Prominent Chin Research Articles

Lifestyle of Cleft Lip/Palate Patients in Korea Before the Introduction of the Millard Technique.

The authors introduce a short story about the lifestyle of a cleft lip woman in Korea, published in 1936, about 2 decades before Dr Millard operated on his first patient in Korea. A short story entitled "Ugly Thing," written by Yao-hsieh Chu, analyzed by Eonnyeon, a girl born in a rural area with a cleft lip and palate who excelled at household tasks such as sewing. Her forehead was bulging, and her eyes were protruding. She had a low-profile nose with wide nostrils. She had a left unilateral complete primary cleft, including an alveolar cleft. There was midface retraction, accompanied by a relatively prominent chin. Her voice exhibited hypernasality. People often laugh when they see Eonnyeon eating her food, exclaiming, "She's eating like a rabbit!" However, she married a young man who deserted her on their wedding night because of her appearance. Subsequently, she moved to an urban area and found work as a housemaid. One day, she was raped by a middle-aged water delivery man, who then fled. Ten months later, she gave birth to a girl who also had a cleft lip. In a moment of despair, Eonnyeon attempted to smother her baby with a pillow but stopped herself. She resolved to raise her daughter despite the challenges ahead. The mockery directed at her could be viewed as an expression of the latent sadism inherent in human nature. It is remarkable to consider the progress made since Millard performed his first cleft lip surgery in Korea in 1954.

Cephalometric Assessment of Skeletal Class II Malocclusion in a Sample of Kurdish Population in Sulaimani City (Retrospective Study)

Objective: This retrospective comparative cephalometric study aims to identify the cephalometric features of skeletal class IImalocclusion in a sample of the Kurdish population, the result of this study willl be useful in diagnosing and treating orthodontic andjaw surgery.
 Methods: A total of 85 pre-treatment lateral cephalometric radiographs with skeletal class II malocclusion (ANB>=4) and 81 withskeletal class I malocclusion (1=<ANB<4) were obtained from the pre-orthodontic patient records in a private orthodontic clinic inSulaimani city. The patients were between 18 and 35 years old. The lateral cephalometric radiographs were analyzed digitally usingFACAD cephalometric software. Twenty-two variables were measured from each cephalometric radiograph. The correlation betweenClass I and II was analyzed using the Mann-Whitney Test.
 Results: The result showed that the values of SNA, ANB, Y-axis, Convexity angle, Gonial angle, Intermaxillary angle, facial angleand FMA, posterior cranial base, effective maxillary length, LAFH were higher in skeletal Class II than in Class I cases, which indicatesthat skeletal class II Kurdish population have more vertical mandibular growth and prognathic maxilla, retrognathic mandible, andlonger face than class I. Meanwhile, SNB, Mandibular length, TFH, UAFH, Maxillary length, UI-Palatal plane angle, IMPA, andeffective mandibular length values were lower and the difference was statistically significant in the majority of cases.This illustratesthat the incisors are more proclined in class I than skeletal class II, whereas the mandible is shorter in skeletal class II patients. Theseresults summarize the characteristic features of skeletal class II patients in a sample of the Kurdish population in Sulaimani City, whichare caused by etiological factors (genetic, congenital). This information is useful for enabling orthodontists and maxillofacial surgeonsto attain a diagnosis and treatment plan for skeletal class II patients in a shorter period.
 Conclusions: Skeletal class II malocclusion in the Kurdish population is characterized by a prognathic but short maxilla, retrognathic,short, backward, and downward rotated mandible, and a prominent chin.

Coronal-splitting Reduction Genioplasty Combined with Bilateral Osteotomies of the Mandibular Inferior Border for Macrogenia

