed procedures by plastic surgeons worldwide for more than a decade. On the other hand, implant removal has been the fastest growing procedure since 2015, with an overall increase in 46.3% over the past 5 years. In relation to male aesthetic surgery, the number of men undergoing aesthetic procedures has remained stable in recent years at around 14%. Male aesthetics is certainly a growing trend, and our practices should be more inclusive. Another prominent field is regenerative medicine. In relation to plastic surgery, regenerative surgery strategies often involve adipose tissue with stem cells and preadipocytes, alone or in combination with scaffolds. In terms of prevention, regenerative medicine aims to improve the quality of the skin by improving our outcomes and would make it possible to avoid the need for facelifts in the future. Finally, given the increasing popularity of medical procedures abroad ("medical tourism") and the fact that safety regulations and guidelines vary widely from place to place, we encourage patients to choose a board-certified, specialized, trained and experienced plastic surgeon for their procedure and an accredited surgical facility to ensure the procedure in done under the highest patient safety standards. CONCLUSIONS: Despite the obvious cultural and social differences from country to country that make certain procedures more desirable in some geographic areas and less so in other parts of the world, the results of this study show a significant overall increase in all surgical and nonsurgical procedures aimed at improving the aesthetic appearance of the body during14 years. As plastic surgeons, we are open to new possibilities in aesthetic procedures and are responsible for patient safety protocols and procedures. LEVEL OF EVIDENCE III: 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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Bioproducts derived from platelets have been extensively used across various medical fields, with a recent notable surge in their application in dermatology and aesthetic procedures. These products, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), play crucial roles in inducing blood vessel proliferation through growth factors derived from peripheral blood. PRP and PRF, in particular, facilitate fibrin polymerization, creating a robust structure that serves as a reservoir for numerous growth factors. These factors contribute to tissue regeneration by promoting cell proliferation, differentiation, and migration and collagen/elastin production. Aesthetic medicine harnesses these effects for diverse purposes, including hair restoration, scar treatment, striae management, and wound healing. Furthermore, these biological products can act as adjuvants with other treatment modalities, such as laser therapy, radiofrequency, and microneedling. This review synthesizes the existing evidence, offering insights into the applications and benefits of biological products in aesthetic medicine.

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Sensory Processing Sensitivity (SPS) is a temperament trait rooted in biology, and is distinguished by heightened awareness, emotional responsiveness, and sensitivity to environmental stimuli. In this study, we aimed to enable the assessment of SPS within Spanish-speaking populations. To achieve this, we translated, adapted, and validated the Sensory Processing Sensitivity Questionnaire (SPSQ), which offers a comprehensive evaluation of SPS, encompassing both positive and negative aspects of the trait. Participants were 1,004 (844 females, mean age 37) mainly from Chile (964), and 40 were from other Spanish-speaking regions. Confirmatory factor analysis, utilizing the diagonally weighted least squares method, was applied to validate the internal structure of the Spanish version of the SPSQ (S-SPSQ). Fit indices such as GFI, CFI, TLI, RMSEA, and SRMR were scrutinized. Reliability assessment utilized Cronbach's alpha and McDonald's Omega. Three models were examined: Model I (six factors) displayed robustness, Model II (six factors plus a general factor) did not show substantive improvement, and Model III (Higher Order and Bifactor) excelled in fit while balancing complexity and representation, thus validating the findings of the original SPSQ and indicating similar reliability coefficients. The study offers a balanced perspective on SPS and contributes to cross-cultural validation of an SPS instrument which may facilitate research and guide personalized therapeutic interventions, thus enhancing outcomes for highly sensitive persons.

