Chin Area Research Articles

Factors Influencing Bone Resorption after Augmentation Mentoplasty with Implants: A Retrospective Study Using Three-Dimensional Imaging.

Augmentation mentoplasty with implants is an extremely rewarding procedure. Bone resorption is almost unavoidable. The high-risk factors for chin bone resorption have not been explored in the past. This study aimed to analyze and evaluate the factors influencing bone resorption after augmentation mentoplasty with implants using three-dimensional imaging. We retrospectively analyzed preoperative craniofacial Computed Tomography scan data from 105 patients who underwent mandibular implantation surgery and 108 patients who did not. We also examined the extent to which different factors influenced the occurrence of bone resorption in the chin area. Patients with silicone gel implants are more prone to bone resorption than those with Medpor implants. Patients who experienced bone resorption had thicker mentalis muscles than those who did not experience bone resorption (6.35 ± 1.mm vs. 5.73 ± 1.25mm, P < 0.05), and thinner cortical bone (3.25 ± 1.65mm vs. 5.22 ± 2.04 mm, P < 0.05). Additionally, implants placed above the mandibular bone were more likely to induce bone resorption than those placed below it. This study is the first to systematically reveal the impact of implant type, placement position, mentalis muscle thickness, and cortical bone thickness on bone resorption after chin augmentation surgery. For patients with thicker mentalis muscles and thinner cortical bones, greater attention should be paid to the occurrence of bone resorption. Choosing silicone implants or placing the implants higher on the mandible can help reduce the occurrence of bone resorption. This study can assist clinicians in selecting appropriate treatment methods, thereby reducing post-implantation bone resorption. 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.

An Inflammatory Myofibroblastic Tumour Presenting with Limited Mouth-Opening, Hypoesthaesia of The Left Chin and Infraorbital Area, Intermittent Left Eye Ptosis and Converging Strabismus.

An inflammatory myofibroblastic tumour (IMT) is a challenging disease.Given the variable clinical and radiological presentation of the disease, it is of paramount importance to know it, to be swiftly recognised so diagnosis can be promptly made.The adapted treatment should be immediately started to prevent possible life-threatening outcomes.

Rosacea in East Asian populations: Clinical manifestations and pathophysiological perspectives for accurate diagnosis.

Rosacea is a chronic inflammatory disorder primarily affecting the facial skin, prominently involving the cheeks, nose, chin, forehead, and periorbital area. Cutaneous manifestations encompass persistent facial erythema, phymas, papules, pustules, telangiectasia, and flushing. The pathogenesis of rosacea is associated with various exacerbating or triggering factors, including microbial infestation, temperature fluctuations, sunlight exposure, physical exertion, emotional stress, consumption of hot beverages and spicy foods, and exposure to airborne pollen. These environmental factors interact with genetic predispositions in the development of rosacea. The roles of the lipophilic microbiome, ultraviolet radiation, nociceptive responses, and vascular alterations have been proposed as significant factors in the pathogenesis. These insights contribute to understanding the anatomical specificity of facial involvement and the progressive nature of rosacea. East Asian skin, predominantly classified as Fitzpatrick skin phototypes III to IV, is characterized by relatively diminished skin barrier function and increased sensitivity to irritants. Airborne pollen exposure may particularly act as a trigger in East Asian individuals, possibly mediated through toll-like receptors. The lack of specificity in objective clinical and histopathological findings leads to diagnostic challenges for individuals with colored skin, including East Asians, particularly when erythema is the sole objective manifestation. An alternative diagnostic scheme may thus be necessary. A diagnostic approach emphasizing vascular manifestations and nociceptive symptoms potentially holds promise for individuals with darker skin tones. More research focusing on potential variations in skin physiology across different racial groups is essential to establish more effective diagnostic schemes applicable to both dark and light skin colors.

