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INTRODUCTION: The development of filler biomaterials with high hyaluronic acid concentrations, cohesiveness, and elastic modulus has become an option for chin augmentation, as the balance of these rheological properties promotes high lifting capacity, providing minimally invasive perceptible improvements in patient appearance. PRESENTATION OF CASE: The present study reviewed clinical and anatomical aspects of patients referred for chin augmentation and created a flowchart to assertively diagnose patients with an indication of Juvéderm® Volux™ for defining the lower third of the face. DISCUSSION: The chin is vital for facial proportions and attractiveness perception. Its relevance to facial appearance is noticed the most when chin size is less than ideal, making other facial areas seem larger or smaller. The adjacent soft tissues of the neck and jaw appear prematurely aged when chin projection or width is inadequate. Hyaluronic acid-based fillers have a confirmed history of safe and effective use for treating facial volume loss or deficiency. CONCLUSION: Juvéderm® Volux™ is a safe, effective, and long-lasting alternative for restoring and creating facial volume and sculpting, shaping, and contouring the chin and jaw.
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Mentoplasty or genioplasty is a simple procedure to enhance facial aesthetics. While usually considered simple, it might present certain difficulties during execution, especially when a minimally invasive approach is preferred. Drilling and cutting guides are a valuable tool to overcome such challenges but usually require larger incision and dissection to allow adequate positioning and bone rigid fixation. In this article, we describe a novel guide design that permits adequate bone repositioning while preserving minimally invasive protocols.
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Mentoplastia , Osteotomia , Humanos , Mentoplastia/métodos , Queixo/cirurgiaRESUMO
Introducción: la mentoplastia es una herramienta importante en la cirugía estética del tercio inferior de la cara, permite la armonización mediante movimientos del segmento osteotomizado en diferentes planos. Objetivo: describir el análisis prequirúrgico para una mentoplastia en un paciente con anomalía esquelética y macrogenia en las dimensiones vertical y horizontal. Resultados: el análisis concluye una reducción de mentón en dos planos, un procedimiento infrecuente en el manejo quirúrgico del tercio inferior. Discusión: aunque la mayoría de las correcciones realizadas en la actualidad implican un avance o descenso del mentón en casos de retro o microgenia, es importante reconocer otras deformidades y evaluar las proporciones faciales, la oclusión dental, las mediciones cefalométricas y las imágenes fotográficas identificando las necesidades específicas de cada paciente. Conclusión: realizar una correcta identificación de la clase esquelética y un análisis estético facial permite identificar el tipo de deformidad y planificar su manejo quirúrgico.
Introduction: Sliding Genioplasty is an important tool in the aesthetic surgery of the lower third of the face, it allows the harmonization by moving the osteotomi-zed segment in different planes. Objective: to describe the pre-surgical analysis for a Genioplasty in a patient with skeletal anomaly and macrogenia in the vertical and horizontal dimensions. Results: the analysis concludes a chin reduction in two planes, an infrequent procedure in the surgical management of the lower third. Discussion: although most of the corrections made today involve an advance or descent of the chin in cases of retro or microgenia, it is important to recognize other deformities and evaluate facial proportions, dental occlusion, cephalometric measurements and photographic images identifying the specific needs of each pa-tient. Conclusion: performing a correct identification of the skeletal class and an aesthetic facial analysis allows identifying the type of deformity and planning its surgical management.
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Humanos , Masculino , FemininoRESUMO
Introducción: Estudios previos han demostrado diferencias en la percepción de asimetrías dentales y faciales entre profesionales de la odontología y personas no expertas. Sin embargo, la literatura sobre las diferencias en la percepción de las asimetrías del mentón es limitada. Objetivo: Comparar la percepción estética de las asimetrías del mentón entre ortodoncistas, odontólogos especialistas, estudiantes y pacientes de la Facultad de Odontología de la Universidad Central del Ecuador. Métodos: Estudio observacional, analítico y transversal. El universo estuvo conformado por 36 ortodoncistas, 77 odontólogos especialistas, 96 estudiantes y 2580 pacientes de esta Facultad. El tamaño de la muestra fue de 30 participantes para cada grupo. Se modificó digitalmente la posición transversal del mentón de 0° a 6° en las fotografías de dos sujetos (hombre-mujer) ecuatorianos. La evaluación se realizó por medio de una escala visual análoga. Resultados: Las fotografías de asimetrías del mentón con 0° de desviación fueron calificadas como muy estéticas y las asimetrías con 6° fueron poco estéticas para los cuatro grupos. Los ortodoncistas, odontólogos especialistas y estudiantes consideraron como límite estético los 2° de desviación del mentón para la fotografía del sujeto femenino y masculino. Los límites estéticos fueron los 2° de desviación para el sujeto femenino y 3° para el sujeto masculino. Se encontraron diferencias significativas entre los grupos de evaluadores y las fotografías (p < 0,05). Conclusiones: Los ortodoncistas percibieron la estética facial cercana a la norma de la asimetría del mentón, que tiene un papel importante en la percepción de la estética facial(AU)