Summary: There are various types of chin deformities, and the least established surgical method for deformity correction may be reduction for anteroposterior macrogenia. Anteroposterior macrogenia is commonly corrected by either setback genioplasty or burring reduction, but these approaches are less likely to produce aesthetically pleasing results. Both procedures have poor reduction effects because of the low response rate of soft tissues to skeletal alterations. There is a high likelihood of chin ptosis and flattening. Setback genioplasty can also yield step deformities at the inferior mandibular border. To overcome these drawbacks of conventional methods, I developed a novel technique of coronal-splitting reduction genioplasty. I have performed more than 83 procedures with a high success rate over the past 10 years. Alloplastic chin implant-shaped bone fragments were resected from the prominent bony chin, in which the average thickness of resected bone was 8.2 mm. Sufficient sagittal reduction effects were then achieved in most cases, although the soft tissue response rate remains 25%–50%, as reported in the literature. The no-degloving technique with cephalic suspension of the mentalis muscle prevents chin ptosis. Combined bilateral oblique osteotomies of the inferior mandibular border contribute to minimizing obvious postoperative chin flattening. Moreover, macrogenia can be large in multiple planes, including anteroposterior, vertical, transverse, or their combinations. This new technique can handle all three planes by combining both bilateral oblique osteotomies of the inferior mandibular border and burr ostectomy. Overall, these findings suggest that the coronal-splitting genioplasty method may replace conventional methods for correcting macrogenia.

Correlation Between Cephalometric Values and Soft Tissue Profile in Class I and Class II Adult Patients based on Vertical Patterns.

To compare soft tissue profile variations between Class I and Class II adult patients due to three vertical skeletal facial patterns (normodivergent, hypodivergent and hyperdivergent) and determine which skeletal variation has the most significant impact on soft tissue profile. Retrospective soft tissue profile analysis was performed on lateral cephalograms of 131 adult patients. The analysis was divided into two categories correlated with subnasal and general soft tissue profiles. The sample was divided based on two sagittal skeletal patterns (Class I and II) and three vertical groups. In addition, comparisons were made between males and females. Viewbox 4 was used for the analysis. Descriptive, comparative, and correlation statistics were performed using SPSS software. Statistically significant inter-gender differences were found at the subnasal profile level, but not at the general profile level. No significant differences were observed when comparing subnasal profiles for the sagittal groups. However, significant differences were observed at the level of the general profile, especially at the level of Z-angle, lower lip, and chin prominence. In the vertical groups, hyperdivergent facial patterns had significant differences at the level of subnasal and general profiles compared with other vertical facial patterns. Females had more convex subnasal profiles than males. Hyperdivergent facial patterns had an impact on both general and subnasal soft tissue profiles. The sagittal dimension affected only the general soft tissue profile. Therefore, changes in the vertical dimension had the greatest impact on facial esthetics.

Genetic and environmental impact on mandibular growth in mono- and dizygotic twins during adolescence: A retrospective cohort study

This study aimed to discover the genetic and environmental factors that contribute to the mandibular development of untreated monozygotic and dizygotic twins. The sample, taken from the Forsyth Moorrees Twin Study, included 52 untreated monozygotic twins (36 male, 16 female) and 46 untreated dizygotic twins (23 male, 23 female). At the ages of 12 and 17, lateral cephalograms were collected and traced to assess total mandibular length, mandibular ramus length, mandibular corpus length, gonial angle, SNB, and bony chin prominence. The genetic and environmental components of variation were assessed using multilevel mixed-effects structural equation modelling. At 12 years of age, high additive genetic influences were observed for total mandibular length (74%), gonial angle (76%), SNB (41%), and bony chin prominence (64%), whereas strong dominant genetic components were observed for corpus length (72%), and mandibular ramus length was under unique environment influence (54%). At 17 years of age, only total mandibular length (45%), ramus length (53%), gonial angle (76%), and bony chin prominence (68%) were under strong additive genetic control, while the remainder were under strong dominant genetic control. Although monozygotic and dizygotic twins share at least a portion of their DNA, additive, dominant, or environmental components were discovered during adolescence. Nonetheless, by the age of 17, the majority of the mandibular traits are under either additive or dominant genetic impact.

Establishing cephalometric norms using Arnett\'s soft tissue analysis for males and females of Jaipur population

This study was aimed to determine and compare soft tissue cephalometric norms between male and female population of Jaipur and compare them with Arnett’s soft tissue cephalometric norms with 50 males and 50 females which fall under selected inclusion criteria. One hundred samples (50 males and 50 females) were selected on random basis with harmonious facial appearances, good functional occlusions and first permanent molars in Angle's class I relation. Samples selected for the study were of age group between 18 to 25 years. Measurements were recorded and subjected to statistical analysis. 1.Cephalometric norms using Arnett's Soft tissue Analysis were established formales and females of Jaipur population. 2. Soft tissue cephalometric values show Sexual dimorphism with all the soft tissue thicknesses and the facial lengths being greater in males indicating longer faces, long upper & lower lips for males and more prominent the midfacial region in Jaipur females compared to males with more protrusive mandibular dentition with a prominent chin.