Facial skin rejuvenation with poly-l-lactic acid (PLLA): Four case studies

Background: Facial aging is characterized by the decline and loss of skin structure. Poly-l-lactic acid (PLLA) is a biopolymer and biodegradable injection material that functions as a collagen stimulator. This active ingredient works by stimulating the formation of skin collagen after interacting with the PLLA crystal component. The expected final result is an increase in the skin volume with the thickening and increased density of the skin layers due to collagen remodeling. At present, data on the application of PLLA for facial photorejuvenation remains limited. Case Illustration: Four patients aged 22-49 years old, with different severity of aging, underwent PLLA injection procedures. The active component was administered through injection with a dilution ratio of 1:1 to 1:2 for the cheeks and temporal area and without dilution for the forehead, smile lines, and chin area. After the injection, a gentle massage was performed, and the patient was instructed to self-massage every day. Each patient was evaluated on the twentieth day and underwent additional injection sessions up to two times. Discussion: All patients showed improvement as assessed using photography and the Global Aesthetic Improvement Scale (GAIS) 20 days after the procedure. All patients were satisfied with the final result. There was no significant pain during the procedure. Conclusion: PLLA injection is a safe and effective procedure that stimulates the formation of new collagen adequately. Patient satisfaction with the treatment was excellent, and no complications were observed in all patients.

Satisfaction Level of Patients with the Outcome of Genioplasty.

We aimed to assess the satisfaction level of patients with the outcome of genioplasty and the influential parameters in this respect. This retrospective study was conducted on 70 patients between 18 to 59 years, who underwent genioplasty in the Oral and Maxillofacial Surgery Department at Shariati and Sina Hospitals, Tehran, Iran, between 2010 and 2020. Patient records were evaluated and a questionnaire was filled out over the phone to assess the influential parameters on the satisfaction level of patients with the outcome of genioplasty. Data were analyzed by PASS 11 (alpha=0.1). Seventy patients were evaluated including 56 (80%) females and 14 (20%) males. Forty patients (52.6%) had no complaint with regard to the outcome of genioplasty. Postoperative chin deviation (not correcting the initial complaint) (10.52%), postoperative pain in the chin area (10.52%), and lower lip paresthesia (9.21%) were the most common patient complaints. The minimum and maximum satisfaction scores were 22 and 80, respectively. Number of follow-up sessions had a significant effect on satisfaction with the outcome of genioplasty (P=0.076). Patients who underwent advancement genioplasty alone had the highest level of long-term satisfaction with the outcome while those who underwent setback genioplasty alone had the lowest level of long-term satisfaction. Advancement genioplasty had the highest rate of patient satisfaction, and chin asymmetry in the frontal view was the most common patient complaint after genioplasty.

Exploring facial gestures and visual speech articulation cues during the production of Canadian English voiced stops

Decades of research on visual information for speech has demonstrated the informativeness of visual cues to enhance (Cho et al., 2020; Kawase et al., 2014) and influence (MacDonald and McGurk, 1978) speech perception. However, it is unclear which specific visual cues are spatially and temporally correlated to certain features of speech segments. This study explored visual cues of voicing during the production of Canadian English stops using facial recognition technology (Baltrušaitis et al., 2018) and manual coding (using ELAN 2022). We recorded the audio along with two videos, capturing both front and side views simultaneously, from six native Canadian English speakers. We paid special attention to the throat (larynx), chin, and neck areas which have been understudied by the previous literature. Preliminary data shows expanding movement in the submental triangle and throat during the production of voiced stops compared to voiceless stops. This finding supports tongue body lowering and larynx lowering found in the production of English voiced stops (Westbury, 1983). The comparison between utterance initial stops with post-vocalic stops shows that certain visual cues may be related to phonological voicing categorization irrespective of actual voicing during closure, while others reflect phonetic voicing reality.

Accuracy of artificial intelligence-assisted growth prediction in skeletal Class I preadolescent patients using serial lateral cephalograms for a 2-year growth interval.