Introduction: Previous studies have shown differences in the perception of dental and facial asymmetries between dental professionals and non-experts. However, the literature on differences in the perception of chin asymmetries is limited. Objective: Compare the aesthetic perception of chin asymmetries among orthodontists, specialist dentists, students and patients of the Faculty of Dentistry of the Central University of Ecuador. Methods: Observational, analytical and cross-sectional study. The universe was made up of 36 orthodontists, 77 specialist dentists, 96 students and 2580 patients from this Faculty. The sample size was 30 participants for each group. The transverse position of the chin was digitally modified from 0° to 6° in the photographs of two Ecuadorian subjects (male-female). The evaluation was carried out by means of an analogous visual scale. Results: The photographs of asymmetries of the chin with 0° of deviation were qualified as very aesthetic and the asymmetries with 6° were unsightly for the four groups. Orthodontists, specialist dentists and students considered as an aesthetic limit the 2nd deviation of the chin for the photography of the female and male subject. The aesthetic limits were 2° of deviation for the female subject and 3° for the male subject. Significant differences were found between the groups of evaluators and the photographs (p < 0.05). Conclusions: Orthodontists perceived facial aesthetics close to the norm of chin asymmetry, which has an important role in the perception of facial aesthetics(AU)
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Humanos , Percepção , Literatura de Revisão como Assunto , Estudo ObservacionalRESUMO
Introduction: The chin is one of the most visible facial structures. Chin surgery, was initially described, for, the treatment of facial abnormalities, advancing the mandibular symphysis; achieved anterior displacement of the base of the tongue showing some value in the treatment of snoring and obstructive sleep apnea, and achieved adequate lip competence. We designed the Basal Extended Mentoplasty (BEM) based on the needs of patients orthodontically compensated, but dissatisfied with the appearance of his face as well as upper airway problems looking for a solution to this, design and planning the advances of the chin. Materials and Methods: Patients operated in the service of Maxillofacial Surgery, Specialist Hospital, "Dr. Bernardo Sepulveda "XXI Century National Medical Center, during the period of 2015-2019, orthodontically compensated patients, with labial incompetence and Class II skeletal. Sixty-five patients were operated during this period, and eight cases are presented. Results: Lip competition, osseointegration of the segments is observed, with a proper projection of the lower third, no nerve or vascular damage in the area. Conclusions: The design of the osteotomy is for orthodontically compensated patients with labial incompetence and Class II skeletal, giving a result mandibular lengthening. The BEM achieved adequate lip competence demonstrated by an interlabial gap of 0 mm, achieved adequate osseous consolidation of the fracture site with a more harmonious facial balance and profile, without nerve or vascular damage with spectacular results.
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Without a doubt, the chin plays an important role on facial harmony. Both position and shape of the chin can significantly affect the facial profile. Genioplasty is a relatively simple surgical procedure that allows to correct deformities associated to the chin area. Several techniques and modifications have been described in the literature for different types of deformities. Anterior posterior reduction osteotomies of the chin have an unpredictable effect on the soft tissues and the use of the conventional sliding osteotomy have shown unsatisfactory cosmetic outcomes, this associated with step deformity, notching at the inferior border of the mandible among others. We propose a simple and effective technique that allows the correction of a chin deformity in cases where sagittal or vertical reduction is required with excellent esthetic results. Four case examples are presented for technique illustration.
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Estética Dentária , Mentoplastia , Queixo/anormalidades , Queixo/cirurgia , Mentoplastia/métodos , Humanos , Mandíbula/cirurgia , Osteotomia/métodosRESUMO
A busca por procedimentos estéticos voltados para a perda de definição do submento é crescente. Um correto diagnóstico é imperativo para o sucesso do tratamento e redução das complicações. Adiposidade localizada, flacidez cutânea e perda da estrutura óssea são os principais achados. Um algoritmo de tratamento foi discutido nesta revisão, lembrando-se, claro, da possibilidade de tratamentos combinados e sequenciais para melhores resultados
The search for aesthetic procedures aimed at the loss of submental definition is increasing. A correct diagnosis is imperative for successful treatment and the reduction of complications. Localized adiposity, skin flaccidity, and loss of bone structure are the main findings. A treatment algorithm was discussed in this review, remembering, of course, the possibility of combined and sequential treatments for better results.
