Facial Reanimation Utilizing Combined Orthodromic Temporalis Muscle Flap and End-to-Side Cross-Face Nerve Grafts

Individuals with facial paralysis of 6 months or more without evidence of clinical or electromyographic improvement have been successfully reanimated utilizing an orthodromic temporalis transfer in conjunction with end-to-side cross-face nerve grafts. The temporalis muscle insertion is released from the coronoid process of the mandible and sutured to a fascia lata graft that is secured distally to the commissure and paralyzed hemilip. The orthodromic transfer of the temporalis muscle overcomes the concave temporal deformity and zygomatic fullness produced by the turning down of the central third of the muscle (Gillies procedure) while yielding stronger muscle contraction and a more symmetric smile. The muscle flap is combined with cross-face sural nerve grafts utilizing end-to-side neurorrhaphies to import myelinated motor fibers to the paralyzed muscles of facial expression in the midface and perioral region. Cross-face nerve grafting provides the potential for true spontaneous facial motion. We feel that the synergy created by the combination of techniques can perhaps produce a more symmetrical and synchronized smile than either procedure in isolation.Nineteen patients underwent an orthodromic temporalis muscle flap in conjunction with cross-face (buccal-buccal with end-to-side neurorrhaphy) nerve grafts. To evaluate the symmetry of the smile, we measured the length of the two hemilips (normal and affected) using the CorelDRAW X3 software. Measurements were obtained in the pre- and postoperative period and compared for symmetry.There was significant improvement in smile symmetry in 89.5 % of patients.Orthodromic temporalis muscle transfer in conjunction with cross face nerve grafts creates a synergistic effect frequently producing an aesthetic, symmetric smile.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 at www.spinger.com/00266.

Avaliação temporal e espacial do balanço de radiação, de energia e da evapotranspiraçâo no noroeste paulista, face a mudança no uso do solo

Pós-graduação em Agronomia - FEIS

Sexualidade e infância: contribuições da educação sexual em face da erotização da criança em veículos midiáticos

This article proposes to show the contributions of the sex education in the school as a way to mitigate the effects of the media, which sometimes leads to early sexualisation of children. Bibliographical in nature, it points out some aspects of sexuality in childhood, and reveals the issues brought by the media, particularly for the formation of the child, when addressing sexual issues, highlighting the role of sex education for a more reflective thinking about this theme.

Estudo cefalométrico comparativo dos traçados predictivos e resultados ortodôntico-cirúrgicos em pacientes com face longa

The purpose of this research was to compare, by cephalometric analysis (McNamara and Legan & Burstone) the predictive tracings (by methods manual, and by softwares Dentofacial Planner Plus and Dolphin Image) with the post surgical results. Were selected the pre and post surgical lateral telerradiograph (six months after orthognatic surgery) of the 25 long face patients treated with combined orthognatic surgery. Were made the prediction tracings for each method and comparing cephalometrically with the post surgical results. This protocol was repeated once more for the error method evaluation, and the statistical was made by variance analysis and Tuckey overtest. The results show more frequency of the cephalometric values' aproximation of the post surgical results when the manual method (50% of the similarity with the post surgical result), followed of the DFPlus (31,2%) and Dolphin (18,8%) softwares. The experimental condition permits to conclude that the manual method had more precision, although the previsibility of the digital methods was reasonable satisfactory.

Estudo comparativo entre traçados cefalométricos predictivo e pós operatório imediato de pacientes que foram submetidos à cirurgia ortognática para correção da síndrome da face longa

The aim of this research was to verify the accuracy of the prediction trace. Records in 15 patients admitted for orthognathic surgical treatment were analysed. Predictive and postoperative positíons of maxilla were compared with linear measurements. Statistically significant difference between predicted and postoperative position were demonstrated, but the prediction trace revealed to be very useful to help in decision of direction of movements, easy to do at low cost

Relationship between the morphology of the maxillary central incisor and horizontal and vertical measurements of the face

Purpose: In order to assist in the selection of artificial teeth for complete dentures, this study aimed to assess the relationship between horizontal and vertical measurements of the face and the morphology of the maxillary central incisor. Materials and Methods: This was a study of 50 plaster casts and 100 teleradiographs - 50 in lateral norm and 50 in frontal norm, belonging to 50 individuals, Caucasian, with a naturally optimal occlusion, matching at least four of the six keys of Andrews. Images of the upper central incisors were obtained by scanning the plaster casts (three-dimensional) and subjectively classified by three examiners as oval, triangular or quadrangular. Facial measures (vertical and horizontal) were defined by means of teleradiographs. In order to check inter-examiner agreement on the classification of central incisor, the Kappa test was used. To verify whether data had normal distribution, the Kolmogorov-Smirnov test was used ( P > 0.2) was used. One-way analysis of variance was employed to assess the association between variables (P > 0.05). Results: When vertical measurements were compared with the three incisor shapes, there was no statistically significant difference (P > 0.05): Triangular (0.54), oval (0.63) and quadrangular (0.51). Similarly, no difference (P > 0.05) was found for facial width (139.08, 143.37, 141.65), maxillary width (76.68, 78.99, 76.91) and mandibular width (103.47, 105.50, 103.11). Conclusions: The majority of cases showed that horizontal and vertical measurements of the face cannot be used as a reference for determining the morphology of the maxillary central incisor crown. It is relevant to analyze and compare other morphological structures to improve the oral health-related quality of life for the conventional denture wearer.