To investigate the accuracy of artificial intelligence-assisted growth prediction using a convolutional neural network (CNN) algorithm and longitudinal lateral cephalograms (Lat-cephs). A total of 198 Japanese preadolescent children, who had skeletal Class I malocclusion and whose Lat-cephs were available at age 8 years (T0) and 10 years (T1), were allocated into the training, validation, and test phases (n = 161, n = 17, n = 20). Orthodontists and the CNN model identified 28 hard-tissue landmarks (HTL) and 19 soft-tissue landmarks (STL). The mean prediction error values were defined as 'excellent,' 'very good,' 'good,' 'acceptable,' and 'unsatisfactory' (criteria: 0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm, respectively). The degree of accurate prediction percentage (APP) was defined as 'very high,' 'high,' 'medium,' and 'low' (criteria: 90%, 70%, and 50%, respectively) according to the percentage of subjects that showed the error range within 1.5 mm. All HTLs showed acceptable-to-excellent mean PE values, while the STLs Pog', Gn', and Me' showed unsatisfactory values, and the rest showed good-to-acceptable values. Regarding the degree of APP, HTLs Ba, ramus posterior, Pm, Pog, B-point, Me, and mandibular first molar root apex exhibited low APPs. The STLs labrale superius, lower embrasure, lower lip, point of lower profile, B', Pog,' Gn' and Me' also exhibited low APPs. The remainder of HTLs and STLs showed medium-to-very high APPs. Despite the possibility of using the CNN model to predict growth, further studies are needed to improve the prediction accuracy in HTLs and STLs of the chin area.

Orthodontic Treatment and Mini Wing Osteotomy: A Case Report of Changes in Facial Aesthetic

For correction of dentofacial deformities, orthosurgical treatment is recommended and often involves bi-maxillary orthognathic surgery. The chin area is an important key for a harmonious facial profile and plays an important role. The present case (of a 38- year-old female) describes one successful surgical-orthodontic treatment. The treatment consisted of the use of an Edgewise fixed appliance (0.022”×0.028”), mini Wing osteotomy (mWo), correction of the deviated nasal septum, and rhinoplasty. The treatment resulted in a better facial harmony and aesthetic with greater definition and lengthening of the submental region, adipose tissue elimination, and an upturned nose due to the correction of the deviated nasal septum associated with rhinoplasty. The Class I canine and molar relationship, the upper and lower midlines coincident with the facial midline, and the compensatory projection of the lower incisors were maintained. A satisfactory overbite and overjet, and leveled curve of Spee were obtained. In conclusion, the orthodontic treatment associated with mWo, correction of the deviated nasal septum, and rhinoplasty surgery provided satisfactory functional and aesthetic results.

Coronectomy? A case report following coronectomy of a ‘high-risk’ mandibular third molar

Background The surgical removal of mandibular third molar (M3M) is a common procedure performed by oral and maxillofacial surgeons, oral surgeons, and general dental practitioners. Apart from risks such as pain, swelling, bruising, bleeding, trismus, alveolar osteitis, post-op infection, and damage to adjacent structures which are common to all surgical extractions, M3M removal includes the risk of permanent or temporary damage to the inferior alveolar nerve (IAN) or the lingual nerve. IAN damage can significantly impact the quality of life due to altered sensation of the lip and chin area. As such, the alternative surgical option of coronectomy, which is the sectioning of the crown from the tooth and deliberate retention of the roots, can be offered to high-risk cases to avoid IAN damage. Case presentation 36-year-old female was diagnosed with recurrent pericoronitis of her left M3M. Her left M3M was partially erupted and horizontally impacted with bulbous roots that were in close proximity to the IAN. Due to a higher risk of IAN damage, she underwent a coronectomy procedure of her left M3M instead of a complete removal. She experienced typical post-operative pain and swelling but no other complications such as altered nerve sensation were reported. The surgical site was healed with full mucosal coverage after 12 weeks. Conclusion Coronectomy provides a viable alternative surgical option to removal for mandibular third molars that are at high risk of IAN damage. This is due to the significant reduction of risk of IAN damage and low incidence of failure.

