Esthetic Profile Research Articles

Evaluation of the effect of different amounts of movement on profile aesthetics in orthognathic surgery patients

Evaluation of the effect of different amounts of movement on profile aesthetics in orthognathic surgery patients

Perception and appreciation of tactile objects: The role of visual experience and texture parameters (JPI-first)

This exploratory study was designed to examine the effects of visual experience and specific texture parameters on both discriminative and aesthetic aspects of tactile perception. To this end, the authors conducted two experiments using a novel behavioral (ranking) approach in blind and (blindfolded) sighted individuals. Groups of congenitally blind, late blind, and (blindfolded) sighted participants made relative stimulus preference, aesthetic appreciation, and smoothness or softness judgment of two-dimensional (2D) or three-dimensional (3D) tactile surfaces through active touch. In both experiments, the aesthetic judgment was assessed on three affective dimensions, Relaxation, Hedonics, and Arousal, hypothesized to underlie visual aesthetics in a prior study. Results demonstrated that none of these behavioral judgments significantly varied as a function of visual experience in either experiment. However, irrespective of visual experience, significant differences were identified in all these behavioral judgments across the physical levels of smoothness or softness. In general, 2D smoothness or 3D softness discrimination was proportional to the level of physical smoothness or softness. Second, the smoother or softer tactile stimuli were preferred over the rougher or harder tactile stimuli. Third, the 3D affective structure of visual aesthetics appeared to be amodal and applicable to tactile aesthetics. However, analysis of the aesthetic profile across the affective dimensions revealed some striking differences between the forms of appreciation of smoothness and softness, uncovering unanticipated substructures in the nascent field of tactile aesthetics. While the physically softer 3D stimuli received higher ranks on all three affective dimensions, the physically smoother 2D stimuli received higher ranks on the Relaxation and Hedonics but lower ranks on the Arousal dimension. Moreover, the Relaxation and Hedonics ranks accurately overlapped with one another across all the physical levels of softness/hardness, but not across the physical levels of smoothness/roughness. These findings suggest that physical texture parameters not only affect basic tactile discrimination but differentially mediate tactile preferences, and aesthetic appreciation. The theoretical and practical implications of these novel findings are discussed.

Definitive Impression Technique for Maxillary Defects in Patients with Reduced Mouth Opening- A Novel Approach

Palatal defects are categorised as a multicausal pathology, with its aetiology ranging from trauma and microbial infections to oncogenic origin. This by and large leads to surgical defects of the palatal tissues which warrants immediate treatment. Due to this, the patient faces a plethora of challenges, namely psychological, functional and social. These defects can be catered to by means of surgical closure or prosthetic therapy. Thereby, this uplifts the patient’s self-confidence and performance of day-to-day activities. However, surgical closure by free flaps is not feasible in all cases due to the dearth of favourable tissues or prevalent co-morbid conditions. So, this makes fabrication of a palatal obturator the treatment of choice to rehabilitate these cases. An obturator is a maxillofacial prosthesis which blocks the oro-nasal communication and thus ameliorates the mastication, phonation and aesthetic profile of the affected subject. For fabricating well-fitting obturator prosthesis, making an accurate impression with appropriate spatial orientation of the orofacial structures is imperative. Many obstacles come in the way of a prosthodontist while making impression in such cases due to the complexity of the supporting stomatognathic system in terms of compressibility and multitude of geometric planes of the tissues. These patients present with restricted mouth opening due to scarring of tissues or radiation therapy. In this article, the authors describes a technique which predominantly addresses most of the problems related to the impression making procedures in patients treated with maxillectomy experiencing limited mouth opening.

