Improvement In Facial Esthetics Research Articles

A Case Study on Orthodontic-Surgical Management of Skeletal Class III Malocclusion in Adults: Clinical Approach and Outcomes

This article presents a case study illustrating the successful management of skeletal Class III malocclusion in an adult through an orthodontic-surgical approach. The clinical case outlines the entire process, from initial assessment to post-treatment outcomes, conducted within our service. Key steps include diagnostic planning using advanced tools such as 3D imaging and virtual surgery simulation. Pre-surgical orthodontic treatment was carefully planned to prepare dental and skeletal structures for surgical correction. Orthognathic surgery was performed precisely according to the established plan, followed by a post-surgical orthodontic phase to finalize occlusion. Short-term and long-term outcomes are evaluated, highlighting significant improvement in facial aesthetics, occlusal function, and post-treatment stability. This case study demonstrates the effectiveness of our integrated approach in managing skeletal Class III malocclusions in adults, underscoring the importance of interdisciplinary collaboration for optimal outcomes

Improvement in facial aesthetics of orthognathic patients after surgery-first approach

Facial appearance significantly affects psychosocial wellbeing, and an improvement in facial aesthetics is considered an essential outcome of orthognathic treatment. The surgery-first approach (SFA) has emerged as a promising alternative to the conventional orthodontics-first approach (OFA) due to its potential advantages in reducing treatment duration and cost, delivering early aesthetic improvement, and increasing patient satisfaction. However, its impact on final facial aesthetics and how it compares with the OFA has, to our knowledge, not yet been investigated. This retrospective study aimed to compare the improvement in facial aesthetics after orthognathic surgery in an SFA and an OFA group. Preoperative and postoperative 3-dimensional stereophotogrammetry facial images of 40 patients were evaluated by five professional assessors using the Global Aesthetic Improvement Scale (GAIS). Similar aesthetic improvement outcomes were found in both the SFA and OFA groups. The GAIS score significantly correlated with the following facial variables: upper lip projection, chin prominence, facial proportions, paranasal hollowing, lip competence, mandibular projection, and facial profile. No significant correlation was found between a change in aesthetic score and the surgical variables. There was a positive association between overall GAIS score and the gender and experience level of the individual assessors. This study suggests that aesthetic facial improvement achieved with the SFA is satisfactory and comparable to that of the OFA.

A case report on management of complex malocclusion using infra-zygomatic bone screws

Here is a case report of a 20 year old male patient who reported with chief complaint of irregular teeth and un-esthetic smile. Patient was diagnosed with hypodivergent face pattern, retroclined upper incisors and anterior deep bite. Molars were in End-on relationship. Treatment was planned using passive self-ligation (Damon system) and enmasse arch distalization using Infra-zygomatic bone screws. Treatment result showed marked improvement in facial esthetics and occlusion by incorporating predictable biomechanics.

Treatment Plan and Discussions of Class I with Smilestream: A Case Report

The aim of the study was to present a Class I case and the treatment plan related to orthodontic diagnosis. The chief complaint of a patient and his parents are crowded teeth upper and lower and anterior crossbite. “@I’m looking like a crocodile” were the first words of the boy sitting on the dental chair. The main task was functional but also esthetics because it was from the first important to him. The treated malocclusion is characterized with a narrow maxillary width and prominence of the mandible. The maxilla was deficient in anteroposterior and transverse dimensions, causing a slightly concave and unpleasant profile, a crossbite relationship of lateral incisors and upper and lower anterior crowding. The use of mechanics was preferred and accepted as a better solution for the patient according to the idea to generate well directed growth. The patient was 12 year-old boy with Class I malocclusion and anterior crossbite. A molar and canine class 1 and correction of the malocclusion were obtained. The improvement of facial aesthetics and smile enlarging were also ensured.

Single-Step Full-Face Surgical Treatment of the Facial Profile.