Case Report of Numb Chin Syndrome (NCS) in Sickle Cell Disease (SCD)

Numb chin syndrome is a rare presentation due to injury to mental nerve characterized by numbness, hypoesthesia, and paresthesia. This syndrome is mostly presented with dental interventions, traumatic injuries, or malignant pathologies. We report a unique case of a 20-year-old male diagnosed with sickle cell disease presented with loss of sensation over right chin area secondary to the vaso-occlusive crisis. This case depicts a complex relationship between neurological complications and hemoglobinopathies of SCD.

THU646 Postmenopausal Hyperandrogenism Secondary To Ovarian Leydig Cell Tumor

Abstract Disclosure: J.T. Batch: None. G.Y. Gandhi: None. Introduction: Hirsutism is typically the initial presentation of virilization, including male pattern balding, deepening of the voice, and clitoromegaly. Postmenopausal hyperandrogenism can originate from adrenal or ovarian causes. This report describes marked hirsutism and scalp hair loss in a patient, leading to significant negative psychological and social impacts. Case Report: A 73-year-old female presented to the clinic complaining of scalp hair loss and increased facial hair in the upper lip and chin. She has hypertension (treated with amlodipine, losartan, metoprolol tartrate, and hydrochlorothiazide), dyslipidemia (treated with omega-3 fatty acids), hypothyroidism (treated with levothyroxine), and transvaginal hysterectomy without oophorectomy in 1994 for menorrhagia (no hormonal replacement therapy after surgery). The patient reported regular menstrual periods before the hysterectomy but developed menorrhagia during her early 50s. For the past five years, she noted bitemporal scalp hair loss that progressed significantly and created recession of the hairline and thinning of hair in her crown area. She developed dark pigmented hair on her upper lip and chin area, lower abdomen, and chest. Due to the significant impact of these physical changes, she became socially withdrawn and admitted to only leaving home to attend doctors’ appointments. She denied using supplements or physical contact with anyone using topical testosterone. She denied enlargement of her clitoris. She did note a deepening of her voice, although she is a chronic smoker. A hormonal work-up revealed a significantly high total testosterone of 511 ng/dL (normal range 2-45 ng/dL). DHEA-sulfate was normal at 62 mcg/dL (4-157 mcg/dL), and 17-hydroxyprogesterone was not significantly high at 192 ng/dL. MRI abdominal and pelvis with and without contrast revealed a 1.8 cm avidly enhancing left ovarian nodule. The patient underwent bilateral salpingo-oophorectomy. Pathology showed tumor cells with eosinophilic cytoplasm, central nucleus, and prominent nucleolus, consistent with a Leydig cell tumor measuring 1 cm and was confined to the left ovary. Four weeks after surgery, a repeat hormonal work-up revealed a normal total testosterone level of 23 ng/dL (normal range 2-45 ng/dL). Discussion: Hyperandrogenism with rapidly progressing hirsutism indicates a tumoral etiology. Leydig cell ovarian tumors are uncommon neoplasms arising from the gonadal stroma, accounting for &amp;lt;0.1% of all primary ovarian tumors. The diagnosis is based mainly on clinical and laboratory data since imaging studies may not show the small androgen-producing lesion. Bilateral oophorectomy should be recommended in postmenopausal women when an ovarian source is suspected. Most ovarian virilizing tumors are benign, and bilateral salpingo-oophorectomy results in a cure. Presentation: Thursday, June 15, 2023

Artificial intelligence for treatment planning and soft tissue outcome prediction of orthognathic treatment: A systematic review.

The accuracy of artificial intelligence (AI) in treatment planning and outcome prediction in orthognathic treatment (OGT) has not been systematically reviewed. To determine the accuracy of AI in treatment planning and soft tissue outcome prediction in OGT. Systematic review. Unrestricted search of indexed databases and reference lists of included studies. Clinical studies that addressed the focused question 'Is AI useful for treatment planning and soft tissue outcome prediction in OGT?' were included. Study screening, selection and data extraction were performed independently by two authors. The risk of bias (RoB) was assessed using the Cochrane Collaboration's RoB and ROBINS-I tools for randomised and non-randomised clinical studies, respectively. Eight clinical studies (seven retrospective cohort studies and one randomised controlled study) were included. Four studies assessed the role of AI for treatment decision making; and four studies assessed the accuracy of AI in soft tissue outcome prediction after OGT. In four studies, the level of agreement between AI and non-AI decision making was found to be clinically acceptable (at least 90%). In four studies, it was shown that AI can be used for soft tissue outcome prediction after OGT; however, predictions were not clinically acceptable for the lip and chin areas. All studies had a low to moderate RoB. Due to high methodological inconsistencies among the included studies, it was not possible to conduct a meta-analysis and reporting biases assessment. AI can be a useful aid to traditional treatment planning by facilitating clinical treatment decision making and providing a visualisation tool for soft tissue outcome prediction in OGT. PROSPERO CRD42022366864.