Protocol for Establishing the Norms of Total Tooth Material for Central Indian Population

Background: Appealing profile is dependent on constructive interrelation of craniofacial structure so as to establish systemic equilibrium . An esthetic profile may also be associated with single tooth or inter-arch malocclusion. To correct these malocclusions, the corresponding link of tooth material of upper and lower arch is the prerequisite to achieve functional stability of occlusion, structural balance and esthetic harmony.
 Objectives: To determine tooth size ratios for maxillary and mandibular dentition in Central Indian population.
 Methodology: The study sample comprised of 500 subjects (250 males and 250 females) aged between 12-20 years with all permanent first molar erupted will be obtained from the department. The mesio–distal width of all teeth anterior to first molar of maxillary and mandibular teeth from right to left side will be calculated
 Expected Results: Proof of sexual dimorphism was seen among Indian male subjects have greater mean values as compared to females. Statistically considerable differences were establish between Indian samples and Bolton Caucasian standards.
 Conclusion: The research presents, evidence that size of teeth are population specific. Mean values specific to peculiar population samples should be obtained in order to make treatment regime more precise as well as predictable.

What Is the Perception of an Esthetic Lower Facial Third Profile in the Korean Layperson Population?

The purpose of this study is to investigate whether there were differences in perception of facial profile esthetics at the upper lip, gnathic, and genial levels according to observer gender and age in the Korean layperson population. Ten male (M1 to M10) and 10 female (F1 to F10) silhouettes with differing facial profiles at the level of the upper lip, mandibular, and chin were created from a male and female facial profile deemed well-balanced and orthognathic by reviewer consensus. These silhouettes were presented to 288 participants who were asked to rank the 5 most attractive male and female profiles. The participants were composed of 144 males and 144 females divided into 4 age groups: group I (under 20years), group II (20 to 39years), group III (40 to 59years), and group IV (over 60years). The most preferred profile and observer scores were investigated and calculated. Descriptive analysis, χ2 test, and analysis of variance were used for statistical analysis according to age and gender. The most preferred male and female silhouettes were orthognathic profiles. There was no significant difference according to gender when rating male (P=.281) and female (P=.442) silhouettes. No statistically significant difference was observed even when analyzed according to age groups. Although the difference in observer scores among each ranking showed a statistical difference according to age groups, the overall rankings showed a similar pattern both in male and female silhouettes. In the same age group, no difference in rank scores according to gender was observed. Severe concave profiles were found to have the lowest rank. An orthognathic profile was rated as the most desirable in the Korean layperson population, with few differences in perception of esthetic facial profile according to age and gender.

A multidisciplinary approach to the comprehensive treatment of edentulous patients with perioral wrinkles of the skin

Objectives: The purpose of this study was to comparative analysis of effectiveness of isolated use of intradermal injections of modified hyaluronic acid (Hyalorepair 04) and its combination with platelet-rich autologous plasma in edentulous patients with perioral wrinkles of the skin. Materials and Methods: A total of 56 patient’s presence of perioral wrinkles of the skin participate in the study after dental implant prosthodontics rehabilitations. They were randomly divided into 2 groups in accordance with the applied therapy method (29 isolated implementation of modified hyaluronic acid bio-repairing and 27 bio-repairing combined with autologic plasmotherapy). Treatment included implant-prosthetic rehabilitation followed by hyaluronic acid injections in order to correct cheek-zygomatic sulcus, nasolabial folds and marionette wrinkles. Preparations in an amount from 1 to 4 ml were injected into the face area, depending on the zones to be corrected at the request of the patients. Results: The complex treatment restored the aesthetic profile of the face and oral cavity and increased the effectiveness of the chewing function. On M03 and M05, 2/3 of patients had significant improvement as assessed by physician and patient according to GAIS. Most of the patients also showed significant improvement at visit M12. Conclusion: A multidisciplinary approach to the treatment of edentulous patients with perioral wrinkles increases the functional and aesthetic effect of the treatment. Implementation of combined of bioreparation and autologous plasmotherapy is significantly more effective comparatively to the isolated implementation of modified hyaluronic acid. Keywords: Facial Esthetic; Implant-Prosthetic Rehabilitation; Hyaluronic Acid

Do simultaneous mandibular advancement and temporomandibular joint prosthesis impact the upper airway in TMJ ankylosis patients?