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This paper reports on an infected silicone chin implant due to the nonideal placement of dental implants, in a female patient aged 67 years old. A patient unsatisfied with her facial profile had received a silicone chin implant 25 years ago and had recently undergone surgery for placement of dental implants in a region close to the silicone implant. The nonideal positioning of dental implants and close contact with the silicone implant led to the absence of osseointegration, with consequent mobility and infection of both. The mobile dental implants and silicone implant were removed. Imaging exams revealed other complications of the silicone implant as bone resorption and formation of a narrow bone layer around the inferior silicone implant border. Alloplastic implants are an option for the esthetic correction of chin deformities. Solid silicone is biocompatible and highly resistant to degradation, with minimal allergic reaction and risk of toxicity. However, several postoperative complications may arise, such as migration or displacement, extrusion, foreign body reaction, bone resorption, heterotopic bone formation, and infection. Precise imaging exams are critical for diagnosis and to indicate the best treatment plan.
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Reabsorção Óssea , Implantes Dentários , Idoso , Queixo/cirurgia , Estética Dentária , Feminino , Humanos , SiliconesRESUMO
O mentoéconsideradocomoum doscomponentesmaisimportantesna harmoniafacial.Porém,estaregiãodeveserponderadanoplanodetratamento devidoàsinervaçõeseestruturasdelicadaspresentes. Deformidadesesqueléticascausam severosproblemasfuncionaiseestéticos aopaciente.Em algunscasosaopçãoterapêuticadeescolha,combinadaa outrostratamentos,podeservantajosavistoqueosresultadosobtidospodem oferecerumamelhorestéticaaopaciente. Estadissertaçãotem comoobjetivoestudararelevânciaeindicaçãodas diferentestécnicasdeharmonizaçãofacial,quandoofocodeintervençãoéo terçoinferiordaface.
Importanceofthechinapproachinharmonizingthelowerthirdoftheface:a clinicalcasereport Intheface,thechinisconsideredoneofthemostimportantcomponentsof facialharmony,andthisregionmustbeconsideredinthetreatmentplandueto thedelicateinnervationandstructurepresented. Skeletaldeformitiescauseseriousfunctionalandaestheticproblemstothe patient.Insomecases,theoptioncombinedwithothertreatmentscanbe advantageousforthetherapyastheresultscanofferbetteraestheticstothe patient. Thisdissertationaimstostudytherelevanceandindicationofdifferentfacial harmonizationtechniques,whenthefocusofinterventionisthelowerthirdof theface.
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Relatos de Casos , Queixo , Mentoplastia , Ácido Hialurônico , MandíbulaRESUMO
ABSTRACT Objective: To evaluate the influence of anteroposterior position of the soft tissue on facial attractiveness in black people, and compare the perception of aesthetics and satisfaction between orthodontists and black laypersons. Methods: The sample was composed of 69 orthodontists and 69 laypersons of black ethnicity (n=138). Facial profile photographs of two black volunteers, a man and a woman, were digitally manipulated to change the position of the lips and chin, by making gradual changes of 4mm in relation to the true vertical line, simulating advance or retrusion of the soft tissues by -2, -6, -10, +2, +6, +10mm, totalling six images per sex. The photographs were classified by the research participants using a visual analogue scale (VAS), from 0 (unpleasant) to 100 (pleasant). The results were analyzed by generalized linear model and by the Fisher's exact test, considering the level of significance of 5%. Results: The orthodontists and black laypersons considered straight profiles the most pleasant. The two groups classified the male profile as being more unpleasant in comparison with the female facial profile, which was concave. When evaluating all the images together, the image most indicated as being the most pleasant, once again, was the one with the straight profile, for both sexes. Conclusion: The influence of orthodontists' and laypersons' aesthetic perception on evaluating the facial profile of blacks was similar. The straight profile was classified as the most pleasant and the concave, as the most unpleasant.
RESUMO Objetivo: Avaliar a influência do posicionamento anteroposterior dos tecidos moles na atratividade facial de indivíduos negros, e comparar sua agradabilidade entre ortodontistas e leigos. Métodos: A amostra foi composta por 138 avaliadores, 69 ortodontistas e 69 indivíduos leigos da raça negra. Fotografias de perfil de dois pacientes negros, um homem e uma mulher, foram modificadas quanto ao posicionamento dos lábios e do mento, deslocados digitalmente em incrementos de 4 mm em relação a uma linha vertical verdadeira, simulando avanços e recuos dos tecidos moles de -2, -6, -10, +2, +6, +10 mm, totalizando seis imagens por sexo, classificadas pelos participantes da pesquisa usando uma escala visual analógica (EVA) de 0 (desagradável) a 100 (agradável). Os resultados foram analisados por meio de modelos lineares generalizados, considerando-se que todos os observadores avaliaram todas as imagens. A análise das escolhas das imagens consideradas mais agradáveis ou mais desagradáveis foi realizada pelo teste exato de Fisher, com um nível de significância de 5%. Resultados: Os ortodontistas e leigos consideraram mais agradáveis as alterações que se aproximavam do perfil reto. Nas imagens em que havia birretrusão facial, os dois grupos classificaram como mais desagradável o perfil do homem do que o perfil da mulher. Ao avaliar todas as imagens juntas, a imagem mais indicada como a mais agradável foi, novamente, a com perfil reto, para os dois sexos. Conclusão: A influência da percepção estética dos ortodontistas e leigos na avaliação do perfil facial de negros foi semelhante, sendo o perfil reto classificado como o mais agradável e o côncavo, o mais desagradável.
