Influence of the facial pattern on ANB, AF-BF, and Wits appraisal.

AIM: To assess the correlation between Wits and AF-BF appraisals with the ANB angle, and verify the influence of the facial type on these appraisals. METHODS: Lateral cephalometric radiographs from 118 untreated individuals were separated into 3 groups according to the facial pattern (brachyfacial, mesofacial, and dolichofacial). The radiographs were digitized and submitted to ANB angle and Wits and AF-BF appraisals on computer software. All radiographs were retraced for intraobserver and interobserver error tests. RESULTS: The Student's t test demonstrated no statistically significant differences on the intraobserver's test (P > .05). There were statistically significant differences in the readings of Wits values of the 3 groups and for AF-BF values in the brachyfacial and mesofacial groups (P <.05). The multiple linear regression tests demonstrated high correlation between ANB and AF-BF for the 3 groups (r2, 0.768). The same result was found for ANB and Wits (r2, 0.624). CONCLUSION: Facial pattern does not have an influence on the correlation between ANB and AF-BF nor between ANB and Wits, but it does influence the measurements of ANB, AF-BF, and Wits.

Divine proportions and facial esthetics after manipulation of frontal photographs.

AIM: To investigate the relationship between divine proportion and facial esthetics in frontal photographs as well as whether any of the 4 ratios for manipulation provide more favorable facial esthetics. MATERIAL AND METHODS: The sample comprised 20 frontal photographs of Caucasian individuals (11 males and 9 females). The photographs were digitized and stored on a compact disk. A photometric analysis was created with 7 facial segments that were measured on Image Tool software and 4 ratios between 2 facial segments calculated using Microsoft Excel. This manipulation led to 5 different photographs of the same individual: one photograph with no manipulation and the others with 1 of the ratios manipulated in the Deformer 2.0 to very close or equal to 1.618. Thereafter, the 5 photographs of all individuals were evaluated by 12 examiners. The examiners selected those photographs that were esthetically more pleasant. CONCLUSION: After evaluation, a chi-square test revealed a relationship between divine proportion and facial esthetics. Among the ratios selected, R1 and R2 provided more favorable facial esthetics.

Homogenous demineralized dentin matrix for application in cranioplasty of rabbits with alloxan-induced diabetes: Histomorphometric analysis

Purpose: The aim of this work was to evaluate the bone-repair process after implantation of homogenous demineralized dentin matrix (HDDM) slices in surgical defects created in the parietal bones of rabbits with alloxan-induced diabetes. Materials and Methods: Forty-eight rabbits were selected and divided into 4 groups of 12 rabbits: the control group, diabetic rabbits (D), diabetic rabbits with a PTFE barrier (D-PTFE), and diabetic rabbits with a PTFE barrier and with slices of homogenous demineralized dentin matrix (D-PTFE+HDDM). The diabetic animals received a single dose of alloxan monohydrate (90 mg/kg) intravenously on the marginal ear vein, and their blood glucose was verified daily. The rabbits were sacrificed after 15, 30, 60, and 90 days. The histologic findings show both better bone structure and significantly greater bone density, as determined by histomorphometric analysis, for the D-PTFE + HDDM group than for the other 3 groups (P < .01). It was also observed that the mean bone density increased gradually from 15 to 90 days (except in the D-PTFE group). Conclusion: It was concluded that the HDDM was biocompatible with the bone repair of diabetic rabbits and that HDDM slices stimulated bone tissue formation. Facilitation of bone repair with HDDM could be useful in diabetic patients.

Alterações dentoesqueléticas e do perfil facial em pacientes tratados ortodonticamente com extração de quatro primeiros pré-molares

Objective: the purpose of this prospective study was to cephalometrically analyze the dentoalveolar and soft tissue changes after the orthodontic treatment followed by the extraction of four premolars. Material and methods: the sample was comprised by 30 Class II division 1 patients with mean initial age of 12 years and 4 months. Two lateral cephalograms were obtained from each patient at the beginning and at the end of the treatment. The variables analyzed were the nasalabial changes and upper and lower incisors changes in relation to a vertical and horizontal x and y reference lines. Results: upper and lower incisors retraction was 3.4 and 1.8mm, respectively. The SNA angle was decresead by 1.7 degrees followed by a retraction of point A mainly due to the upper incisor retraction. There was a significant decrease of the Wits and ANB variables. There was an increase in the lower anterior facial height. Upper incisor retraction was followed by an increase in the nasolabial angle (ratio 1:2.8 degrees). However, a wide range of individual variability was found. Conclusions: the present study did not support the simple expectation that treatment with extractions of four premolars will result in a dished in face. It appeared that facial changes were more related to a normal facial growth, the amount of incisor retraction and the anchorage control during the upper and lower incisor.