The present study was performed to describe how much affordable, feasible, and straightforward is the approach the authors called "single-stage full-face surgical profileplasty," tailored to greatly improve the surgery of the facial profiling setting and achieve complete profile correction at the same time. From January 2010 to May 2019, 113 patients (95 females and 18 males; aged 19 - 63 years) were surgically treated for full-face profile amelioration. Profile correction was performed by using a combination of five procedures out of other various previously experienced: forehead fat grafting, rhinoplasty, lip fat grafting, genioplasty, and submental liposuction. All patients were assessed at 1, 3, 6, and 12 months following surgery for assessing the surgical profile treatment (SPT) outcome and any possible side effects of the combined treatment. Facial profile stability at 1 year was taken as the completion point of this treatment. Arnett et al's "Soft Tissue Cephalometric Analysis" (1999) was used to clinically evaluate the soft tissues before and after the SPT. Patients' satisfaction was measured with the Client Satisfaction Questionnaire-8" at 3 and 12 months after surgery. Statistics were used for Arnett et al's evaluation. Almost all the values were consistent and reached the normal ranges indicated by Arnett et al (p < 0.001), confirming that the desired results of the surgical profileplasty have been achieved. Single-stage full-face surgical profile treatment helps in correcting faults of the global facial deformity, in every single treated area, providing an overall improvement in facial aesthetics and harmony. Obtaining the simultaneous correction in the whole face has also the advantage of avoiding multiple surgical procedures, reducing postoperative discomfort, and the overall risks for the patient due to multiple surgical and anesthetic procedures.

Use of fat graft to correct facial asymmetries in patients undergoing Orthognathic Surgery: the systematic review

Introduction: Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible. In this scenario, fat grafting is a powerful tool for corrections and also for facial aesthetic improvement together or after OS. The benefits of fat grafting during orthognathic surgery; to maximize aesthetic results, minimize swelling and optimize wound healing. Objective: To analyze the main clinical studies on the benefits and risks of facial fat grafting in orthognathic surgery, to know the current state of the art. Methods: It followed a systematic literature review model on the main clinical findings of orthognathic surgery and fat grafting, according to the rules of PRISMA. The research was carried out from January 2021 to May 2021 and developed based on Google Scholar, Scopus, PubMed, Ovid, Scielo, and Cochrane Library. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: 123 studies were analyzed, with only 52 medium and high-quality studies selected, according to GRADE rules, and with risks of bias that do not compromise scientific development, based on the Cochrane instrument. Studies have shown that OS aims to establish harmonious facial esthetics, excellent functional occlusion, and improved airway conditions. As an important adjunct to OS, fat grafting is becoming more and more common due to its anti-inflammatory role and effects on facial swelling. High patient satisfaction with the results. Postoperative swelling resolved at week 12 in the fat graft group and persistent edema. The edema decrease over time, with almost complete resolution within 1 year, improvement in facial morphology, function, quality, and skin texture in most of their patients. The use of assisted lipo transfers containing mesenchymal stem cells derived from adipose tissue, enables improvement in skin quality, smoothing of wrinkles, pore size, and attenuation of pigmentation and resolution of scars. Furthermore, enrichment of the lipoaspirate with stem cells derived from adipose tissue increases graft retention. Conclusion: Most of the studies analyzed in this review study showed that fat grafting in orthognathic surgery is a safe and effective tool to improve wound healing, improve aesthetic results, present an anti-inflammatory effect and reduce edema.

Esthetic preferences of orthodontists, dentists, and plastic surgeons for balanced facial profiles.

The aim of this investigation was to determine whether the facial esthetics of subjects rated as "attractive" can be related to specific cephalometric soft tissue parameters. The profile silhouettes of 100 subjects (45 males and 55 females) were rated by 60 esthetics specialists (20 orthodontists, 20 dentists, and 20 plastic surgeons) using a Likert scale, and 30 of the subjects were selected as being "attractive". The cephalometric measurements of the attractive group were then compared with norms for the general Caucasian population. The effects of specific measured parameters on profile beauty grades were assessed using the median test, and the following variables were found to show significant correlations between the Caucasian norms and the attractive profile group: the ratio of the upper to lower face height (P = 0.011), the ratio of the subnasale - labrale inferius (Sn-Li) and labrale inferius - menton (Li-Me`) lines (P = 0.011), the distance between the chin and the subnasale perpendicular (P = 0.002), upper lip thickness (P = 0.021), soft tissue chin thickness (P = 0.021), vertical height ratio (P = 0.021), and nasolabial angle (P = 0.021). A straight profile with a fuller and more protruded upper lip, a higher nasal tip, and a smaller lower facial third are considered to be the most attractive facial features, and may be useful for improvement of facial esthetics.