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Resumen Introducción: La sínfisis del mentón aporta equilibrio, simetría y armonía al rostro. Por ser una estructura anatómica mandibular muy importante y altamente modificable en cirugía estética, se considera indispensable conocer su morfología y así obtener una correcta interacción en el diagnóstico, pronóstico y terapéutica médico-odontológica. Objetivo: Determinar la morfología sínfisis del mentón en jóvenes adultos de la ciudad de Quito- Ecuador, año 2019, mediante la identificación de las longitudes sagitales y coronales. Metodología: Este estudio tuvo un enfoque cuantitativo, tipo descriptivo-observacional, con temporalidad retrospectiva. Se calibraron, analizaron y trazaron 384 radiografías digitales laterales de adultos jóvenes de la ciudad de Quito-Ecuador, año 2019 en el software AutoCAD-2019. Resultados: Existió una elevada frecuencia de la forma geométrica cuadrada (60%) con respecto a la rectangular (40%), adicionalmente se identificó que la figura cuadrada es más frecuente en individuos de sexo femenino y sujetos clase I (56%) y II (70%), además de todos los patrones de crecimiento vertical hipodivergentes (58%), normodivergentes (64%) e hiperdivergentes (57%). Conclusiones: La forma cuadrada de la sínfisis del mentón es mayor que la forma rectangular. Por la originalidad de los resultados, se sugiere realizar nuevos estudios que correlacionen la morfología mentoniana con las diferentes estructuras cráneo-maxilofaciales.
Abstract Introduction: The chin symphysis contributes to the balance, symmetry and harmony of the face. Since it is an important anatomical jaw structure and highly modifiable in aesthetic surgery, it is considered crucial to know its morphology and, thus, obtain a correct interaction in the diagnosis, prognosis and medical-dental therapy. Objective: To determine the symphysis morphology of the chin in young adults in the city of Quito, Ecuador, in the year 2019, through the identification of sagittal and coronal lengths. Methodology: This study had a quantitative approach, descriptive-observational type, with retrospective temporality. We calibrated, analyzed and plotted 384 lateral digital radiographs of young adults from the city of Quito-Ecuador, year 2019 in the software AutoCAD-2019. Results: There was a high frequency of the square geometric shape (60%) in comparison to the rectangular one (40%). Additionally, it was identified that the square figure is more frequent in female individuals and class I (56%) and II (70%) subjects, in addition to all the hypodivergent (58%), normodivergent (64%) and hyperdivergent (57%) vertical growth patterns. Conclusions: The square shape of the chin symphysis is larger than the rectangular shape. Due to the originality of the results, it is suggested to carry out new studies that correlate chin morphology with the different cranio-maxillofacial structures.
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Humanos , Adolescente , Adulto , Queixo/anatomia & histologia , EquadorRESUMO
Numb chin syndrome is an uncommon presentation that has been reported as secondary to metastatic disease, trauma, and infections of the maxilla, mandible, or oral cavity. The hypoesthesia, paraesthesia, or pain are a result of injury to the inferior alveolar nerve, which is particularly vulnerable as it exits the mandible through the mandibular foramen as the mental nerve. In persons with sickle cell disease, it has been reported as a manifestation of mandibular vaso-occlusive crisis. This case series presents 13 patients with sickle cell disease who presented with numb chin syndrome, the largest number of cases that has been described in the literature to date. The report illustrates the wide variety of presentations and therefore possible differential diagnoses to consider. In this case series, the symptoms were associated with vaso-occlusive crises, allergic reactions, dental infections, malignancy, rheumatoid arthritis, and pregnancy. Most appeared to be self-limiting; however, one patient was having his second episode, and the numbness has persisted in three patients. The series illustrates that it is important not only to ensure that the source of the local vaso-occlusive crisis is treated, but also to not miss important differentials such as metastatic disease, where this can be the first presentation of malignancy and would represent a very poor prognosis. There is no reported successful treatment for the hypoesthesia in this case series, and this presents an area for further research.