Reconstruction of Mandibular Segmental Defects Using the Guided-Bone Regeneration Technique With Polylactide Membranes and/or Autogenous Bone Graft: A Preliminary Study on the Influence of Membrane Permeability

Purpose: Bone maintenance after mandibular reconstruction with autogenous iliac crest may be disappointing due to extensive resorption in the long term. The potential of the guided-bone regeneration (GBR) technique to enhance the healing process in segmental defects lacks comprehensive scientific documentation. This study aimed to investigate the influence of polylactide membrane permeability on the fate of iliac bone graft (BG) used to treat mandibular segmental defects. Materials and Methods: Unilateral 10-mm-wide segmental defects were created through the mandibles of 34 mongrel dogs. All defects were mechanically stabilized, and the animals were divided into 6 treatment groups: control, BG alone, microporous membrane (poly L/DL-lactide 80/20%) (Mi); Mi plus BG; microporous laser-perforated (15 cm2 ratio) membrane (Mip), and Mip plus BG. Calcein fluorochrome was injected intravenously at 3 months, and animal euthanasia was carried out at 6 months postoperatively. Results: Histomorphometry showed that BG protected by Mip was consistently related to larger amounts of bone compared with other groups (P ≤ .0001). No difference was found between defects treated with Mip alone and BG alone. Mi alone rendered the least bone area and reduced the amount of grafted bone to control levels. Data from bone labeling indicated that the bone formation process was incipient in the BG group at 3 months postoperatively regardless of whether or not it was covered by membrane. In contrast, GBR with Mip tended to enhance bone formation activity at 3 months. Conclusions: The use of Mip alone could be a useful alternative to BG. The combination of Mip membrane and BG efficiently delivered increased bone amounts in segmental defects compared with other treatment modalities. © 2008 American Association of Oral and Maxillofacial Surgeons.

Direct and indirect connections between cochlear root neurons and facial motor neurons: Pathways underlying the acoustic pinna reflex in the albino rat

Cochlear root neurons (CRNs) are involved in the acoustic startle reflex, which is widely used in behavioral models of sensorimotor integration. A short-latency component of this reflex, the auricular reflex, promotes pinna movements in response to unexpected loud sounds. However, the pathway involved in the auricular component of the startle reflex is not well understood. We hypothesized that the auricular reflex is mediated by direct and indirect inputs from CRNs to the motoneurons responsible for pinna movement, which are located in the medial subnucleus of the facial motor nucleus (Mot7). To assess whether there is a direct connection between CRNs and auricular motoneurons in the rat, two neuronal tracers were used in conjunction: biotinylated dextran amine, which was injected into the cochlear nerve root, and Fluoro-Gold, which was injected into the levator auris longus muscle. Under light microscopy, close appositions were observed between axon terminals of CRNs and auricular motoneurons. The presence of direct synaptic contact was confirmed at the ultrastructural level. To confirm the indirect connection, biotinylated dextran amine was injected into the auditory-responsive portion of the caudal pontine reticular nucleus, which receives direct input from CRNs. The results confirm that the caudal pontine reticular nucleus also targets the Mot7 and that its terminals are concentrated in the medial subnucleus. Therefore, it is likely that CRNs innervate auricular motoneurons both directly and indirectly, suggesting that these connections participate in the rapid auricular reflex that accompanies the acoustic startle reflex. © 2008 Wiley-Liss, Inc.

Orthognathic Surgery in the Young Cleft Patient: Preliminary Study on Subsequent Facial Growth