Orthognathic surgery and fat injection for corrective liposculpture: a systematic review

Introduction: Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible. In this scenario, fat grafting is a powerful tool for corrections and also for facial aesthetic improvement together or after OS. The benefits of fat grafting during orthognathic surgery; to maximize aesthetic results, minimize swelling and optimize wound healing. Objective: To analyze the main clinical studies on the benefits and risks of facial fat grafting in orthognathic surgery, to know the current state of the art. Methods: It followed a systematic literature review model on the main clinical findings of orthognathic surgery and fat grafting, according to the rules of PRISMA. The research was carried out from July to September 2022 and developed based on Google Scholar, Scopus, PubMed, Ovid, Scielo, and Cochrane Library, using scientific articles from 1986 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: 123 studies were analyzed, with only 32 medium and high-quality studies selected, according to GRADE rules, and with risks of bias that do not compromise scientific development, based on the Cochrane instrument. Studies have shown that OS aims to establish harmonious facial esthetics, excellent functional occlusion, and improved airway conditions. As an important adjunct to OS, fat grafting is becoming more and more common due to its antiinflammatory role and effects on facial swelling. High patient satisfaction with the results. Postoperative swelling resolved at week 12 in the fat graft group and persistent edema. The edema decrease over time, with almost complete resolution within 1 year, improvement in facial morphology, function, quality, and skin texture in most of their patients. The use of assisted lipo transfers containing mesenchymal stem cells derived from adipose tissue, enables improvement in skin quality, smoothing of wrinkles, pore size, and attenuation of pigmentation and resolution of scars. Furthermore, enrichment of the lipoaspirate with stem cells derived from adipose tissue increases graft retention. Conclusion: Most of the studies analyzed in this review study showed that fat grafting in orthognathic surgery is a safe and effective tool to improve wound healing, improve aesthetic results, present an anti-inflammatory effect and reduce edema.

Effect of lip thickness and competency on soft-tissue changes

Improvement in facial esthetics is a major reason for seeking orthodontic treatment. Soft tissues responsible for esthetics show a variable response to the movement of underlying teeth during orthodontics. The purpose of this cross-sectional study was to analyze the response of soft tissues and compare it among groups presenting with different lip thickness and competence. It was carried out on 37 patients with Class I and Class II Division 1 malocclusion who had undergone extractions of maxillary first premolars and had completed their orthodontic treatment. Data were obtained by corresponding lateral cephalometric radiographs taken before and at the end of orthodontic treatment. Association was analyzed with a Pearson correlation test. Differences among groups exhibiting varying competency and lip thickness were tested with an independent sample t test. A P value of≤0.05 was considered statistically significant. Pearson correlation revealed significant associations among incisor tip retraction with lip base retraction (r= 0.68), lip base thinning (r= 0.41) and vermilion retraction (UV) (r= 0.73). Regression analysis showed a moderate increase in lip length (AB) and thickness at vermilion, which were 0.11 mm and 0.15 mm for each mm of incisor retraction at the tip, whereas stronger effects were observed for UV (0.38 mm) and lip base retraction (0.55 mm). There was significantly more lip base thinning (P= 0.03) and UV (P= 0.04) in the incompetent group compared with the competent group. The AB increased significantly in the sample with thicker lips (P= 0.01). Pearson correlation coefficient showed a strong association of lip retraction at the base and vermilion with the incisor movement at the cervical area, for competent and incompetent lips, and thicker and thinner lips. Lip retraction at vermilion and lip base thinning was significantly more in patients with incompetent lips, whereas the AB increased significantly more in the group with thicker lips.