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Anemia Falciforme/complicações , Queixo/inervação , Hipestesia/etiologia , Nervo Mandibular/fisiopatologia , Adolescente , Adulto , Arteriopatias Oclusivas/etiologia , Neoplasias da Mama/complicações , Queixo/irrigação sanguínea , Diagnóstico Diferencial , Dor Facial/etiologia , Feminino , Humanos , Hipestesia/epidemiologia , Hipestesia/fisiopatologia , Jamaica/epidemiologia , Masculino , Traumatismos do Nervo Mandibular/diagnóstico , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Gravidez , Complicações na Gravidez/etiologia , Síndrome , Adulto JovemRESUMO
ABSTRACT Objectives: This study aimed to (I) assess the morphology of the symphysis and soft tissue chin associated with sex, age and sagittal/vertical skeletal patterns, and (II) identify the individual and combined contributions of these variables to different portions of the symphysis. Methods: This cross-sectional study included 195 lateral cephalometric radiographs from untreated adults. Alveolar, basal, and soft tissue of the symphysis were measured by an X/Y cranial base coordinate system, and divided in accordance to four predictor variables: sex, age, and sagittal/vertical skeletal patterns. Parametric tests were conducted for comparison and correlation purposes, while multiple regression analysis was performed to explore combined interactions. Results: Alveolar inclination is related to sagittal and vertical patterns, and both explained 71.4% of the variations. Alveolar thickness is weakly predicted and poorly influenced by age. Symphysis height was 10% higher in males, and associated with a vertical skeletal pattern and sex, and both explained 43.6% of variations. Basal symphyseal shows an individual thickness, is larger in males, and vertically short-positioned with age. Soft tissue chin is not necessarily related to the size of the underling skeletal pattern, and enlarges with age, even in adulthood. Conclusions: The symphysis and surrounding tissues are influenced by sex, age, and sagittal and vertical patterns, acting differently on the alveolar, basal and soft tissue portions. Sagittal and vertical skeletal patterns are the strongest association on alveolar symphysis inclination, whereas sex and age acts on the vertical symphysis position and soft tissues thickness.
RESUMO Introdução: O presente estudo objetivou: 1) avaliar a morfologia da sínfise mandibular e dos tecidos tegumentares do mento, associada ao sexo, idade, padrões sagital e vertical; e 2) identificar as contribuições dessas variáveis, individualmente ou combinadas, às diferentes regiões da sínfise. Métodos: Este estudo transversal incluiu 195 radiografias cefalométricas laterais de adultos não tratados ortodonticamente. Os tecidos alveolar, basal e mole da sínfise foram medidos por um sistema de coordenadas x, y e z da base do crânio e divididos de acordo com quatro variáveis preditoras: sexo, idade e padrões esqueléticos sagitais e verticais. Testes paramétricos foram conduzidos para fins de comparação e correlação, enquanto a análise de regressão múltipla foi realizada para explorar as interações combinadas. Resultados: A inclinação alveolar está relacionada aos padrões sagitais e verticais, e ambos explicaram 71,4% das variações. A espessura alveolar é fracamente prevista e pouco influenciada pela idade. A altura da sínfise foi 10% maior no sexo masculino e esteve associada ao padrão esquelético vertical e ao sexo, sendo que ambos explicaram 43,6% das variações. A sínfise basal mostra espessura individual, é maior no sexo masculino e verticalmente curta com a idade. O tecido mole do mento não está necessariamente relacionado ao tamanho do padrão esquelético subjacente e aumenta com a idade, mesmo na idade adulta. Conclusões: A sínfise e os tecidos circundantes são influenciados pelo sexo, idade e padrões sagitais e verticais, que atuam de forma diferenciada nas porções alveolar, basal e de tecidos tegumentares. Os padrões esqueléticos sagitais e verticais são a associação mais forte na inclinação da sínfise alveolar, enquanto o sexo e a idade atuam na posição vertical da sínfise e na espessura dos tecidos tegumentares.
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Humanos , Masculino , Adulto , Mandíbula/diagnóstico por imagem , Radiografia , Cefalometria , Estudos Transversais , Queixo/anatomia & histologia , Queixo/diagnóstico por imagemRESUMO
ABSTRACT Purpose: to investigate the existence of changes in the electromyographic patterns of the mentalis and inferior orbicularis oris muscles in oronasal breathers, submitted to massage therapy on the mentalis muscle. Methods: a controlled blind placebo experiment, with a sample of 19 oronasal breathers (1 man and 18 women), mean age (standard deviation) 22.3 (2.63) years, randomly divided into control and experimental groups, respectively with 7 and 12 volunteers. The experimental group alone underwent myotherapy with massages for 3 months, while electromyographic data were collected from both groups at the beginning and end of the treatment, both at rest and when swallowing water. The analysis of variance was conducted to test the existence of differences between the means; the 5% significance level was used. Results: the analysis of variance revealed signs of interaction between the group and phase effects when analyzing the root mean square values of both the inferior orbicularis oris and the mentalis muscles. As expected, no signs of significant differences were found between the means of the phases in the control group. On the other hand, signs of significant difference were found in the experimental group, with reduced root mean square values in both muscles. The inferior orbicularis oris muscle, which in the pre-phase had a mean (standard deviation) of 202.10 (161.47) µV, had, in the post-phase, values of 131.49 (159.18) µV. The mentalis muscle, in its turn, had in the pre- and post-phase, respectively, a mean (standard deviation) of 199.31 (279.77) µV and 114.58 (253.56) µV. Conclusion: given that no effect was detected in the control group, the decrease in the root mean square values of the mentalis and inferior orbicularis oris muscles in oronasal breathers was attributed to the massage therapy on the mentalis muscle.