Purpose: This study evaluated the long-term effects of orthognathic surgery on subsequent growth of the maxillomandibular complex in the young cleft patient. Patients and Methods: We evaluated 12 young cleft patients (9 male and 3 female patients), with a mean age of 12 years 6 months (range, 9 years 8 months to 15 years 4 months), who underwent Le Fort I osteotomies, with maxillary advancement, expansion, and/or downgrafting, by use of autogenous bone or hydroxyapatite grafts, when indicated, for maxillary stabilization. Five patients had concomitant osteotomies of the mandibular ramus. All patients had presurgical and postsurgical orthodontic treatment to control the occlusion. Radiographs taken at initial evaluation (T1) and presurgery (T2) were compared to establish the facial growth vector before surgery, whereas radiographs taken immediately postsurgery (T3) and at longest follow-up (T4) were used to determine postsurgical growth. Each patient's lateral cephalograms were traced, and 16 landmarks were identified and used to compute 11 measurements describing presurgical and postsurgical growth. Results: Before surgery, all patients had relatively normal growth. After surgery, cephalograms showed statistically significant growth changes from T3 to T4, with the maxillary depth decreasing by -3.3° ± 1.8°, Sella-nasion-point A by -3.3° ± 1.8°, and point A-nasion-point B by -3.6° ± 2.8°. The angulation of the maxillary incisors increased by 9.2° ± 11.7°. Of 12 patients, 11 showed disproportionate postsurgical jaw growth. Maxillary growth occurred predominantly in a vertical vector with no anteroposterior growth, even though most patients had shown anteroposterior growth before surgery. The distance increased in the linear measurement from nasion to gnathion by 10.3 ± 7.9 mm. Four of 5 patients operated on during the mixed dentition phase had teeth that erupted through the cleft area. A variable impairment of postoperative growth was seen with the 2 types of grafting material used. No significant difference was noted in the effect on growth in patients with unilateral clefts versus those with bilateral clefts. The presence of a pharyngeal flap was noted to adversely affect growth, whereas simultaneous mandibular surgery did not. After surgery, 11 of 12 patients tended toward a Class III end-on occlusal relation. Conclusions: Orthognathic surgery may be performed on growing cleft patients when mandated by psychological and/or functional concerns. The surgeon must be cognizant of the adverse postsurgical growth outcomes when performing orthognathic surgery on growing cleft patients with the possibility for further surgery requirements. Performing maxillary osteotomies on cleft patients would be more predictable after completion of facial growth. © 2008 American Association of Oral and Maxillofacial Surgeons.

La technique de l’arc segmenté. Contrôle de l’ancrage et modification significative du profil facial : une étude de cas

This article evaluates space closure mechanics efficiency in an extraction case where maximum anchorage was a requirement. The Segmented Arch Technique (SAT) was utilized as an anchorage control strategy to obtain maximum anterior retraction and, in consequence, significant facial profile change. A 20-year-10-month old woman needed severe labial and profile changes. The patient had four premolars extracted and SAT with type A mechanics [1] (Marcotte [2] activation protocol) was applied. The results showed significant reduction in labial protrusion and incisal angulation with effective anchorage control. The results were compared to others available in the literature derived from different techniques, where anterior retraction was also accomplished with maximum anchorage [3-7]. In conclusion, the SAT with type A mechanics has been shown to be another treatment option when significant changes in the soft-tissue profile are needed in extraction cases. © 2008. CEO. Published by Elsevier Masson SAS. All rights reserved.

Evaluation of dimensional change and detail reproduction in silicones for facial prostheses.

The aim of this study was to evaluate the dimensional stability and detail reproduction of two silicones used for facial prosthesis, under the influence of chemical disinfection and storage time. Twenty-eight test specimens were obtained, half made of Silastic MDX 4-4210 silicone, and the other half of Silastic 732 RTV silicone. The test specimens were divided into 4 groups: Silastic 732 RTV and Silastic MDX 4-4210, with disinfection 3 times a week with Efferdent and without disinfection. Dimensional change was analyzed using an electronic comparison microscope and detail reproduction was observed under a stereo microscope, immediately and 2 months after the test specimens were made. Once the results were obtained, an analisis of variance (ANOVA) was applied, followed by the Tukey's Test with 1% confidence. The storage time factor had a statistical influence on dimensional stability: Silastic MDX 4-4210 had less contraction than Silastic 732 RTV. Chemical disinfection did not significantly alter the dimensional stability of the materials used. Regarding detail reproduction, no alteration of values was observed in any of the materials analyzed, regardless of storage period or disinfection.

Oxygen reduction on PtFe/C electrocatalysts prepared in microemulsions

PtFe/C nanocatalysts of different compositions and nearly constant particle size were prepared by a microemulsion method. Crystallite sizes and degree of alloying were determined by X-ray diffraction. Particle size and distribution were characterized by transmission electron microscopy and average composition was determined by energy dispersive X-ray analysis. Measurements of electrocatalytic activity for oxygen reduction were done using the rotating disk electrode technique in O2 saturated 0.5 mol L-1 sulfuric acid solutions, at room temperature. For all catalysts oxygen reduction begins at ̃ 0.90V. Tafel plots show slopes of c.a. 60 and 120 mV dec in the regions of low and high overpotentials, respectively. The best results for the ORR were obtained for the PtFe/C catalyst of composition Pt:Fe 70:30. This catalyst was also found to exhibit the largest methanol tolerance. © The Electrochemical Society.