BackgroundAnkylosis of the temporomandibular joint (TMJ) is a pathological disorder which results in patients’ limited or even complete failure of mouth opening. When TMJ ankylosis occurs during the growing age, moderate to severe micrognathia might be the proposed scenario of such cases, accompanied by obstructive sleep apnea and hypopnea syndrome (OSAHS). TMJ reconstruction using total TMJ prostheses with mandibular advancement (MA) can simultaneously improve the function and aesthetic profile of such patients. The purpose of this study was to determine whether the upper airway can be improved after TMJ reconstruction with total TMJ prostheses combined with or without MA in TMJ ankylosis patients.MethodsFourteen patients with pre-(T1) and post-(T2) operative CT scans were included. Patients were divided into two groups according to the operation with or without MA (MA/WoMA). The changes of the upper airway and jaw bones were comparatively analyzed within and between the two groups.ResultsIn MA Group, the volume of the total upper airway (Vt) and palatopharynx (V1), together with the surface area (SA) of the total upper airway (SAt) and palatopharynx (SA1) increased significantly after the operation by 41.4%, 43.2%, 36.3% and 36.6%, respectively. In WoMA Group, V1, SAt and SA1 increased significantly by 21.0%, 19.0% and 23.1% following surgery. The changes of Point B (P<0.01), Y-axis angle (P<0.01), SNB (P<0.01), and ANB (P<0.01) were significantly greater in MA Group than in WoMA Group. Comparing both groups, the maxilla, and mandible were more backward in MA Group than in WoMA group before the operation, but there was no significant difference of the final position of the maxilla and mandible after the operation between both groups.ConclusionsRelease of TMJ ankylosis and condylar reconstruction using total joint prostheses simultaneously with MA could significantly improve the total volume and other various parameters of the upper airway, while, only the dimension of the palatopharynx increased in cases without MA.

Determinants of Upper Lip Form: An Analysis Using Geometric Morphometrics

Orthodontics and orthognathic surgery can alter an individual's facial form, and it is the clinician's goal to predictably control changes in the facial soft tissues to achieve treatment goals. Within the facial profile, controlling projection of certain structures, such as the chin, is predictable, as the soft-tissue response to hard-tissue changes in such areas is predictable. The upper lip, on the other hand, presents a different challenge. While multiple studies have shown relationships between advancement of the upper incisor and advancement of the soft-tissue lip, unlike the chin, the anterior position of the upper lip is only a small component of upper-lip profile esthetics. Given the structure of the upper lip, the angulation plays a prominent role in upper-lip profile esthetics besides just its anteroposterior projection. No direct or indirect relationships have been established between the maxillary incisal orientation and upper-lip angulation. The clinical significance in understanding the upper lip to hard-tissue relationship is to predictably control the upper-lip angulation in orthodontics and/or orthognathic surgery in patients with dentofacial deformities. In the absence of reliable data, planning often becomes overly subjective or arbitrary, which could lead to poor esthetic outcomes. To the author's knowledge, there are no studies that analyze the relationship between the hard tissues and the upper-lip angulation. This is presumably the case because of the difficulty in comparing the contours of the hard and soft tissues in these non-linear structures. Any “parallelism” cannot be reliably measured in a reliable or quantitative way using conventional cephalometric or other linear techniques.A retrospective cross-sectional study was designed to analyze cone beam computerized tomography (CBCT) scans from 104 patients, using geometric morphometrics. The contour of the hard tissue was evaluated by taking a point below anterior nasal spine (ANS) at the point of greatest convexity between ANS and maxillary alveolus, as well as the most anterior point of the maxillary alveolar bone between the central incisors. Once these points were identified, 3 semi-landmarks were taken at equidistant points between these in order to best trace the curvature of this area. For the soft-tissue analysis, subnasale and labrale superioris were identified and, once again, 3 semi-landmarks were taken at equidistant points between these landmarks to map the upper-lip curvature.The data were then compiled, giving a total of 1040 data points, 520 hard-tissue and 520 soft-tissue points. While the results of the principal components analysis and partial least squares are pending, the initial data show a positive correlation between contour of the alveolar bone and teeth and the upper-lip position and form.Based on these findings, it appears that the upper-lip contour in the dentofacial deformity patient can be predictably controlled by manipulating the position of the maxillary alveolus and incisor position via orthodontic and surgical means.