RESUMO Objetivo: investigar a existência de modificações dos padrões eletromiográficos dos músculos mentual e orbicular inferior da boca em respiradores oronasais submetidas à massoterapia no músculo mentual. Métodos: experimento cego placebo controlado, com amostra de 19 respiradores oronasais, 1 homem e 18 mulheres, com média de idade (desvio-padrão) de 22,3 (2,63) anos, aleatoriamente dividida nos grupos controle e experimental, respectivamente com 7 e 12 voluntários. Apenas no grupo experimental foi aplicada mioterapia por meio de massagens, por três meses e em ambos os grupos foram coletados dados eletromiográficos no início e no final do tempo de tratamento nas condições de repouso e deglutição de água. A análise de variância foi aplicada para testar a existência de diferenças entre as médias e foi adotado o nível de significância de 5%. Resultados: a análise de variância revelou indícios de interação entre os efeitos de grupo e fase quando analisados os valores de Root Mean Square (RMS), tanto do músculo orbicular inferior como do músculo mentual. Como esperado, não foram encontrados indícios de diferenças significantes entre as médias das fases no grupo controle, entretanto, foram encontrados indícios de diferença significante no grupo experimental havendo redução das médias de RMS em ambos os músculos. O orbicular inferior, que na fase pré apresentava média (desvio padrão) de 202,10 (161,47) µV, apresentou valores de 131,49 (159,18) µV na fase pós, enquanto que o músculo mentual apresentou, respectivamente, nas fases pré e pós, média (desvio padrão) de 199,31 (279,77) µV e 114,58 (253,56) µV. Conclusão: tendo em vista a não detecção de efeito no grupo controle, atribui-se à massoterapia no músculo mentual a redução das médias de Root Mean Square dos músculos mentual e orbicular inferior da boca em respiradores oronasais.
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Humanos , Masculino , Feminino , Adulto Jovem , Terapia Miofuncional/métodos , Respiração Bucal/reabilitação , Eletromiografia , Forame Mentual , Massagem , Músculos da MastigaçãoRESUMO
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.
Assuntos
Humanos , Queixo/cirurgia , Mentoplastia/métodosRESUMO
Introdução: A falta da projeção mentoniana no terço inferior da face algumas vezes é responsável pela quebra da harmonia do contorno facial. A utilização de implantes aloplásticos, preenchimentos submetidos à ritidoplastia para correção destas deformidades. Neste estudo, propomos uma nova manobra para aumento da projeção mentoniana com uso de um retalho cervical associado à ritidoplastia. Métodos: Foram avaliados 11 pacientes operados no período de 01/2017 a 01/2018, utilizando-se o retalho cervical para projeção mentoniana, e tendo como critério de inclusão somente pacientes que almejavam um aumento mentoniano, sem utilização de próteses, preenchimentos ou abordagem óssea, e que seriam submetidos à ritidoplastia. Resultados: Através da análise cefalométrica evidenciou-se melhora da projeção mentoniana e do contorno cervical, e não houve complicações no pós-operatório imediato ou tardio. Conclusão: O retalho cervical utilizado para aumento mentoniano além de apresentar resultados e aceitação satisfatórios, elimina o uso de materiais sintéticos, redução de custos, segurança e durabilidade, alcançando um contorno mandibular mais refinado e uma projeção mentoniana mais natural.
Introduction: The lack of chin projection in the lower third of the face is sometimes responsible for the breaking of the facial contour harmony. Alloplastic implants, fillers, and osseous advancements have been used to correct these deformities. In this study, we propose a new maneuver to increase chin projection by using a cervical flap associated with rhytidoplasty. Methods: We assessed 11 patients who underwent operations using the cervical flap for chin projection between January 2017 and January 2018. The inclusion criteria were only patients who desired chin augmentation without the use of prosthetics, fillers, or osseous approaches, and those who would undergo rhytidoplasty. Results: A cephalometric analysis revealed improvements in chin projection and cervical contour, and no complications in the immediate or late postoperative period. Conclusion: In addition to presenting satisfactory results and acceptance, the cervical flap used for chin augmentation eliminated the use of synthetic materials, reduced surgical costs, and improved safety and durability, achieving a more refined mandibular contour and natural chin projection.