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Introduction: The umbilicus is a unique physiologic scar of human body. Its absence leads to an unnatural abdominal appearance and can cause psychological and social complexes. Objective: To present a case of neoumbilicoplasty with vertical island pedicle flap for a large pigmented umbilical nevus. Clinical case: A healthy 50-year-old female patient with a history of a pigmentated nevus on the umbilicus since childhood that complains of changes in size and color of it. She also referred notice a lump in the upper umbilical region which was an umbilical hernia. The patient underwent an omphalectomy with oncological margins, an umbilical hernia repair and a neoumbilicoplasty with vertical island pedicle flap. Seroma was the only postoperative complication. Aesthetic results were acceptable and satisfied the patient. Conclusions: This is a rare case not only because the umbilical skin lesions are uncommon but the neoumbilicoplasty technique is rarely used(AU)

Introducción: El ombligo es la única cicatriz fisiológica del cuerpo humano. Su ausencia provoca un aspecto abdominal antinatural y puede provocar complejos psicológicos y sociales. Objetivo: Presentar un caso de neoumbilicoplastia con colgajo pediculado vertical en isla para un nevo umbilical pigmentado de gran tamaño. Caso clínico: Paciente femenina sana de 50 años con antecedentes de nevo pigmentado en ombligo desde la infancia, que refiere cambios en el tamaño y color de este. También refirió notar un bulto en la región umbilical superior que era una hernia umbilical. La paciente fue sometida a onfalectomía con márgenes oncológicos, reparación de la hernia umbilical y neoumbilicoplastia con colgajo pediculado vertical en isla. El seroma fue la única complicación postoperatoria. Los resultados estéticos fueron aceptables y satisficieron a la paciente. Conclusiones: Es un caso raro, no solo porque las lesiones cutáneas umbilicales son poco comunes, sino que la técnica de neoumbilicoplastia, rara vez se utiliza(AU)

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OBJECTIVE: Describe a new, safe, technique that uses titanium mesh to partially cover skull defects immediately after decompressive craniectomy (DC). METHODS: This study is a retrospective review of 8 patients who underwent DC and placement of a titanium mesh. The mesh partially covered the defect and was placed between the temporalis muscle and the dura graft. The muscle was sutured to the mesh. All patients underwent cranioplasty at a later time. The study recorded and analyzed demographic information, time between surgeries, extra-axial fluid collections, postoperative infections, need for reoperation, cortical hemorrhages, and functional and aesthetic outcomes. RESULTS: After craniectomy, all patients underwent cranioplasty within an average of 112.5 days (30-240 days). One patient reported temporalis muscle atrophy, which was the only complication observed. During the cranioplasties, no adhesions were found between temporalis muscle, titanium mesh, and underlying dura. None of the patients showed complications in the follow-up computerized tomography scans. All patients had favorable aesthetic and functional results. CONCLUSIONS: Placing a titanium mesh as an extra step during DC could have antiadhesive and protective properties, facilitating subsequent cranioplasty by preventing adhesions and providing a clear surgical plane between the temporalis muscle and intracranial tissues. This technique also helps preserve the temporalis muscle and enhances functional and aesthetic outcomes postcranioplasty. Therefore, it represents a safe alternative to other synthetic anti-adhesive materials. Further studies are necessary to draw definitive conclusions and elucidate long-term outcomes, however, the results obtained hold great promise for the safety and efficacy of this technique.

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This work aimed to develop a three-dimensional (3D) wearable drug-loaded earring tap to treat affections caused by aesthetic perforations. The initial phase involved a combination of polymers to prepare filaments for fused deposition modeling (FDM) 3D printing using a centroid mixture design. Optimized filament compositions were used in the second phase to produce 3D printed earring taps containing the anti-inflammatory naringenin. Next, samples were assessed via physicochemical assays followed by in vitro skin permeation studies with porcine ear skin. Two filament compositions were selected for the study's second phase: one to accelerate drug release and another with slow drug dissolution. Both filaments demonstrated chemical compatibility and amorphous behavior. The use of the polymer blend to enhance printability has been confirmed by rheological analysis. The 3D devices facilitated naringenin skin penetration, improving drug recovery from the skin's most superficial layer (3D device A) or inner layers (3D device B). Furthermore, the devices significantly decreased transdermal drug delivery compared to the control containing the free drug. Thus, the resulting systems are promising for producing 3D printed earring taps with topical drug delivery and reinforcing the feasibility of patient-centered drug administration through wearable devices.