Evaluation of Facial Profile Esthetics After Maxillomandibular Advancement Surgery for the Treatment of Obstructive Sleep Apnea

Maxillomandibuar advancement (MMA) surgery has been shown to be a successful treatment for obstructive sleep apnea (OSA), but concerns still exist regarding esthetic outcomes due to the large advancements involved. The objective of this study was to evaluate facial profile changes in patients who underwent MMA surgery for OSA by utilizing panels of external evaluators. Pre- and posttreatment silhouettes of 21 patients (10 females, 11 males; mean age 43.2 [±11.5] years), who underwent MMA surgery for OSA, were generated from profile photographs. Utilizing survey software, the individual silhouettes were shown in random order to surgeons, orthodontists and laypeople, who assessed the esthetics of each via a sliding visual analogue scale (0 to 10). For all evaluators combined, postsurgical esthetic scores were significantly improved in 19 of 21 patients (P < .001). Ninety-five percent of evaluators judged the changes after surgery as positive or neutral. There was a mean increase in postsurgical esthetic scores of 1.9 [±1.9], which was moderately correlated with AHI changes (r=0.48, P < .05). Mean esthetic score changes were significantly different between evaluator groups for 12 of 21 patients (P < .05), with surgeons and orthodontists reporting more positive change than laypeople. Overall, MMA surgery for the treatment of OSA does not have a negative impact on facial profile esthetics, with external evaluators judging the changes as favorable in the majority of patients assessed.

Patterns of Facial Profile Preference in a Large Sample of Dental Students: A Cross-Sectional Study.

The objective of this study was to explore dental students’ facial profile preferences in a large sample of students. Nine hundred and nineteen dental students of four dental schools were involved. As part of a larger study on dentofacial esthetics, six photo series consisting of one unaltered and four altered variants of the same female profile were distributed among the students. The altered features were ones that are esthetically significant according to the literature. The students had to indicate the photo in each series that they preferred. The data were analyzed in a regression model in which preference in the given photo series was the dependent variable and gender, grade of studies, and dental school were the factors. Eight hundred and sixty-one students (93.7%) responded. Gender and dental school were not associated with the observed preferences, but the grade of studies was associated for three of the modified parameters: chin prominence, the sagittal position of the maxillary dental arch, and the simultaneous modification of the prominence of the chin and the nose. This study has confirmed several earlier observations, and new observations have also been made. We have demonstrated that the anteroposterior position of the maxillary incisors may be an important determinant of profile esthetics, even if this position does not influence the situation of the soft tissues and if the forehead cannot be used as a reference. We have also shown that the harmony between the nose and the chin overrides the importance of their individual dimensions.

Personalized Orthodontics: From the Sagittal Position of Lower Incisors to the Facial Profile Esthetics.

Background: One of the goals of orthodontic treatment is to obtain maximum facial harmony. The sagittal position of the lower incisors plays a significant role in the planning of orthodontic treatment. The aim of the study was to evaluate the relationship between the sagittal position of lower incisors and facial profile esthetics with reference to the skeletal vertical dimension. Methods: There were 200 patients included in the study. Patients were allocated into three groups, depending on the vertical growth pattern: normal-angle, low-angle, and high-angle cases. Tweed–Merrifield cephalometric analysis was used to assess the sagittal and vertical position of the mandible, as well as to assess the sagittal position of the lower incisors. Results: Z-angle and Frankfort mandibular incisor plane angle (FMIA) decreased significantly (p < 0.001) with the increase of the skeletal vertical dimension. Incisor mandibular plane angle (IMPA) was significantly higher (p < 0.001) in low-angle patients compared to the high-angle ones. Z-angle appeared to be the most accurate parameter (area under curve, AUC = 0.957) describing patients with a convex profile. The cutoff value of Z-angle 68.0° was characterized by the sensitivity of 94.1% and the specificity of 84.3%. Conclusions: The sagittal position of the lower incisors significantly affects the facial profile convexity. The Z-angle is the parameter which most accurately describes the patients with a convex profile.