VYC-20L is Safe and Effective for Improving Volume and Aesthetic Appearance of the Nose in Chinese Adults

PurposeSoft tissue filler injection is less invasive than surgical approaches for facial aesthetic improvement. This study evaluated the safety and effectiveness of the soft tissue filler VYC-20L (Juvéderm Voluma® XC) for improvement of volume and aesthetic appearance of the nose in Chinese subjects.Patients and MethodsIn a prospective, multicenter, no-treatment–controlled study in China, adult subjects were randomized 3:1 to receive VYC-20L (treatment group) or have optional treatment delayed by 24 weeks (control group). The treatment group received VYC-20L on day 1 plus optional touch-up at week 8 for suboptimal improvement. The primary effectiveness measure was mean change in nose area volume from baseline to week 24 by digital analysis of three-dimensional (3D) images. Multiple secondary effectiveness and safety measures were assessed.ResultsOf 164 subjects randomized, 162 were treated, and 157 comprised the modified intent-to-treat population (mean age, 31 years; 94% female). In the treatment group, mean VYC-20L volume injected was 1.18 mL (initial treatment) and 0.67 mL (touch-up; n = 46 [38.3%]). VYC-20L achieved significantly larger changes in nose area volume than control at week 24 (2.032 vs ‒0.005 cm3, respectively; p < 0.0001) and greater improvements on the Global Aesthetic Improvement Scale (investigator and subject), Nose Satisfaction Scale, and other 3D measures. No treatment-related adverse events occurred. Most injection site responses were mild/moderate, resolving within 14 days. Mean initial/touch-up treatment procedural pain ratings were less than 3 (0‒10 scale; higher = worse pain).ConclusionVYC-20L is safe and effective for nose augmentation in Chinese adults.

Partial Bone Necrosis Following Sagittal Split Ramus Osteotomy: Report of a Complicated Orthognathic Jaw Surgery

Study Design Case Report. Objective To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result. Method A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal split ramus osteotomy performed five years earlier, which resulted in aseptic bone necrosis on the right side. The patient had marked mandibular deviation, chin and midface retrusion and a pronounced occlusal discrepancy. Imaging demonstrated a bony defect at the right mandibular angle with a superiorly displaced proximal segment. Deviation of the mandible was corrected first by performing vertical ramus subsigmoid osteotomy (RSO) on the left side. The right bone defect was then reconstructed with a reconstruction plate and bone grafting. Maxillary and chin advancement was performed at a second stage. Results On follow-up, the patient shows a significant improvement in facial esthetics and mandibular symmetry and is currently under orthodontic management to enhance the occlusal relationship. Conclusion Bone necrosis is a rare but dreaded problem in orthognathic surgery. Minimizing the musculo-periosteal dissection and competent execution of the bone osteotomy is substantially effective in reducing the risk of bone ischemia and necrosis.

Motivations and Concerns of Preorthognathic Surgery Patients.

This study aims to investigate motivations, ways of gaining information, and concerns for orthognathic surgery of patients with skeletal dentomaxillofacial deformities before receiving the treatment, and to explore directions for improvement in doctor-patient communications in the clinical practice. Presurgical patients were asked to fill out a questionnaire about their basic information, the approaches via which they knew about the surgery, as well as their motivations and concerns for the surgery. One hundred ninety two questionnaires were included in the analysis in total. Patients (females: males = 2.69:1) with an average age of 23.79 ± 4.36 mainly regarded facial esthetics (103, 53.65%) as a primary concern. Although about 80.20% of patients accessed medical information through the Internet, it was still an irreplaceable way to know through consulting specialists. The majority of patients were young, unmarried women without a stable income. For most patients, the primary motivation to receive the surgery was an improvement in facial esthetics and the biggest concern was the operation effect. Access to medical information through the Internet has become very important access to medical knowledge.

Efficacy and safety of two hyaluronic acid fillers withdifferent injection depths for the correction of moderate-to-severe nasolabial folds: A 52-week, prospective, randomized, double-blinded study in a Chinese population.