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INTRODUCTION: This study aimed to evaluate the perception of facial attractiveness when nose and teeth, together or isolated, present different degrees of disharmony. The secondary objective was to compare the perception of laypersons with that of dentists. MATERIALS AND METHODS: This cross-sectional observational study included 112 individuals (58 laypersons and 54 dentists) that evaluated 6 manipulated images of the face of the same model, scoring their attractiveness using 10 cm Visual Analogue Scales (VAS), with least and most attractive at the left and right anchors, respectively. The images contained manipulations performed only on the nose (laterorhinia) and mouth (misaligned teeth), as follows: (1) standard photograph, with symmetrical nose + aligned teeth; (2) 2 mm nasal deviation + aligned teeth; (3) 4 mm nasal deviation + aligned teeth; (4) symmetrical nose + misaligned teeth; (5) 2 mm nasal deviation + misaligned teeth and (6) 4 mm nasal deviation + misaligned teeth. We used the repeated measures ANOVA test and Tukey's post-test for intra-group comparison of the images. The independent t-test was used for inter-group comparison of each image. RESULTS: In the laypersons' group, the highest grades were given to images with aligned teeth and the lowest to misaligned teeth (smallest mean difference = 2.88 cm). For this group, there was no statistically significant difference (P-values ranged from .988 to 1.000) between scores of the three images in which teeth were aligned (range of 7.70-7.78 cm). In the group of dentists, highest grades were given to images with aligned teeth and the lowest to misaligned teeth. Difference between images 3 and 4 was not statistically significant (P = .204). All other differences between any image of straight teeth and any image with misaligned teeth were significant and the smallest mean difference between the two groups of images was 1.87 (P = .039). However, in the images with aligned teeth, there was also a statistically significant difference with higher scores to the images with symmetrical nose in contrast with those with significant laterorhinia (mean difference = 1.03 cm). CONCLUSION: Teeth disharmonies had a more negative impact on the aesthetic perception of the face than did nose deviations, for both dentists and laypersons.

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Nos últimos anos, os avanços na Odontologia têm proporcionado novas abordagens para o alinhamento dentário, visando não apenas a correção eficaz das más oclusões, mas também o conforto e a estética para os pacientes. Entre essas inovações, os alinhadores ortodônticos do tipo bolha e abaulamento emergiram como uma alternativa promissora aos aparelhos tradicionais. Este artigo visa explorar o histórico, as indicações clínicas, as vantagens estéticas e o conforto oferecido por esses dispositivos, destacando evidências tanto da literatura antiga quanto de estudos recentes.(AU)

In recent years, advances in dentistry have provided new approaches to dental alignment, aiming not only for effective correction of malocclusions but also for patient comfort and aesthetics. Among these innovations, bubble and bump orthodontic aligners have emerged as a promising alternative to traditional braces. This article aims to explore the history, clinical indications, aesthetic advantages, and comfort offered by these devices, highlighting evidence from both old literature and recent studies (AU)

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Resumo Este artigo analisa tensões e disputas entre o campo da ginecologia e da cirurgia plástica estética, especialidades autorizadas a realizar a cirurgia estética genital feminina no Brasil. Utiliza material documental, incluindo artigos científicos desde a década de 1990, e sites institucionais. Enquanto ginecologistas têm se mantido mais cautelosos com a prática, defendendo sua realização apenas quando há indicações funcionais, cirurgiões/ãs plásticos/as têm sido mais influentes na disseminação do procedimento, privilegiando a dimensão estética. Argumenta-se que, para além de disputas entre campos profissionais, esse fenômeno precisa ser entendido à luz da crescente ênfase no aprimoramento de si, via recursos biomédicos, e dos imperativos de gênero.

Abstract This article analyzes the tensions and disputes between the fields of gynecology and esthetic plastic surgery, the specialties which are authorized to perform aesthetic female genital surgeries in Brazil. Documentary materials are used, including scientific articles from the 1990s onward and institutional websites. While gynecologists have remained more cautious, recommending the surgery only for functional reasons, plastic surgeons have been more influential in publicizing these procedures and emphasizing the aesthetic dimension. Beyond professional disputes, we debate whether this phenomenon needs to be understood in light of the growing emphasis on self-improvement via biomedical resources and gender imperatives.