Dosimetric investigation of radiation-induced trigeminal nerve toxicity in parotid tumor patients.

We aimed to describe the association between trigeminal nerve (TN) dose and toxicity and determine a threshold value that leads to TN toxicity in patients with parotid tumors treated with adjuvant conventional fractionated radiation therapy. Eighteen patients who underwent adjuvant radiotherapy (RT) between 2013 and 2018 were included in this retrospective study. TN and its branches were outlined subsequently on the planning CT scans. The doses received by TN were obtained based on the dose-volume histogram. The dose and toxicity relationship was investigated over the total prescribed dose. RT-related toxicity was graded according to Common Terminology Criteria for Adverse Events V4.0 (CTCAEv4.0). The median follow-up was 29.5 months. After RT, 61% of patients had Grade I-II late TN toxicity divided into Grade I in 4 (22%) and Grade II in 7 (39%) patients. TN injury symptoms were as follows: loss of sensation in the chin area in 3, difficulty in jaw movements in 3, and paresthesia in 5 patients. The total RT dose (p = 0.001), Dmax (p = 0.001), PTV-TN Dmax (p = 0.001), D1cc (p = 0.004), D0.5cc (p = 0.001), and D0.1cc (p = 0.01) had a significant effect on TN toxicity. Cut-off values leading to toxicity were determined as 66, 65.5, 65.25, 63.6, and 62.7 Gy for Dmax, PTV-TN Dmax, D0.1cc, D 0.5cc, and D1cc, respectively. Radiation-induced TN injury in head and neck cancer patients may further be investigated in clinically prospective trials by virtue of high toxicity rates with current RT doses in our retrospectively designed dosimetric study in parotid tumors.

Dose delivery reproducibility for PBS proton treatment of breast cancer patients with and without mask immobilization

BackgroundSetup reproducibility of the tissue in the proton beam path is critical in maintaining the planned clinical target volume (CTV) dose coverage and sparing the organs at risk (OAR). In this study, we retrospectively evaluated radiation therapy dose reproducibility for proton pencil beam scanning (PBS) treatment of breast cancer patients with and without mask immobilization.MethodsNinety-four patients treated between January 2019 and September 2022 with at least one verification CT scan (V-CT) in treatment position were included for this study. All patients were set up with arms up using the Orfit AIO patient positioning system, with (69 patients) or without (25 patients) mask immobilization in chin, neck, shoulder, upper arm, and chest areas. Two to three enface or near enface single field uniform dose PBS beams were optimized using a commercial treatment planning system. Prescription doses were 25 to 60 GyRBE in 5 to 45 fractions. Treatment plan doses re-calculated on V-CTs were compared to the corresponding planned doses. Cumulative doses were also calculated for patients with at least 3 V-CTs by deform and weighted sum doses from V-CTs to corresponding P-CTs. CTV D95%, ipsilateral-lung V40%, esophagus D0.01cc, and heart mean dose were evaluated and reported as percentages of prescription doses. Differences were large dose deteriorations (LDD) if: (1) CTV (V-CT/cumulative D95%) – (Planned D95%) < − 5%; or (2) Ipsilateral-lung (V-CT/cumulative V40%) – (Planned V40%) > 5%; or (3) Esophagus (V-CT/cumulative D0.01cc) – (Planned D0.01cc) > 10%; or (4) Heart (V-CT/cumulative mean) – (Planned mean) > 1.5%.ResultsOn average, V-CT/cumulative and planned CTV/OAR dose parameter differences were less than 2.2%/1.7% and 3.4%/3.7% for masked and maskless patients, respectively. The percentages of patients with at least one CTV or OAR V-CT/cumulative dose LDD were 20.3%/25.0% and 72.0%/54.0% for masked and maskless patients, respectively.ConclusionsOn average, masked/maskless setups achieved delivered and planned CTV/OAR dose parameters agreed within 2.2%/3.7% for PBS treatment of breast cancer patients in this study. Maskless patients had higher rate of CTV/OAR LDDs compared to masked patients. Dosimetric differences large enough to raise clinical concerns in either group were able to be addressed with replannings.