The Role of Arts Education in Today's Educational Process

At present, there are discussions and research on the renewal of teaching methods in modern education. This explains the relevance of the study. In connection with the renewal of the teaching principle, it is necessary to introduce a new teaching method in educational institutions. The procedure for the implementation of the foundations of goal-setting also of the current school self-awareness changes the figures, the essence and the ways of educational work of students, the main transformations of educational activity. This work aims to study the problem of art education in the current realities, as well as outline the prospects for its development based on this. The problem was studied by using art as a teaching method. As a result, the authors came to a consensus that there can be only one way out of this situation – a fundamental shift towards weakening and increasing the humanity of the educational strategy. As a result, there is the restructuring and renewal of the entire machine of the educational process in the development of new educational concepts, areas of improvement, updating of existing aspects, as well as non-traditional forms of education. Prospects for the further development of the education sector are primarily in solving the identified dilemmas, namely, increasing the importance of art and aesthetic education at the state level, as well as qualitative and quantitative changes in the program for the creative and aesthetic profile and art.

EVALUATION OF FACIAL AESTHETIC PROFILE IN UNIVERSITY STUDENTS: A PILOT STUDY

Introduction: Consequences on the face cause several symptoms of rejection, so the skin exam is essential for a specific treatment according to the aesthetic needs of each individual. Objective: To evaluate the facial aesthetic profile in university students. Methods: Cross-sectional study with university students, independent of gender and in the age group of 18 to 59 years old, from May to June 2019. A facial evaluation questionnaire was applied based on the main aesthetic complaints and the data were analyzed using SPSS version 20.0. Results: Most university students were female (n=119), mean age 22 years old, and acne was the most frequent disease (100%), especially moderate acne (53.5%). Melasma was identified in 17.3%, mainly in females (74.2%). There were poor nutrition and irregular skin care without using sunscreen and other skin care routine. The side effects may include emergence of acne and melasma. Conclusion: Risk factors and irregular skin care may lead to facial skin lesions. Keywords: Acne Vulgaris; Melanosis; Students; Face; Esthetics.

A retrospective comparison of 3 approaches of vestibuloplasty around mandibular molar implants: apically positioned flap versus free gingival graft versus modified periosteal fenestration.

PurposeThis study aimed to clinically evaluate the efficacy of vestibuloplasty around lower molar implants using 3 different modalities: apically positioned flap alone (APF), APF with a free gingival graft (FGG), and APF with modified periosteal fenestration (mPF).MethodsThree different vestibuloplasty procedures during second-stage implant surgery were performed at the mandibular molar area in 61 patients with a shallow vestibule and insufficient keratinized tissue (KT). The clinical measurements of KT width were recorded at baseline, immediately after surgery (T0), 6 months after surgery (T6), and 12 months after surgery (T12). Soft tissue esthetic scores were measured.ResultsAn additional KT width gain from baseline to T12 of approximately 2 mm was obtained with FGG and mPF compared to that with APF. Shrinkage of the re-established tissue was lower with mPF and FGG than with APF, whereas the esthetic profile was better with APF and mPF than with FGG.ConclusionsWithin the limitations of this study, mPF showed potential as a promising approach for vestibuloplasty around the lower molar implants compared to the traditional APF and FGG.