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En la actualidad, la alogenosis iatrogénica es una condición reconocida en todo el orbe, especialmente en Latinoamérica, donde es evidente la ausencia de control en la administración de sustancias no reguladas con fines estéticos, lo que ha devenido un problema emergente por la magnitud de las complicaciones, ya que algunos productos, como aceites minerales, hidrocarburos, silicona industrial, generan graves consecuencias, tanto locales como sistémicas, en el organismo. Muchos países aún no han regulado la prohibición de esta práctica, aunque cada día son más las campañas para prevenirla; sin embargo, al mismo tiempo aumenta la incidencia de la enfermedad en todo el mundo por el incremento de estos procedimientos estéticos. Al respecto, en Cuba, el creciente número de afectados por esta causa evidencia vulnerabilidad en el cumplimiento de lo establecido hasta la fecha, por lo que se impone instaurar un marco legal de estricto cumplimiento que regule la inyección de sustancias modelantes con fines estéticos.

Currently, iatrogenic allogenosis is a condition recognized throughout the world, especially in Latin America, where the absence of control in the administration of unregulated substances for aesthetic purposes is evident, which has become an emerging problem due to the magnitude of complications, since some products, such as mineral oils, hydrocarbons, industrial silicone, generate serious consequences, both local and systemic, in the body. Many countries have not yet regulated the prohibition of this practice, although every day there are more campaigns to prevent it. However, at the same time the incidence of the disease increases worldwide due to the increase in these aesthetic procedures. In this regard, in Cuba, the growing number of people affected by this cause shows vulnerability in compliance with what has been established to date, that is why it is necessary to establish a legal framework of strict compliance that regulates the injection of modeling substances for aesthetic purposes.

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BACKGROUND: A previous injection algorithm termed the "Toxin Lift" was recently introduced and described volume increases in the midface following neuromodulator treatments of the jawline. Increase in midfacial volume due to soft tissue repositioning could also affect the severity of infraorbital hollows. OBJECTIVE: The objective is therefore to evaluate whether the severity of infraorbital hollows can be improved by injecting neuromodulators in the supra-mandibular segment of the platysma. MATERIALS AND METHODS: A total of 35 volunteers (11 males/24 females) with a mean age of 39.8 (9.6) years and a mean BMI of 25.2 (5.2) kg/m2 were investigated. Bilateral infraorbital regions were evaluated via clinical assessment and semi-quantitative 3D imaging. The applied injection technique targeted the platysma via four injection points administering 5 I.U. per injection point resulting in a total of 20 I.U. per facial side. RESULTS: Volume increase of the infraorbital region was 0.13 cc at 15 days (p = 0.001) and was 0.02 cc at 30 days (p = 0.452) whereas the skin displacement in cranial direction was 0.54 mm at 15 days (p < 0.001) and was 0.31 mm at 30 days (p < 0.001). Clinical evaluation revealed a highly statistically significant improvement of the tear trough, palpaebromalar groove, and of the lid-cheek junction when compared to baseline with all p < 0.001. CONCLUSION: The results of this clinical prospective interventional analysis revealed that the "Toxin Lift" injection technique is capable to improve the clinical appearance of infraorbital hollows. The effects can be explained by the concepts of facial biomechanics.

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Objective: The robust safety and efficacy profile associated with the use of biodegradable fillers such as poly-L-lactic acid (PLLA) for facial rejuvenation has resulted in a growing interest in off-label use for various aesthetic applications, including gluteal augmentation. The authors describe a novel targeted and individualized technique of PLLA injection into the buttock region. Methods: The technique involves clinical and anatomical evaluations of the gluteal region, and there are three distinct approaches for injecting PLLA in the gluteal region based on the most important factor to be improved: (1) skin quality, (2) contour and lifting, or (3) projection and volume. Results: This novel technique is associated with favorable patient outcomes in terms of improvements across all key areas of gluteal augmentation; improvement in skin quality and laxity, contour improvement and lifting, and gluteal volume and projection. Since its initiation, this technique has been found to be both cost-effective and clinically efficacious, with demonstratable benefits achieved with a lower volume of PLLA compared to other PLLA injection techniques. Limitations: Assessment of patient outcomes with this technique have, to date, been subjective clinical observations, which does not include quantitative outcomes such as patient satisfaction data or safety outcomes. Conclusion: We describe an optimized and individualized approach for injecting the collagen biostimulator PLLA in the gluteal region according to the needs of each patient.