Neurolymphomatosis in Non-Hodgkin's Lymphoma

non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of hematopoietic puffins, with diphun B-velicocyclotinous lymphoma accounting for 25% of all NHLs and having the greatest midline to axis growth (Leeuwenуе et al., 2014). Of all NHLs, the central and peripheral nervous systems are most often affected in diphytic B-lycocytic lymphoma (Padala, &amp; Kallam, 2022. Liu, &amp; Barta, 2019). In NHL, infiltration of cranial and peripheral nerves can be detected - neurolymphomatosis (NL) emerges. NL is a very rare condition and occurs in about 0.2% of patients with NHL (Baehring, Damek, Martin, Betensky &amp; Hochberg, 2003). These infiltrations can manifest with detection of mononeuropathy, multiple neuropathy, symmetric neuropathy or plexopathy (Grisold W., Grisold A., Marosi, Meng, &amp; Briani, 2015). The aim of the work was to study the features of the clinical course, diagnosis and treatment of neurolymphomatosis in the form of lesions of the trigeminal, facial cranial nerve and the left ulnar nerve in diffuse B-bollichelial non-Hodgkin lymphoma based on a clinical case. We present a review of a clinical case of peripheral nervous system involvement in a patient born in 1977 with diffuse B-cell non-Hodgkin's lymphoma. The diagnosis was established on the basis of clinical manifestations of lesions of the branches of the trigeminal and left facial nerves, the left ulnar nerve, magnetic resonance imaging of the head and brain, electroneuromyography, and immunohistochemical examination of the infiltrate biopsy from the affected buccal branch of the left facial nerve. In March 2022, the patient developed moderate peripheral paresis of the mimic muscles on the left side, burning pain with impaired tactile and pain sensitivity of the dorsum, wing of the nose, and left instep. A week later there was a decrease in the strength, tactile and pain sensitivity, and patience of the fourth and fifth fingers of the left hand. Within a month, the burning pain had spread to the left cheek, periorbital, and chin areas of the face. In 2021, the patient was diagnosed with B-bollichelial non-Hodgkin's lymphoma with involvement of the right axillary, supraclavicular lymph nodes, left breast, followed by chemotherapy and clinical remission. Magnetic resonance imaging of the head revealed a perineural lesion of the third branch of the right trigeminal nerve, the second branch of the left trigeminal nerve, and the cheek branch of the left facial nerve. Electroneuromyography revealed an axonal lesion of the left ulnar nerve. The results of examination of the infiltrate biopsy from the affected buccal branch of the facial nerve specimens confirmed non-Hodgkin's diffuse B-cell lymphoma, GCB-phenotype and nerve damage due to NHL. Treatment of multiple neuropathy with glucocorticosteroids, nonsteroidal anti-inflammatory drugs, acelicholinesterase inhibitors, and specific chemotherapy resulted in limited therapeutic effect. Prescribing pregabalin resulted in decreased reduction of neuropathic facial pain. Thus, neurolymphomatosis is a rather rare manifestation of non-Hodgkin's lymphomas, the use of magnetic resonance imaging of the head and brain as well as immunohistochemical examination of the affected nerve infiltrate biopsy is important to confirm the diagnosis.&#x0D; In the Ukrainian scientific medical literature, there are few descriptions of cases of neurolymphomatosis in NHL, although they occur in patients, and it is necessary to describe in more detail the peculiarities of the collicular course of the diagenesis and treatment in these cases.