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.

Submentonial fat reduction with 1470nm diode laser and Endolifting® technique: case report

Purpose: This study aims to present a clinical case of significant reduction in submental fat using the Endolifting®technique and the 1470nm diode laser, supported by an extensive literature review. Case report: The ongoing quest for innovative and minimally invasive aesthetic procedures has propelled research in the field of aesthetic dermatology. Submental fat reduction, commonly referred to as a double chin, is a prevalent aesthetic concern that impacts facial harmony and the self-esteem of many patients. In this clinical case report, we introduce the application of the 1470nm diode laser in combination with the Endolifting®technique as a non-surgical alternative for double chin reduction. A 45-year-old patient with a prominent double chin performed a single treatment session. Following the treatment, a noticeable reduction in submental fat was observed, resulting in a more balanced and rejuvenated facial profile. The patient reported an enhancement in self-esteem and satisfaction with the outcomes. Conclusion: This case report validates the effectiveness of the 1470nm diode laser and the Endolifting®technique in reducing double chin, showing it as an innovative, efficient, safe, and replicable approach for submental fat reduction.

Hyper‐IgE syndrome presenting with early life craniosynostosis in monozygotic twin sisters

<scp>Hyper‐IgE</scp> syndrome presenting with early life craniosynostosis in monozygotic twin sisters

PowerScope 2 functional appliance: A 3D finite element simulation of its action on the mandible.

of study: This study evaluated the action of the PowerScope 2 appliance for correcting Class II malocclusion and the stresses and displacement of the mandible during loading using three-dimensional finite element analysis (FEA). The sites of the mandibular skeletal and/or dental corrections were also distinguished. Using the AutoCAD (2010) Program, a 3D model of the human mandible with teeth was created based on a CT image of a 20-yr-old patient. Orthodontic stainless-steel brackets with Standard Edgewise (0.022 in) slots bonded to five mandibular teeth and inserted into a bounded tube on the first molar were simulated. A rectangular archwire (0.019×0.025 in) ligated the brackets. The created models were uploaded to the Autodesk Inventor Professional Computer Program (FE) version (2020). The FEA presented the three-dimensional results qualitatively and quantitatively as von Mises stress and displacement. The colour ruler on the upper left side demonstrates the stress and displacement distribution pattern of the mandible, with the minimum value in blue and the maximum value in red. Mandibular movement was achieved three-dimensionally. There was obvious sagittal forward mandibular movement, and high stress was observed at the chin prominence (the pogonion). In the transverse plane, the mandible was highly bent buccally, especially at the gonial angle and antegonial notch. In the vertical plane, the highest ranges of mandibular movements were seen in the chin, the anterior part of the mandibular body, and the associated dentoalveolar region. The results of this FEA, PowerScope 2 functional appliance proved to be effective as a Class II malocclusion corrector. Its mode of action on the mandible was achieved in three planes of space, and its orthodontic effects were gained dentally and skeletally. An bbvious sagittal forward mandibular movement was observed, particularly at the chin prominence. Apparent buccal bending, especially at the gonial angle and antegonial notch, was observed. Vertically, the chin and anterior part of the mandible, with the associated dentoalveolar structures, were clearly stressed under the action of this appliance.

Facial features of lysosomal storage disorders

ABSTRACT Introduction The use of facial recognition technology has diversified the diagnostic toolbelt for clinicians and researchers for the accurate diagnoses of patients with rare and challenging disorders. Specific identifiers in patient images can be grouped using artificial intelligence to allow the recognition of diseases and syndromes with similar features. Lysosomal storage disorders are rare, and some have prominent and unique features that may be used to train the accuracy of facial recognition software algorithms. Noteworthy features of lysosomal storage disorders (LSDs) include facial features such as prominent brows, wide noses, thickened lips, mouth, and chin, resulting in coarse and rounded facial features. Areas covered We evaluated and report the prevalence of facial phenotypes in patients with different LSDs, noting two current examples when artificial intelligence strategies have been utilized to identify distinctive facies. Expert opinion Specific LSDs, including Gaucher disease, Mucolipidosis IV and Fabry disease have recently been distinguished using facial recognition software. Additional lysosomal disorders LSDs lysosomal storage disorders with unique and distinguishable facial features also merit evaluation using this technology. These tools may ultimately aid in the identification of specific LSDs and shorten the diagnostic odyssey for patients with these rare and under-recognized disorders.