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Introducción y objetivo: Existen numerosos procedimientos en los cuales más allá de la adecuada manipulación del músculo temporal y del cierre craneal, los pacientes pueden presentar defecto óseo, muscular por atrofia y asimetría facial consecuente, provocando un malestar psicológico y deterioro funcional. Nuestro equipo decidió aunar los conocimientos de cirugía plástica y aplicarlos a reconstrucciones craneales con lipotranferencias en pacientes post neuroquirúrgicos. El objetivo del siguiente trabajo consiste en presentar los resultados en una serie de pacientes donde se aplicó la mencionada técnica. Materiales y métodos: Durante 2022 se realizaron 45 procedimientos de lipotransferencias para corrección de defectos craneofaciales, de los cuales 29 fueron femeninos y 16 masculinos. Todos presentaban el antecedente quirúrgico de craneotomías pterionales y sus variantes, abordajes orbitocigomáticos y transcigomáticos, con el consiguiente déficit de volumen. Resultados: El procedimiento se realizó de manera ambulatoria, con anestesia local y en un tiempo promedio de 30 a 40 minutos. Se utilizó como zona donante la región hemiabdominal inferior; procesamiento de la grasa mediante técnica de decantación e inyección en la zona receptora a nivel craneo facial. Los pacientes toleraron el procedimiento adecuadamente sin complicaciones intraoperatoria ni eventos sobreagregados. Conclusión: La lipotransferencia constituye una técnica mínimamente invasiva, con baja morbilidad y altas tasas de efectividad en cuanto al resultado estético y a la satisfacción por parte del paciente. Es una herramienta que todo neurocirujano debería considerar ante un defecto secundario a un abordaje anterolateral a la base del cráneo(AU)

Background: There are numerous procedures in which, beyond adequate manipulation of the temporalis muscle and cranial closure, patients may present bone and muscle defects due to atrophy and consequent facial asymmetry, causing psychological discomfort and functional deterioration. Our team decided to combine the knowledge of plastic surgery and apply it to cranial reconstructions with fat transfers in post neurosurgical patients. The objective of the following work is to present the results in a series of patients where the aforementioned technique was applied. Methods: During the year 2022, 45 fat transfer procedures were performed for the correction of craniofacial defects, of which 29 were female and 16 male. All had a surgical history of pterional craniotomies and their variants, orbitozygomatic and transzygomatic approaches, with the consequent volume deficit. Results: The procedure was performed on an outpatient basis, with local anesthesia and in an average time of 30 to 40 minutes. The lower hemiabdominal region was used as the donor area, processing the fat using the decantation technique and injection into the receptor area at the craniofacial level. The patients tolerated the procedure adequately without intraoperative complications or superadded events. Conclusion: Fat transfer is a minimally invasive technique, with low morbidity and high rates of effectiveness in terms of aesthetic results and patient satisfaction. It is a tool that every neurosurgeon should consider when faced with a defect secondary to an anterolateral approach to the skull base(AU)

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el texto busca ampliar las fronteras del concepto de "bioética global", centro de la propuesta teórica de Van Rensselaer Potter sobre la "bioética ecológica" en su obra Global Bioethics, de cara a la "ética de la tierra" desarrollada por el ecólogo y ambientalista Aldo Leopold y el análisis de la "ecosofía" planteado por el filósofo y psicoanalista Félix Guattari en Las tres ecologías. Dicha caracterización se plantea con el fin de establecer presupuestos teóricos en torno a las nociones de bioética ecológica y ecosofía en la perspectiva de la bioética global en un renovado intento de ampliación de sus horizontes disciplinares. Se establecen tres momentos para el análisis: inicialmente se caracteriza la ética de la tierra propuesta por Arnold Leopold en su obra A Sand County Almanach. Posteriormente, se analizan los principales aspectos de la "ética ecológica" en la obra Global Bioethics. Finalmente, se destacan varios aspectos de la ecosofía de Félix Guattari que ponen en perspectiva el acento ecológico de la bioética global de Potter y que podrían considerarse como presupuestos divergentes útiles para enriquecer la bioética global en la actualidad.