Safety and aesthetic outcomes of using fillers with different cross-linking agents. A case report.

Of the several dermal fillers developed in recent decades, hyaluronic acid fillers have become the material of choice. They are safe, long-lasting, non-immunogenic, available to most patients, and can be removed with hyaluronidase. Unfortunately, early and delayed complications can also occur after HA filler injection. Below, we present the case of a 42-year-old patient who had complications after the aesthetic procedure using hyaluronic acid dermal fillers in the past. Surprisingly, the treatment performed with hyaluronic acid cross-linked with another cross-linking agent was without complications. The affected places were the chin and malar area. In 2021, after performing augmentation with hyaluronic acid in the chin area, a patient developed swelling, which subsided after using hyaluronidase (Hylase Dessau 300 I.E.) and corticosteroids. The patient repeated the procedure in 2022, where she was administered 2 ml of hyaluronic acid in July 2022. About 3 weeks after injection, oedema and nodules appeared at the injection site in the zygomatic/malar area; after using Prednisone, the changes subsided. In September 2022, 3 ml of PEG-cross-linked hyaluronic acid was successfully performed with no side effects. In the described case, an important role was played by the ability of the hyaluronic acid hydrogel to modulate human immunological functions, which was associated with a very low risk of immune-related side effects and accompanying cellulitic processes.

Zihinsel engelli bireylerde Demodex akar (Acari: Demodecidae) prevalansı ve yoğunluğu

This study was conducted to determine the prevalence and intensity of D. folliculorum and D. brevis in mentally disabled individuals receiving care and support services in rehabilitation centers in Erzincan province. The study included 217 mentally disabled participants who were receiving care and support services in 7 separate rehabilitation centers operating in the provincial center of Erzincan. Sample materials were taken from the cheek, nasolabial and chin area of each participant by Standard Superficial Skin Biopsy (SSSB) method and examined for the presence and number of Demodex mites under a light microscope. In the study, D. folliculorum (mean 8.34/cm2) was detected in 58% of mentally disabled people, D. brevis (mean 1.26/cm2) in 25%, and Demodex mites (mean 9.59/cm2) was detected in 61% of the all participants. When the participants were evaluated in terms of Demodex prevalence, it was determined that D. folliculorum was approximately 2.3 times more common than D. brevis. Similarly, when evaluated in terms of the average number of mites per cm2, it was found that D. folliculorum was about 7 times denser than D. brevis. On the other hand, it was determined that the prevalence of Demodex mites increased as the severity of intellectual disabilities increased, while it was found that the intensity of Demodex was highest in participants with moderate mentally disabled. As a result, it was found that D. folliculorum and D. brevis were widespread and intense in both healthy individuals and mentally disabled individuals, as well as in many patient groups. It was thought that the findings obtained in our study might be useful to consider mentally disabled individuals with dermatological complaints during the clinical evaluation process.

The effect of cosmetics on the skin of the face

Couperosis is a skin condition in which there is a disorder of the skin covering the face with a network of dilated capillaries; it is usually an inherited skin condition. The development of couperosis is influenced by the weakening of capillaries, chronic diseases that predispose to blood circulation disorders.&#x0D; Aim of the study. To assess the effect of cosmetic products on couperose facial skin.&#x0D; Methods. Mixed method research. In 2023, one 58-year-old subject was used for this study, meeting the criteria required for the study: age, with a couperose skin condition, job specifics that would allow not to wear heavy make-up every day, to be in the sun for a long time, not to have allergic reactions to the components of the used products. The following were used for the study: a skin diagnostic device, a customer card, a course of ten procedures with the active substance, repeated weekly.&#x0D; Results. Mixed skin type, deformational aging. Couperosis can be seen on the cheeks, in the wings of the nose, there are telangiectasias in the area of the wings of the nose, on the left cheek of the eye. The skin is dehydrated, sebum secretion is increased in the forehead, nose and chin area. During the procedures, multi-component X active substances are used to reduce the effect of couperose on the skin, moisturize, stimulate skin regeneration, collagen and elastin synthesis, shrink capillaries and strengthen the hydrolipidic barrier.&#x0D; Conclusions. 1. Damaged facial skin is caused by an improper use of cosmetic products and exposure to the external risk factors. 2. The multicomponent, acid-based active substances used to restore the hydrolipidic barrier and improve the condition of couperose skin strengthened capillaries, improved skin metabolism, accelerated cell regeneration, and reduced the harmful effects of couperose on the skin.