RESUMO
Introdução: Identificar qual projeção do mento é ideal para compor um rosto harmônico, de acordo com a opinião de leigos e cirurgiões buco-maxilo-faciais (BMF), relacionando as variáveis: sexo, etnia(raça) e região de origem(local). Metodologia: Participaram do estudo 386 leigos e 198 cirurgiões BMF. Este estudo foi realizado por meio de um formulário que continha dezoito imagens da face com diferentes projeções do mento: nove do sexo masculino e nove do sexo feminino, tendo o público escolhido a imagem que mais o agradou. Resultados: Em relação à avaliação da imagem masculina, as categorias: grupo(leigos/cirurgiões), sexo masculino e feminino, regiões (Nordeste e Sudeste) e raça, os entrevistados leigos escolheram um mento retraído em relação à linha vertical verdadeira, semelhante à escolha dos cirurgiões. Em relação à imagem feminina, para as mesmas categorias do sexo masculino, as projeções protruídas de mento foram mais escolhidas, tanto para os leigos como para os cirurgiões. Entretanto, as subcategorias leigos da região Sudeste, leigos de raça branca e leigos do sexo masculino escolheram uma imagem feminina com projeções de mento mais retraída. Conclusões: A harmonia facial pode ser considerada subjetiva, pois engloba padrões pessoais de beleza; assim, os cirurgiões devem estar atentos às peculiaridades dos pacientes... (AU)
Introduction: To identify which projection of the chin is ideal for compose a harmonic face according to the opinion of laypeople and oral maxillofacial surgeons, relating the variables: gender, ethnicity (race) and region of origin (local). Methodology: 386 lay people and 198 surgeons participated in the study. This study was carried out by means of a form. This form contained eighteen images of faces with different projections of the chin: nine males and nine females. So, the audience chose the image that most pleased them. Results: In relation to the evaluation of the male image. The categories: group (laymen/ surgeons), male and female, regions (northeast and southeast) and race, lay interviewee chose a retracted chin in relation to the true vertical line, similar to the surgeons' choice. In relation to the female image, for the same male categories, the protruding projections of the chin were more chosen, both for the laymen and for the surgeons. However, for the lay subcategories of the Southeast region, white laymen and male laymen, both chose a female image with more retracted chin projections. Conclusions: The facial harmony can be considered subjective since it includes personal standards of beauty, so surgeons must be attentive to the peculiarities of the patients... (AU)
Assuntos
Humanos , Masculino , Feminino , Queixo , Estética Dentária , Face , Cirurgia Ortognática , Cirurgiões Bucomaxilofaciais , Imagem Corporal , EstéticaRESUMO
Resumen El temblor mentoniano o genioespasmo es un desorden del movimiento de carácter involuntario, rítmico, hereditario autosómico dominante, exacerbado por situaciones de estrés o emocionales. Registrado por primera vez en 1894, en Italia. Se reporta una niña de 4 años de edad con temblor mentoniano desde el año de edad, sin precedente de herencia, con respuesta exitosa al uso de Toxina Botulínica.
Abstract The chin tremor or geniospasm is an involuntary, rhythmic, autosomal dominant hereditary movement disorder, triggered by stress or emotional situations. Registered for the first time in 1894, in Italy. We report a 4-year-old girl with mental tremor from one year of age, with no previous inheritance, with a successful response to the use of Botulinum Toxin.
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Introducción: La relación de la nariz con la morfología facial no es solo estructural. Numerosos estudios sugieren la relación entre la función respiratoria nasal y el de-sarrollo craneofacial. Objetivo: Determinar la mejoría en el ángulo de convexidad facial y proyección del mentón en pacientes en postoperatorio de rinoseptoplastia. Diseño: Estudio observacional analítico tipo corte transversal. Metodología: Mues-tra de 43 pacientes, 26 de género femenino y 17 masculino, entre 12 y 43 años, sometidos a rinoseptoplastia con evolución postoperatoria mínima de 3 meses. Se analizaron las variables de edad, sexo, ángulo de convexidad facial de Legan y proyección del mentón según González Ulloa antes y después de la cirugía, así como tiempo postquirúrgico. Resultados: El ángulo de convexidad facial se redujo 3,72°+2,19. En la técnica de González Ulloa, se evidenció avance del pogonion 2,53 mm+ 1,60. De los 43 pacientes, un 72%, mostró cambios favorables en el án-gulo de convexidad facial y en la proyección del mentón. Los mejores resultados se evidenciaron en menores de 16 años y evolución postquirúrgica mayor a 1 año. Discusión: A diferencia de otras investigaciones, observamos cambios significativos en pacientes adultos. Tal hecho nos lleva a otras interrogantes sobre mecanismos adicionales que pudieran influir en los patrones de crecimiento facial. Conclusiones: La rinoseptoplastia al considerarse un procedimiento que mejora la función respira-toria nasal, favorece cambios neuromusculares y endocrinos que permiten un mejor desarrollo del perfil facial en especial del tercio inferior.