the text seeks to expand the boundaries of the concept of "global bioethics," the core of Van Rensselaer Potter's theoretical proposal on "ecological bioethics" in his work Global Bioethics, in the face of the "ethics of the Earth" developed by the ecologist and environmentalist Aldo Leopold and the analysis of "ecosophy" raised by the philosopher and psychoanalyst Félix Guattari in The Three Ecologies. This characterization is proposed to establish theoretical assumptions around the notions of ecological bioethics and ecosophy from the perspective of global bioethics in a renewed attempt to broaden its disciplinary horizons. Three moments are established for the analysis: initially, the land ethics proposed by Arnold Leopold in his work A Sand County Almanach is characterized. Subsequently, the main aspects of "ecological ethics" in Global Bioethics are analyzed. Finally, several aspects of Félix Guattari's ecosophy are highlighted that put into perspective the ecological accent of Potter's global bioethics, which could be considered valid divergent presuppositions to enrich global bioethics today.

o texto busca ampliar as fronteiras do conceito de "bioética global", cerne da proposta teórica de Van Rensselaer Potter sobre a "bioética ecológica" em sua obra Global bioethics, diante da "ética da terra" desenvolvida pelo ecologista e ambientalista Aldo Leopold e da análise da "ecosofia" proposta pelo filósofo e psicanalista Félix Guattari em As três ecologias. O objetivo dessa caracterização é estabelecer pressupostos teóricos em torno das noções de bioética ecológica e ecosofia na perspectiva da bioética global, em uma tentativa renovada de ampliar seus horizontes disciplinares. Três momentos são estabelecidos para a análise: inicialmente, caracteriza-se a ética da terra proposta por Arnold Leopold em sua obra A sand county almanach. Posteriormente, são analisados os principais aspectos da "ética ecológica" na Bioética Global. Por fim, são destacados vários aspectos da ecosofia de Félix Guattari que colocam em perspectiva o acento ecológico da bioética global de Potter e que podem ser considerados como pressupostos divergentes úteis para enriquecer a bioética global atual.

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Background and Objectives: The necessity for less invasive and patient-friendly surgical therapies guided the development of the "minimally invasive surgical technique" (MIST). The aim of this systematic review was to evaluate the efficacy of MIST for soft tissue management considering aesthetic results, postoperative morbidity, and clinical outcomes. Materials and Methods: Several databases were used to conduct a thorough analysis of the scientific evidence. To investigate randomized clinical trials (RCTs), MeSH terms and keywords were provided. Results: Eleven RCTs were chosen. These experiments included 273 patients. The trials that explored MIST for papilla preservation presented greater efficacy in increasing papillary height (p < 0.05). MIST showed stable clinical outcomes for the management of excessive gingival display and with a flapless technique for single implant placement. Considering the treatment of gingival recessions, some RCTs presented greater root coverage with MIST (p < 0.05), while other trials did not show differences between groups. Regarding aesthetic perception, five RCTs indicated high patient satisfaction with MIST (p < 0.05). Similarly, six RCTs reported that patients in the MIST group presented significantly less post-surgical pain and lower wound healing scores (p < 0.01). Conclusions: It was concluded that using MIST resulted in more clinical studies reporting better clinical outcomes. Considering aesthetic appearance, slightly more than half of the clinical trials also showed improved results with MIST. Likewise, regarding postoperative morbidity, 60% of the clinical trials also described better scores with MIST. All of this indicates that MIST is a good alternative for the management of soft tissues.