Hyaluronic acid (HA) fillers are known to be effective for the correction of facial wrinkles and folds, but there is no clinical study that compares the efficacy of small-to-medium-particle HA fillers and large-particle HA fillers for the correction of nasolabial folds (NLFs). Moreover, injection depth also plays an important role in the correction of NLFs as well as improvement of facial aesthetics. To assess the efficacy, safety, and durability of a small-to-medium-particle HA filler, Restylane, and a large-particle HA filler, Yishumei, as well as the effect of injection depth in the correction of moderate-to-severe NLFs and facial aesthetics in a Chinese population. This 52-week, prospective, randomized, double-blind study enrolled 100 participants with moderate-to-severe NLFs. The participants were randomized to receive either Restylane (Group A) or Yishumei (Group B). Group A and Group B were further randomly divided into a superficial injection group (Group A1 & B1) and a deep injection group (Group A2&B2) according to injection depth. Improvement in the Wrinkle Severity Rating Scale (WSRS) score and Global Aesthetic Improvement Scale (GAIS) and participants' satisfaction were evaluated as endpoints. All adverse events were monitored throughout the study. The treatments were well tolerated by all the participants. All four groups showed a reduction in their mean WSRS scores and GAIS scores by week 12. At week 24, the WSRS and GAIS scores did not change in Group A1 and A2, while participants in Group B1 and Group B2had higher WSRS and GAIS scores than those in the previous weeks. By week 52, the WSRS scores in all the groups returned to almost baseline levels. The mean FACE-Q scores increased compared with the baseline scores in all groups through week 24. Most participants were satisfied with their treatment, and no meaningful differences were found between the fillers in terms of participant satisfaction. The most common adverse events were swelling, redness, and tenderness at the injection site, but they resolved spontaneously without treatment. The two HA fillers had good therapeutic effect on NLFs in the early stage of treatment, but Restylane had a more prolonged effect. Moreover, compared with the superficial injection, the deep injection provided slight midface lifting and improved facial aesthetics.

Intrusion of the maxillary posterior teeth with a single buccal mini-implant positioned bilaterally in young adults with a tendency towards hyperdivergence: A clinical study.

Skeletal anchorage systems have been used for intrusion of the posterior teeth with satisfactory results. To achieve this, mini-implants are placed at anatomically challenging sites such as the palate or require several mini-implants to produce the desired effect. To determine the magnitude of intrusion of the maxillary posterior teeth achieved on a continuous arch wire using a single buccal mini-implant placed bilaterally in young patients with a tendency towards hyperdivergence and to evaluate its influence on the skeletal, dental and soft-tissue structures. A total of 17 patients with proclination of the anterior teeth, tendency towards hyperdivergence and clockwise rotation of the mandible were selected. First premolars were extracted as part of treatment protocol. A 0.022-MBT bracket prescription was used. Mini-implants were placed bilaterally on the buccal aspect at the mucogingival junction or slightly gingival to it between the maxillary second premolar and first permanent molar. A total of 200 g of intrusive force was placed from a continuous 0.019 × 0.025 inch stainless-steel arch wire to the mini-implant by means of an elastomeric thread on both sides. Lateral cephalograms and study models were taken before the start of intrusion and six months later. Parametric and non-parametric tests were done to assess treatment results. Significant intrusion was observed in the maxillary molar and premolar region with tendency towards intrusion in the anterior region. There was significant decrease in lower anterior facial height (LAFH) with anti-clockwise mandibular rotation, decrease in facial proportion index and total facial height. No changes were observed in the transverse plane. Intrusion of the permanent maxillary molar can be achieved on a continuous arch wire with a single buccal mini-implant placed bilaterally with improvement in facial aesthetics, especially in the vertical plane. This method may be beneficial in patients with borderline vertical discrepancy treated with conventional friction mechanics during space closure after first premolar extractions.