Joint Stiffness Leads to the Diagnosis of a Rare Disease

Introduction: A 6-year-old boy was referred to our hospital because of the stiffness of both knees, which had commenced two years ago and gradually progressed to both hips, ankles, elbows, fingers, and toes. He occasionally had arthralgia with no complaint of joint swelling. He had a long face, a prominent forehead and chin, and a short neck. There was a limitation in the range of motion in all appendicular joints with stiffness and deformity. Case Presentation: Skeletal survey images revealed central beaking and a bullet shape appearance in the cervical and lumbar vertebra, tapering of iliac wings, deformity of the femoral head, and short sacral length. A +3 glycosaminoglycan (GAG) excretion was detected in the urine test, but genetic analysis revealed Mucolipidosis type III. Conclusions: The diagnosis of metabolic diseases should be considered whenever there is joint stiffness without any evidence of inflammation. Mucopolysaccharidoses and Mucolipidoses are progressive storage disorders with many clinical and radiological characteristics.

The Open Book Genioplatsy Technique: A Modification.

Genioplasty is a versatile procedure in the repertoire of a maxillofacial surgeon since the time it was conceptualized by Trauner and Obwegeser in 1957.1 The chin improves the facial profile and renders a definition to the jaw. An aligned and proportionate chin adds ample aesthetic value and youthfulness to the face. In addition, it influences the apparent length of the face. Genioplasty holds the potential to alter the dynamics of facial harmony with minimal effort.2 Failure to perform a much required genioplasty can jeopardize the outcome of hours of an otherwise successful major orthognathic or cosmetic surgery.3 The slope and nature of rotation of the osteotomized segments dictate the extent of vertical and horizontal changes.4 In this article, we attempt to introduce a modification to the existing plethora of genioplasty techniques, particularly aimed to rectify a short square jaw into a feminine one. This technique comprises two conventional oblique osteotomies that split the chin into two components, superior and inferior. A margin of 5 mm is kept superiorly from the root tip, inferiorly from the lower border of mandible, and laterally from the mental foramen. Additional stripping of muscles along the lower border of the mandible ensures adequate mobility of the osteotomized inferior segment. The osteotomized segment is rotated outward and downward at an angle of about 30 to 40 degrees, wherein the tip of the inferior osseous segment is regarded as the prominence of the newfound mentum and the anterior surface of the chin becomes the lower border of the mandible (Fig. 1). The osseous segments are secured using two four-hole, 2.0-mm titanium plates (Fig. 2). Bony margins are smoothed. Hemostasis is achieved. Closure is performed done using 4-0 Vicryl sutures. A 1-year pictorial and radiographic follow-up is charted. The same substantiates the successful outcome of the procedure in terms of desired vertical increment, horizontal augmentation, a feminine round chin with a pointy upheal, and desired labiomental fold.Fig. 1.: Schematic representation of the open book genioplasty technique, in which point A becomes the newfound chin prominence, B becomes the lower border of the mandible, and C is the thickness of the mandible seen upon rotation.Fig. 2.: Osseous segment secured using titanium plates and screws depicting an open book fixation.The design of this open book osteotomy can be deemed ideal for a patient with an existing broad chin who desires a sharper, more feminine one. We have so far performed this procedure on female patients, who require a horizontal advancement of about 10 to 13 mm. The greatest advantage lies in negating a step formation along the lower border of the mandible, contributing to a smooth jawline. The downward rotation of the inferior segment helps acquire additional length, thus leading to a vertical increment in the lower half of the face. The possibility of a dual-plane augmentation makes this technique a versatile one. The thickness of the mentum is a vital consideration, as the osseous volume directly translates to the extent of advancement that can be achieved. In our vast clinical experience, the proposed open book genioplasty technique has had gratifying results with the desired osseous and soft-tissue outcomes in female patients with a short, square chin. ACKNOWLEDGMENT This study conformed to all guidelines of the Declaration of Helsinki. DISCLOSURE The authors have no financial interest to declare in relation to the content of this article. No funding was received for this work.