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Microneedle (MN) devices comprise of micron-sized structures that circumvent biological barriers in a minimally invasive manner. MN research continues to grow and evolve; the technology was recently identified as one of the top ten overall emerging technologies of 2020. There is a growing interest in using such devices in cosmetology and dermatological conditions where the MNs mechanically disrupt the outer skin barrier layer, creating transient pathways that allow the passage of materials to underlying skin layers. This review aims to appraise the application of microneedle technologies in skin science, provide information on potential clinical benefits, as well as indicate possible dermatological conditions that can benefit from this technology, including autoimmune-mediated inflammatory skin diseases, skin aging, hyperpigmentation, and skin tumors. A literature review was carried out to select studies that evaluated the use of microneedles as drug delivery enhancement for dermatologic purposes. MN patches create temporary pathways that allow the passage of material to deeper layers of the skin. Given their demonstrable promise in therapeutic applications, it will be essential for healthcare professionals to engage with these new delivery systems.

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Ter um sorriso harmônico é uma das prioridades dos pacientes dentro da odontologia, que procuram os profissionais da área para melhorar nos requisitos estéticos, tanto dos dentes, quanto da gengiva. Com os diversos avanços tecnológicos, o cirurgião-dentista pôde ampliar sua capacidade de diagnóstico e prognóstico, podendo realizar um planejamento de intervenção mais criterioso e com maior possibilidade de sucesso. Por meio desta revisão de literatura integrativa propomos elencar de forma minuciosa quais são essas características que podem desarmonizar um sorriso e ainda apresentamos como restabelecer a harmonia do sorriso por meio de procedimentos e elementos odontológicos. Foi realizada uma pesquisa nos portais eletrônicos PubMed, Biblioteca Virtual em Saúde (BVS), Ebsco host e Scielo, utilizando os descritores: "smile", "periodontal plastic", "aesthetics", "black triangles" e "interdental papila", além dos seus termos relacionados em português, incluído publicações de 2019 a 2022. Foi possível observar que por meio de um quadro multifatorial, a estética e harmonia do sorriso pode ser comprometida por fatores gengivais, faciais e dentários. Assim, um planejamento assertivo deve ser realizado por um profissional capacitado, que identifique os pontos que interferem positivamente e negativamente no equilíbrio do sorriso, com o propósito de gerar soluções clínicas. Com uma abordagem multidisciplinar, pode-se ratificar que é possível restabelecer a harmonia do sorriso e conseguir a satisfação do paciente, por meio de procedimentos plásticos cirúrgicos e restauradores.

Having a harmonious smile is one of the priorities of patients in dentistry, who seek professionals in the area to improve the aesthetic requirements of both teeth and gums. With the various technological advances, the dental surgeon was able to expand his diagnostic and prognostic capacity, being able to carry out a more judicious intervention planning and with greater possibility of success. Through this integrative literature review, we propose to list in detail what are these characteristics that can disharmonize a smile and we also present how to restore the harmony of the smile through dental procedures and elements. A search was carried out in the electronic portals PubMed, Biblioteca Virtual em Saúde (BVS), Ebsco host and Scielo, using the descriptors: "smile", "periodontal plastic", "aesthetics", "black triangles" and "interdental papilla", in addition to of its related terms in Portuguese, including publications from 2017 to 2022. It was possible to observe that through a multifactorial framework, the esthetics and harmony of the smile can be compromised by gingival, facial and dental factors. Thus, assertive planning must be carried out by a trained professional, who identifies the points that interfere positively and negatively in the balance of the smile, with the purpose of generating clinical solutions. With a multidisciplinary approach, it can be confirmed that it is possible to restore the harmony of the smile and achieve patient satisfaction, through plastic surgical and restorative procedures.