Visual evaluation of color stability after accelerated aging of pigmented and nonpigmented silicones to be used in facial prostheses

Objectives: The objective of this study was to evaluate by a visual method of comparison the color stability of nonpigmented and pigmented facial silicones after accelerated aging. Materials and Methods: Two kinds of silicones were used in this study; one specifically formulated for facial prostheses and the other an acetic silicone for industrial use. Twenty-four trial bodies were made for each silicone. These were divided into colorless and intrinsically pigmented groups: ceramic, make-up, and iron oxide. The groups were submitted to accelerated aging for nonmetallic materials. An initial reading and subsequent readings were made at 163, 351, 692, and 1000 hours using a visual method of comparison. The values were annotated in a spreadsheet by two observers, according to scores elaborated for this study. Results: All groups presented color stability in the visual method. According to the results obtained and analyzed in this study, we can conclude that both silicones, Silastic 732 RTV and Silastic MDX 4-4210, behaved similarly, they can therefore be indicated for use in maxillofacial prosthesis. The time factor of aging influenced negatively, independently of the pigmentation, or lack of it, and of silicones and no group had visually noticeable alterations in any of the accelerated aging time, independently of the addition or not of pigments.

Autologous orbicularis muscle for filling facial foldsan experimental and clinical study

Purpose: To present a technique for filling facial folds by using autologous orbicularis oculi muscle, based on an experimental model. Methods: two studies are presented: (1) an experimental study using 15 albino guinea-pigs from which a strip of the sural triceps muscle was removed and implanted in the subcutaneous tissue of the dorsal area. The animals were sacrificed 7, 30 and 60 days after the implantation, and the material was histologically evaluated. And (2%) an interventional prospective clinical trial carried out on 20 patients referred to blepharoplasty surgery. They received autologous preseptal orbicularis muscle for filling facial folds. The results where evaluated by patients satisfaction and clinical exam. Results: the sural tricep muscle, when implanted in the subcutaneous tissue, resulted in fibrosis. The patients whom received autologous orbicularis muscle implanted for filling facial folds showed that the procedure can be successfully carried out. Conclusions: autologous preseptal orbicularis muscle is a good material for filling facial folds. Cicatricial tissue will be formed on its implantation site, filling the tissue gap that forms the folds on the skin.

Neurorrafia do ramo bucal dorsal do nervo facial em coelhos com proteção de segmento intestinal alógeno

18 rabbits, New Zealand, males, adults were used for clinical and histological evaluation of repair dorsal buccal branch of facial nerve after 15, 30 and 60 days postoperatively (PO). The animals were divided into two groups for transection and 10-0 nylon monofilament epineural suture of buccal branch. In animals in Group I, the nerve was coated with protection of jejunum allograft preserved in glycerin 98% and in group II was applied epineural suture. Both groups occurred the return of movement of the upper lip from the eighth week. There was infiltrated cellular and giant cells with fibrosis unsystematic and collagen fibers of the allograft jejunum joing to the connective tissue. At 15 and 30 days of PO, the distal nerve stumps of both groups were found with degeneration wallerian and in 60 days, regenerated fibers. The repair of the dorsal buccal branch of facial nerve with the allograft wasn't significantly different between the control rabbits as to the assessment of histological and functional recovery.

Color stability after accelerated aging of two silicones, pigmented or not, for use in facial prostheses

One of the greatest challenges faced by buccomaxillofacial prosthetists is to reproduce the patient's exact skin color and provide adequate esthetics. To reach this objective, professionals must use materials with easy characterization and that maintain color over long periods of time. The objective of this study was, thus, to evaluate the color stability of two types of silicones, Silastic 732 and Silastic MDX4-4210. Twenty-four test specimens were made from each type of silicone and were divided into a colorless group and groups intrinsically pigmented with ceramics, cosmetics or iron oxide. The specimens were submitted to an accelerated system of aging for non-metallic materials. Readings were carried out initially and after periods corresponding to 163, 351, 692 and 1,000 hours of aging, using a reflection spectrophotometer analysis, and color alterations were calculated by the CIE L*a*b* system. The data were submitted to variance analysis and Tukey's test at a 5% level of probability. The results demonstrated that, irrespective of the period of time analyzed, all the materials underwent some type of chromatic alteration (ΔE > 0). The test specimens made with Silastic 732 and MDX4-4210, without pigmentation, presented the lowest color alteration values after 1,000 hours of aging. Of the pigments, ceramic presented the lowest color alteration values and cosmetic powder presented the highest values. Thus, it may be concluded that the materials without the incorporation of pigments presented similar color alteration values, and did not differ statistically. The cosmetic powder used in this study was the pigment that most altered the color of the test specimens. © 2009 Sociedade Brasileira de Pesquisa Odontológica.