A Formula for Estimating the Mesiodistal Width of Permanent Mandibular Central Incisors

Introduction: A chieving acceptable occlusal contact during orthodontic treatment is very important. Tooth size ratios play a major role in the prediction of treatment outcomes. Aim: The aim of this study is to determine the mesiodistal width of missing mandibular central incisor. Materials and Methods: The study sample consisted of study casts of 300 participants in the age range of 18–30 years. Samples having a full complement of teeth with Angle's Class I molar and canine relationships, good intercuspation, normal overjet and overbite, and minimal crowding and spacing. Tooth dimensions were measured using a digital Vernier caliper. The data calculated were used for measuring schedule variance (SV) formula. Results: Based on the achieved data, SV formula is derived. Conclusion: For achieving esthetic profile, it is essential to calculate the correct mesiodistal width of the teeth. Ideal tooth proportions play an important role in achieving good occlusion at the end of orthodontic treatment.

TECHNIQUE OF EXPOSURE OF THE ESOPHAGOGASTRIC JUNCTION OBTAINED BY THE FLEXIBLE LIVER RETRACTOR IN BARIATRIC SURGERY: A RANDOMIZED CONTROLLED TRIAL.

ABSTRACT - BACKGROUND:In the Roux-en-Y gastric bypass technique, classic laparoscopic surgical retractors are usually rigid, require an additional incision for its installation, or must be handled by an assistant during the surgical procedure, involving a risk of liver injury.Aim: The aim of this study was to evaluate and validate a technique of the esophagogastric junction exposure obtained by the flexible liver retractor in bariatric surgery, comparing its efficacy with the retractor classically used for this purpose.Methods: This study was performed as a randomized, open, prospective, controlled, and comparative design in patients with medical indications of bariatric surgery. The subjects were distributed in the classic (control) and flexible (test) retractor groups.Results: A total of 100 patients (n=50 control group, n=50 test group) were included. No statistically significant difference was observed in the mean duration of surgery. Regarding visibility, 100% of the patients in the flexible retractor group demonstrated an optimal visibility level, although without statistical significance concerning the classic retractor group (94%). Invariably, carrying a trocar was necessary when using the classic retractor.Conclusions: The flexible liver retractor is safe, effective, ergonomic, and inexpensive. Furthermore, it presented a satisfactory aesthetic profile, and the use of specific instruments, new adaptation curve, and training for its handling were not required.

Perception and Appreciation of Tactile Objects: The Role of Visual Experience and Texture Parameters

This exploratory study was designed to examine the effects of visual experience and specific texture parameters on both discriminative and aesthetic aspects of tactile perception. To this end, the authors conducted two experiments using a novel behavioral (ranking) approach in blind and (blindfolded) sighted individuals. Groups of congenitally blind, late blind, and (blindfolded) sighted participants made relative stimulus preference, aesthetic appreciation, and smoothness or softness judgment of two-dimensional (2D) or three-dimensional (3D) tactile surfaces through active touch. In both experiments, the aesthetic judgment was assessed on three affective dimensions, Relaxation, Hedonics, and Arousal, hypothesized to underlie visual aesthetics in a prior study. Results demonstrated that none of these behavioral judgments significantly varied as a function of visual experience in either experiment. However, irrespective of visual experience, significant differences were identified in all these behavioral judgments across the physical levels of smoothness or softness. In general, 2D smoothness or 3D softness discrimination was proportional to the level of physical smoothness or softness. Second, the smoother or softer tactile stimuli were preferred over the rougher or harder tactile stimuli. Third, the 3D affective structure of visual aesthetics appeared to be amodal and applicable to tactile aesthetics. However, analysis of the aesthetic profile across the affective dimensions revealed some striking differences between the forms of appreciation of smoothness and softness, uncovering unanticipated substructures in the nascent field of tactile aesthetics. While the physically softer 3D stimuli received higher ranks on all three affective dimensions, the physically smoother 2D stimuli received higher ranks on the Relaxation and Hedonics but lower ranks on the Arousal dimension. Moreover, the Relaxation and Hedonics ranks accurately overlapped with one another across all the physical levels of softness/hardness, but not across the physical levels of smoothness/roughness. These findings suggest that physical texture parameters not only affect basic tactile discrimination but differentially mediate tactile preferences, and aesthetic appreciation. The theoretical and practical implications of these novel findings are discussed.