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BACKGROUND: Thread lifting procedures for facial rejuvenation have made great strides with the development of absorbable threads. Although they have gained fame among plastic surgeons and dermatologists, there have been very few studies published in scientific articles on the effects of absorbable threads in facial rejuvenation, as well as few studies published by aesthetic physicians. The most effective and efficient techniques to determine the adequate place to insert the reabsorbable thread, and the different ways to evaluate the effectiveness of these aesthetic procedures, are still unknown. OBJECTIVES: This review aims to identify, in the scientific literature, the evaluation techniques for a safe and correct insertion of PDO threads in facial rejuvenation procedures. METHODOLOGY: A review of scientific literature was performed using the following list of keywords, descriptors, or thesauri: PDO threads, aesthetics, facial rejuvenation. Scopus, PubMed, and Web of Science databases were used for the literature search. Articles from years 2012-2022 were selected. The reference lists of the identified articles were included. (16) out of (35) articles associated with the topic were selected. Simple and compound searches were performed with the keywords and very few rigorous studies about the use of PDO threads for aesthetic procedures were found. RESULTS: Very few rigorous scientific studies on the use of PDO threads for facial rejuvenation procedures were found. There is a strong theoretical and methodological gap on this subject, and, also, on the evaluation techniques that could be used for the safe and correct insertion of the threads. CONCLUSION: The bibliographic information found shows a huge theoretical and methodological gap in the subject of procedures for facial rejuvenation with PDO threads, as well as the techniques and tools employed to guarantee the correct insertion of the threads.

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Introdução: A procura pela estética do sorriso é crescente na Odontologia, pois, muitas vezes um sorriso alinhado e periodonto saudável não são o bastante. A cerâmica odontológica apresenta-se como uma ótima possibilidade restauradora, visto o avanço das técnicas de adesão entre o substrato dentário e as cerâmicas, torna-se mais previsível o resultado com este tipo de reabilitação. Objetivo: O presente artigo tem como objetivo descrever um caso clínico com envolvimento de diversos níveis de desgaste dentário para reabilitação estética com cerâmica de dissilicato de lítio. Relato de caso: Paciente 36 anos, gênero feminino, apresentava insatisfação com seu sorriso devido a forma e a alteração de cor dos seus dentes superiores anteriores e pré-molares. O plano de tratamento consistiu em realizar a troca da coroa metalocerâmica por coroa total cerâmica da unidade 14, coroa total cerâmica nas unidades 11, 21 e 22, facetas cerâmicas nas unidades 15, 13, 12, 23, 24 e 25, osteotomia e gengivoplastia das regiões de 2º prémolar superior esquerdo ao 2º pré-molar superior direito, clareamento dental caseiro da arcada inferior e placa oclusal superior de proteção. O material de escolha para a resolução do caso clínico foi a cerâmica vítrea reforçada à base de dissilicato de lítio, pois, possui um índice de refração de luz semelhante à estrutura dentária, sem interferência significativa da translucidez, além de ser passível de cimentação adesiva por se tratar de uma cerâmica ácido sensível e o tamanho do cristal e a sua disposição favorecem o aumento das propriedades mecânicas da restauração. Conclusão: O plano de tratamento realizado permitiu o restabelecimento da função e estética, com reprodução das características dos dentes naturais e promoção da jovialidade e da harmonia no sorriso(AU)

Introduction:The demand for smile aesthetics is growing in Dentistry, because, often a smile aligned and healthy periodontium are not enough. Dental ceramics, presented as an excellent restorative possibility, since the advancement of adhesion techniques between the dental substrate and the ceramics, becomes more predictable the result with this type of rehabilitation. Objective: This article aims to describe a clinical case involving several levels of dental wear for aesthetic rehabilitation with ceramics. Case Report: A 36-year-old female patient presented dissatisfaction with her smile due to the shape and color alteration of her anterior and premolar upper teeth. The treatment plan consisted of exchanging the metal-ceramic crown for the total ceramic crown of unit 14, total ceramic crown in units 11, 21 and 22, ceramic veneers in units 15, 13, 12, 23, 24 and 25, osteotomy and gingivoplasty of the regions from 2nd left upper premolar to 2nd right upper premolar, home tooth whitening of the lower arch and upper occlusal plate of protection. The material of choice for the resolution of the clinical case was the glass ceramic reinforced on the basis of lithium disilicate because it has a refractive index of light similar to the dental structure, without significant interference of translucency, besides being liable to adhesive cementation because it is a sensitive acid ceramic and the size of the crystal and its disposition favor the increase of the mechanical properties of the restoration. Conclusion: The treatment plan performed allowed the restoration of function and aesthetics, with reproduction of the characteristics of natural teeth and promotion of joviality and harmony in the smile(AU)

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