An assessment of factors motivating patients to seek orthodontic treatment in a South-Western Nigerian teaching hospital

Background: Motivation is a concept that describes the conscious or unconscious stimuli for the action toward a desired goal. The motivations for seeking an orthodontic treatment among the population are diverse. Identifying the underlying motivation for treatment is helpful in reducing dissatisfaction with orthodontic treatment outcome. Aim: This study aimed to assess motivating factors for seeking orthodontic treatment and to compare these factors between adolescents and adults attending a Nigerian teaching hospital. Patients, Materials and Methods: Self-administered questionnaires were distributed among 130 subjects (79 adolescents and 51 adults). The subjects were asked to assign a score to the motivating factors listed based on their relative importance using a 5-point Likert scale which ranged from 1 to 5, with 5 rated as very important and 1 rated as very unimportant. The choice of motivating factors was compared between the adolescents and adults and between sexes in each group. Data obtained were analyzed using IBM Statistical Package for Social Sciences (IBM SPSS) version 21.0. P ≤ 0.05 was considered statistically significant. Results: Improvement in dental appearance was the main motivating factor for almost all subjects and there was no statistically significant difference between adolescents (60.8%) and adults (68.6%), P = 0.591. A significantly higher (P < 0.001) number of the adults, (35, 68.6%) chose improvement in facial aesthetics as a motivating factor for orthodontic treatment compared with 29 (44.6%) adolescents. The least motivating factors which were chosen by adolescents were improvement in chewing (9, 13.8%) and relief of temporomandibular joint symptoms (4, 6.2%). There was no statistically significant difference in the choice of motivating factors between female and male in both the adolescent and adult groups. Conclusion: Aesthetic concerns were the most important motivating factors in adolescents and adults seeking orthodontic treatment.

Orthognathic surgery-first approach with lingual appliances: a case report

Abstract Background A surgery-first approach has many advantages related to a shortened treatment time and an immediate facial aesthetic improvement compared to a three-stage conventional orthognathic surgery protocol. Objective The aim of this case report was to describe the treatment of a 21-year-old, female, patient who presented with a skeletal Class III malocclusion, maxillary retrusion, a negative overjet, an anterior and bilateral posterior cross-bite, and a vertical facial pattern highlighted by a high mandibular plane angle. Methods Orthodontic treatment was performed using self-ligating lingual appliances and a surgery-first approach. The active treatment time was 16 months. Results and conclusion Successful treatment results were achieved using a combination of an orthognathic surgery-first approach and lingual appliances in a patient with high aesthetic expectations.

Analysis of bone-reconstructive surgery aimed at normalization of occlusal relationships of the jaws at the final stages of rehabilitation treatment of children with congenital cleft lips and palate (Literature review)

BACKGROUND: The completion of medical rehabilitation of children aged 1618 years with congenital cleft lips and palate is often impossible without surgical correction of occlusal relationships of the jaws and improvement of facial aesthetics. At the same time, the main efforts of the specialists engaged in the treatment of children with orofacial clefts are aimed at correcting local plastic operations of the upper lip, nose, oral cavity, and orthodontic, using non-removable arc equipment, correction of disturbed occlusion.&#x0D; AIM: Our aim is to study and analyze the problems of final bone reconstructive operations in patients with HRGN.&#x0D; MATERIALS AND METHODS: The article presents a review of the literature on this topic, based on 61 sources. The literature was searched by keywords in the databases such as PubMed, ScienceDirect, E-library, and Google Scholar from 1938 to 2020. The data on the treatment of children with combined maxillofacial anomalies and deformities with cleft lips and palate, who underwent reconstructive bone operations on the jaws in order to normalize their occlusal relationships, were analyzed.&#x0D; RESULTS: In order to achieve good morphofunctional and aesthetic results, as well as early socialization of patients with VRGN at the final stages of rehabilitation, complex hardware and surgical treatment are necessary. The indication for reconstructive operations on the jaws in patients is the face disorder and disharmony of the face, which cannot be corrected by orthodontic treatment. The operations should be based on careful planning, including CT modeling, the use of sparing techniques, including various modifications of Le Faure I osteotomy on the upper jaw, and retromolar sagittal osteotomy of the jaw and, according to indications, genioplasty on the lower jaw.&#x0D; CONCLUSIONS: Two-jaw orthognatic bone reconstructive operations on the jaws to restore the correct bite have recently been used in the complex medical rehabilitation of patients, especially in adolescents with VGN. At the same time, there are a number of unresolved issues of orthodontic and surgical treatment that require further study. There is a strong need for a clear understanding of the age of planning and timing of such operations considering the stage of completion of skeletal growth. The criteria for the patients readiness for surgery for multiple occlusive contacts also need to be evaluated. It is of paramount importance to determine the order of performing corrective operations on the soft tissues of the face and oral cavity. Hence there is a necessity to develop new methods of reconstructive operations on the jaws.