Reliable Reference Areas for 3D Smiling Facial Model Alignment: Posed vs Natural Smile Expressions.

To evaluate the reliability of various reference areas for digital alignment between 3D resting and smiling facial models. 3D posed and natural smiling faces of 33 adults were registered to the respective neutral faces, using six matching strategies with different reference matching surfaces: nose (N), nose &#43; central forehead (NFc), nose &#43; whole forehead (NFw), nose &#43; chin (NC), nose &#43; central forehead &#43; chin (NFcC), and nose &#43; whole forehead &#43; chin (NFwC). The positional discrepancies of the registered images were measured at the left and right pupil centers. Two-way ANOVA and post hoc multiple pairwise t test with Bonferroni correction (α &#61; .05) were used to evaluate the measurements. As a result, the use of larger reference areas increases the trueness of image-matching, whereas there was no statistically significant difference between the matching strategies within the same smiling type. Meanwhile, the image registration of posed smiles resulted in fewer positional disparities than the natural smiles with significant differences observed for the registration using the NC and NFcC surface-based matching areas at the right pupil (P &#61; .030 and .026, respectively). The findings of this study suggest that the reference surface areas and smiling types have some impact on the accuracy of 3D smiling facial image alignments. Large and evenly distributed matching surfaces are recommended for posed smiles, whereas caution should be taken when using the chin area as a reference surface for matching natural smile facial images.

FREQUENCY OF PARESTHESIA DUE TO INFERIOR ALVEOLAR NERVE DAMAGE AFTER EXTRACTION OF MANDIBULAR THIRD MOLAR AMONG PATIENTS SHOWING DARKENING OF ROOT IN ORTHOPANTOMOGRAM

Background: Paresthesia is an abnormal dermal sensation with no apparent physical cause. One of the everyday practices in any oral surgery setup is the extraction of the impacted mandibular third molars surgically. Precise measurement of the bone present for support of the implant coronal to the inferior alveolar nerve (IAN) canal is the pertinent way to prevent IAN injuries.&#x0D; Objective: To assess the frequency of paresthesia due to IAN damage after mandibular third molar’s surgical extraction in patients with darkening of root on orthopantomogram.&#x0D; Material &amp; Methods: It was a descriptive case series study which took place in the department of Oral and Maxillofacial Surgery at Sharif Medical and Dental College, Lahore in a time frame of 6 months i.e. from December 2020 till May 2021. After meeting the inclusion/exclusion criteria, 200 patients were made part of the study program. Informed consent and demographic information was recorded. Surgical procedure of all these patients was done. Assessment was done post-operatively first after one week when patient came for suture removal by inquiring about the subjective perception of abnormal feeling or sensation on lower lip and chin area. Patients were then reappointed for a follow-up visit after 1 month as well.&#x0D; Results: Patients’ mean age was 28.05±3.94 years. There were 104 (52%) males and 96 (48%) females in the study population. There were 38 (19%) patients of distoangular impaction, 39 (19.5%) had horizontal impaction, 55 (27.5%) had mesioangular impaction while 68 (34%) had vertical impaction. The IAN paresthesia after 1st month of surgery was found in 13 (6.5%) patients.&#x0D; Conclusion: According to this study, the frequency of paresthesia after 1st month of surgery was 6.5% due to IAN injury after mandibular third molar surgery in patients with darkening of root as observed on orthopantomogram.&#x0D; Keywords: Inferior Alveolar Nerve, Orthopantomogram, Paresthesia, Third Molar Surgery.