Introduction: The relation between the nose and the facial morphology is not only structural. Numerous studies have demonstrated also a relationship between nasal respiratory function and craniofacial development. Objective: To determine the im-provement in the angle of facial convexity and chin projection in patients in the postoperative period of rhinoseptoplasty. Design: Cross-sectional study. Methods: 43 patients were selected. 26 women and 17 men between 12 and 43 years old, undergoing Rhinoplasty with minimum 3 months of postoperative evolution. We analyzed the variables of age, sex, Legan's angle of facial convexity and projection of the chin according to Gonzalez Ulloa before and after surgery, as well as post-surgical time. Results: The angle of facial convexity was reduced X + D.S 3.72 ° + 2.19. The technique of González Ulloa showed progress of the pogonion X + D.S 2.53 mm + 1.60. Of the 43 patients, 72%, showed positive changes at the angle of facial convexity and the projection of the Chin. Best results were apparent in children under 16 years and more than 1 year postsurgical evolution. Discussion: Unlike other research, we observe significant changes in adult patients. This fact leads to other questions about additional mechanisms that might influence the facial growth patterns. Conclusions: Rhinoseptoplasty is a procedure that improves the nasal respiratory function, favors neuromuscular and endocrine changes that allow better development of the facial profile especially in the lower third.
Assuntos
Humanos , Queixo , Tamanho CorporalRESUMO
ABSTRACT Objective: To determine the relationship between symphysis dimensions and alveolar bone thickness (ABT) of the mandibular anterior teeth. Methods: Cone-beam computed tomography images of 51 patients were collected and measured. The buccal and lingual ABT of the mandibular anterior teeth was measured at 3 and 6 mm apical to the cemento-enamel junction (CEJ) and at the root apices. The symphysis height and width were measured. The symphysis ratio was the ratio of symphysis height to symphysis width. Kendall's tau correlation coefficient was used to determine the relationships between the variables at a 0.05 significance level. Results: The mandibular anterior teeth lingual and apical ABT positively correlated with symphysis width (p<0.05). Moreover, these thicknesses negatively correlated with the symphysis ratio (p<0.05). Symphysis widths and ratios showed higher correlation coefficients with total and buccal apical ABT, compared with lingual ABT. Buccal ABT at 3 and 6 mm apical to the CEJ was not significantly correlated with most symphysis dimensions. The mean thickness of the buccal alveolar bone at the upper root half was only 0.2-0.6 mm, which was very thin, when compared with other regions. Conclusion: For mandibular anterior teeth, the apical alveolar bone and lingual alveolar bone tended to be thicker in patients with a wide and short symphysis, compared to those with a narrow and long symphysis. Buccal alveolar bone was, in general, very thin and did not show a significant relationship with most symphysis dimensions.
RESUMO Objetivo: o objetivo desse artigo foi avaliar a correlação entre as dimensões da sínfise e a espessura do osso alveolar (EOA) na região anterior da mandíbula. Métodos: imagens de tomografia computadorizada de feixe cônico (TCFC) de 51 pacientes foram selecionadas e medidas. As EOAs vestibular e lingual dos dentes anteroinferiores foram medidas a 3 mm e a 6 mm para apical da junção cemento-esmalte (JCE) e nos ápices radiculares. A altura e a largura da sínfise foram medidas, e calculou-se a proporção entre ambas, chamada de proporção da sínfise. O coeficiente de correlação tau de Kendall foi utilizado para determinar a correlação entre as variáveis, com nível de significância de 0,05. Resultados: as EOAs vestibular e lingual dos dentes anteroinferiores apresentaram correlação positiva com a largura da sínfise (p< 0,05). Porém, essas EOAs apresentaram correlação negativa com a proporção da sínfise (p <0,05). A largura e a proporção da sínfise apresentaram maiores coeficientes de correlação com a EOA total e vestibular apical e, em comparação com a EOA lingual. A EOA vestibular a 3 mm e a 6 mm para apical da JCE não apresentou correlação significativa com a maioria das dimensões da sínfise. A espessura média do osso alveolar vestibular na metade superior da raiz foi de apenas 0,2 a 0,6 mm - muito delgada quando comparada com outras regiões. Conclusão: nos dentes anteroinferiores, o osso alveolar apical e o osso alveolar lingual tendem a ser mais espessos nos pacientes com sínfise mais larga e curta, em comparação àqueles com sínfise mais estreita e longa. O osso alveolar vestibular foi, em geral, muito fino e não apresentou relação significativa com a maioria das dimensões da sínfise.