Perception and Appreciation of Tactile Objects: The Role of Visual Experience and Texture Parameters &amp;#x2020;

This exploratory study was designed to examine the effects of visual experience and specific texture parameters on both discriminative and aesthetic aspects of tactile perception. To this end, the authors conducted two experiments using a novel behavioral (ranking) approach in blind and (blindfolded) sighted individuals. Groups of congenitally blind, late blind, and (blindfolded) sighted participants made relative stimulus preference, aesthetic appreciation, and smoothness or softness judgment of two-dimensional (2D) or three-dimensional (3D) tactile surfaces through active touch. In both experiments, the aesthetic judgmen t was assessed on three affective dimensions, Relaxation, Hedonics, and Arousal, hypothesized to underlie visual aesthetics in a prior study. Results demonstrated that none of these behavioral judgments significantly varied as a function of visual experience in either experiment. However, irrespective of visual experience, significant differences were identified in all these behavioral judgments across the physical levels of smoothness or softness. In general, 2D smoothness or 3D softness discrimination was proportional to the level of physical smoothness or softness. Second, the smoother or softer tactile stimuli were preferred over the rougher or harder tactile stimuli. Third, the 3D affective structure of visual aesthetics appeared to be amodal and applicable to tactile aesthetics. However, analysis of the aesthetic profile across the affective dimensions revealed some striking differences between the forms of appreciation of smoothness and softness, uncovering unanticipated substructures in the nascent field of tactile aesthetics. While the physically softer 3D stimuli received higher ranks on all three affective dimensions, the physically smoother 2D stimuli received higher ranks on the Relaxation and Hedonics but lower ranks on the Arousal dimension. Moreover, the Relaxation and Hedonics ranks accurately overlapped with one another across all the physical levels of softness/hardness, but not across the physical levels of smoothness/roughness. These findings suggest that physical texture parameters not only affect basic tactile discrimination but differentially mediate tactile preferences, and aesthetic appreciation. The theoretical and practical implications of these novel findings are discussed.

Efficacy of arthroplasty of the temporomandibular joint (TMJ) and insertion of a Matthews distractor as treatment for ankylosis of the joint – a case series

Introduction: TMJ ankylosis is a condition in which the adhesion of the anatomic joint components results in loss of function of the joint. This affects the patient's speech, ability to receive adequate nutrition and causes severe facial deformity in many cases. Frequently, these patients experience additional pain, oral disease and ultimately, a poor aesthetic profile. Although relatively rare, ankylosis can result from trauma, infection, previous TMJ surgery, congenital deformities or systemic diseases.

Commentary on: Expanding Indications for Dorsal Preservation Rhinoplasty With Cartilage Conversion Techniques.

After the “Revolution Rhinoplasty” 1 editorial published together with the “Push Down Reassessed” article,2 clarifying the respective indications of rhinoplasty procedures dedicated to aesthetic profile lines, surgical achievement took an important step. The former article was analyzing the main author’s experience in dorsum preservation procedures, reminding the rhinoplasty surgeons that, besides structure rhinoplasty and dorsum resection following Joseph, there were other options in lowering and fine-tuning the dorsum lines, known as preservation rhinoplasty (PR). Many articles are currently published on this topic, and it is also discussed at many organization meetings and webinars. A few surgeons are publishing their experience, thus enriching the literature.3-9 However, the enthusiasm that has been ignited by this publication may have sometimes led to overdoing procedures associated with inherent risk related to inexperienced surgeons performing a new rhinoplasty technique. The combination of these events would inevitably lead to an excess of indications and...