Face paulista da TV digital: reflexão sobre a multiprogramação na TV cultura

The implantation procedure of the multiprogramming for TV Cultura, a station under the responsibility of the Fundação Padre Anchieta,from the regulation of digital television in Brazil, through the Sistema Brasileiro de Televisão Digital Terrestre (SBTVD-T), involves the creation and implantation of multiprogramming channels of the station, the Univesp TV and the Multicultura channels, which are functioning through means of a special authorization in scientific and experimental character. Analyzed from the Communication Politics Economy point of view, this research contributes to the reflexion about the multiprogramming which may create alternatives to new options in this country programming and content.

Ultra-precision face grinding with constant pressure, lapping kinematics, and SiC grinding wheels dressed with overlap factor

Several machining processes have been created and improved in order to achieve the best results ever accomplished in hard and difficult to machine materials. Some of these abrasive manufacturing processes emerging on the science frontier can be defined as ultra-precision grinding. For finishing flat surfaces, researchers have been putting together the main advantages of traditional abrasive processes such as face grinding with constant pressure, fixed abrasives for two-body removal mechanism, total contact of the part with the tool, and lapping kinematics as well as some specific operations to keep grinding wheel sharpness and form. In the present work, both U d-lap grinding process and its machine tool were studied aiming nanometric finishing on flat metallic surfaces. Such hypothesis was investigated on AISI 420 stainless steel workpieces U d-lap ground with different values of overlap factor on dressing (Ud=1, 3, and 5) and grit sizes of conventional grinding wheels (silicon carbide (SiC)=#800, #600, and #300) applying a new machine tool especially designed and built for such finishing. The best results, obtained after 10 min of machining, were average surface roughness (Ra) of 1.92 nm, 1.19-μm flatness deviation of 25.4-mm-diameter workpieces, and mirrored surface finishing. Given the surface quality achieved, the U d-lap grinding process can be included among the ultra-precision abrasive processes and, depending on the application, the chaining steps of grinding, lapping, and polishing can be replaced by the proposed abrasive process.

A face neodesenvolvimentista do Estado brasileiro: o falseamento da "questão social"

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prevalence of long face pattern in brazilian individuals of different ethnic backgrounds

Conclusions: Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively.

Tratamento de sequelas de queimadura de face com laser de CO2 fracionado em pacientes com fototipos III a VI

INTRODUÇÃO: Relatos sobre melhora em cicatrizes pós-traumáticas ou patológicas com o uso do laser de CO2 fracionado (CO2F) concluem tratar-se de tecnologia segura e efetiva, apesar de utilizado apenas em pacientes com fototipos II a III. O objetivo deste estudo foi avaliar a eficácia do CO2F em pacientes com sequela de queimadura facial com fototipos III a VI. MÉTODO: No total, 14 pacientes, com média de idade de 29 anos, portadores de sequela de queimadura facial e fototipos III a VI, foram submetidos a uma aplicação do laser de CO2F. Após dois meses, a queimadura foi avaliada por meio de escala com 6 parâmetros: cor, textura, hidratação, irregularidades de superfície, volume e distensibilidade. RESULTADOS: A duração média da dor foi de 19 horas; do edema, 1,3 dia; e da hiperemia, 6,5 dias. A queda das crostas finalizou entre 5 dias e 36 dias, com média de 13,4 dias. Dois meses após a sessão, 5 pacientes evoluíram com hipocromia puntiforme no padrão quadriculado correspondente aos pontos de ablação do laser. A satisfação subjetiva dos avaliadores (pacientes e médicos) com o tratamento foi de 84,6%. Para os pacientes, houve melhora das irregularidades de superfície, da distensibilidade e da textura da pele (57% dos casos), da hidratação (43%), do volume (28%) e da cor (14%). Para os médicos, houve melhora das irregularidades de superfície e da distensibilidade (43%). CONCLUSÕES: O tratamento com laser de CO2F com parâmetros suaves foi bem tolerado e apresentou alto índice de satisfação em pacientes com sequela de queimadura facial, com melhora de textura, distensibilidade e irregularidades de superfície. A alta incidência de hipopigmentação é um fator a ser considerado na indicação do laser de CO2F em pacientes com fototipos IV a VI.