Reconstruction of extensive sequel of frontal fracture: optimizing results

Introduction: Fractures of the frontal bone correspond to 5 to 15% of all facial fractures. This type of fracture can lead to difficulties in restoring bone congruence and to postoperative secondary aesthetic problems. Objective: This paper aims to present a clinical case report of frontal bone fracture where a late reconstruction was performed using a titanium mesh with the aid of stereolithographic model prototyping. Case report: Female patient, 26 years old, with aesthetic sequelae in the upper third of the face after a motorcycle accident. The imaging exams showed a comminuted frontal bone fracture, as well as upper edge and right orbit ceiling involvement. The planning consisted of reconstruction of the affected area with the use of a titanium mesh pre-shaped in a stereolithographic model. The procedure was performed under general anesthesia and coronal access. After installation of the fixation material, pericranial flap rotation and suture of the surgical wound were performed. The patient progressed well, with considerable improvement in facial aesthetics. Conclusion: This paper reports the importance of good planning in cases of frontal bone fracture sequel, in which the use of model-shaped mesh in a stereolithographic model tends to optimize surgery, bringing aesthetic and psychosocial benefits. Keywords Frontal bone; Titanium; Craniocerebral trauma.

Harmonização orofacial e a inter-relação com a implantodontia: Uma revisão de literatura

Introdução: A perda dentária influencia diretamente nas funções do sistema estomatognático e através da Implantodontia é possível reestabelecer a função mastigatória e fonética do paciente contribuindo também para melhoria da estética facial. O planejamento reabilitador acontece de forma multidisciplinar, assim aHarmonização Orofacial (HOF) tem se destacado por auxiliar diretamente nos casos de reabilitação promovendo consideráveis melhoras funcionais e estéticas. Objetivo: Avaliar a contribuição da Harmonização Orofacial para a reabilitação com Implantes dentários através de uma revisão de literatura. Metodologia: Foi feita uma revisão bibliográfica da literatura de natureza básica e com análise qualitativa dos dados. A busca foi realizada nas plataformas digitais da PubMed e Google Scholar durante o período de Novembro a Dezembro de 2020, utilizando como principais termos “Harmonização Facial”, “Implantodontia”, “Reabilitação”, e termos livres, em língua inglesa e portuguesa sem filtros anuais. Resultados: Observou-se que a Toxina Botulínica (TB) e o Ácido Hialurônico (AH), substâncias usadas na HOF, contribuem positivamente para implantodontia, favorecendo os resultados ligados a estabilização, osteointegração, diminuição de sobrecargas oclusais e, através de injeções musculares, atuam bem em pacientes com hábitos parafuncionais, diminuindo sobrecargas que levam ao insucesso dos implantes. Ainda, notou-se melhora da estética vermelha, otimizando os resultados estéticos dos blackspaces. Conclusões: A HOF contribui para otimização dos resultados dos implantes em estética e em função. Até o momento da consulta bibliográfica, laserterapia, AH e TB são ligadas diretamente à implantodontia. No entanto, devido à variedade de substâncias existentes, infere-se que sejam necessários mais estudos que associem as demais substâncias aos implantes dentários.

Herbst Appliance palatally anchored in the treatment of dental class II malocclusion

In this case report, Authors describe the correction of a class II malocclusion using only an Herbst appliance palatally anchored with miniscrews. Before sagittal correction in the same appliance we applied a palatal screw to obtain maxillary expansion. The device were removed after 12 months of treatment. The final result included the correction of Class II malocclusion by lower dentoalveolar compensation mainly. The lip function favorite the spontaneous correction of upper frontal torque with consequent improvement of facial esthetics. After a follow up of 12 months the clinical result is satisfactory in terms of occlusion and esthetics. This clinical case showed a simple orthopedic and dentoalveolar approach to correct transversal discrepancy, dental class II malocclusion and also frontal proclination only with one appliance in a very short treatment time.