Orthognathic correction and corticobasal implant-supported prostheses as a treatment modality for partial edentulism with mandibular prognathism: A case report and review of literature

IntroductionMandibular prognathism manifests as elongation of the mandible in the anteroposterior direction, resulting in a sunken appearance of the middle third of the face and sad look of the eyes. It adversely affects esthetics, function, and oral health, reducing the patients' self-esteem. It therefore presents a significant challenge.Presentation of caseA 23-year-old woman presented with prognathic features characterized by mandibular protrusion, maxillary retrusion, a prominent chin, and reduce self-esteem. Intraoral examination revealed multiple extracted teeth, severe fracture of the crown at 23, mobility of the fixed prosthesis on 13, 14, 15, and 16, a root stump of 18, and periodontally compromised teeth (31, 32, 33, 41, and 42).A multidisciplinary team formulated the following treatment plan: stage 1, orthognathic osteotomy to retrude the mandible at 34 and 44; stage II, fabrication of transitional acrylic partial dentures; and stage III: fabrication of definitive corticobasal implant-supported prostheses. The patient was delighted with the treatment and complied with the oral hygiene instructions and follow-up program. After 7 years of function, the patient presented without complaints and exhibited significant improvement in oral health, self-esteem, and quality of life.DiscussionThe management of mandibular prognathism requires a multidisciplinary approach. The treatment implemented was considered the optimal option that aligned with the recommendations of several researchers to reduce facial disfigurement and rehabilitate the edentulous state.ConclusionThe use of corticobasal implant-supported prostheses for the rehabilitation of patients with partial edentulism can significantly improve the treatment outcome following orthognathic surgery in cases with mandibular prognathism.

Perception of facial esthetics in young North Indian population.

INTRODUCTION:A person's ability to recognize a beautiful face is innate, but translating this into defined treatment goals is a challenge for clinicians.AIM:To determine if faces considered esthetic and pleasing in the young North Indian population (both males and females) exhibit similar cephalometric measurements as used for ideal treatment and successful results.MATERIALS AND METHOD:A panel of five judges evaluated a set of one frontal, one frontal during smiling, and one profile extra-oral photograph of 160 students (80 females and 80 males) on a five-point attractiveness scale. For each photographic set, the mean and final scores were calculated. Once the sample was assessed, 60 subjects (30 females and 30 males) with the highest final facial aesthetic score were selected and cephalometric analysis was performed. The obtained data were subjected to statistical analysis using SPSS 20 software.RESULTS:Both males and females with class I skeletal jaw bases were found to be attractive. The females with short faces; mild facial convexity and lower lip closer to the esthetic line were found to be attractive. The males with a prominent chin, straight profile, prominent nose, increased upper lip thickness, upper lip length, and lower lip length were found to be attractive.CONCLUSION:The faces considered attractive in this study fulfilled most of the cephalometric norms commonly used for the diagnosis and treatment planning except for a few inconsistencies which may be attributed to the gender and demographic origin.

The perception of attractiveness of the facial profile among people of Telangana ethnicity

Background: The success of orthodontic treatment to a significant extent is largely dependent on the patient's and lay peoples' perception. Treatment can influence the soft tissue profile of the face, which is why, it is important for orthodontists to perceive what is considered attractive and unattractive amongst locals, and further, incorporate this knowledge in their diagnosis and treatment planning for population-specific groups.Aim: To evaluate differences in perception of attractiveness of the human face (in profile view) among ethnic Telangana subjects when compared to ideal Caucasian facial profile attractiveness standards.Methods: Profile silhouettes of ethnic Telangana subjects with straight, convex and concave facial profiles were rated by 10 adult laypersons (ethnic Telangana origin) and scored from least to most attractive. Fifteen relevant soft-tissue parameters from the Ricketts, Legan-Burstone, Steiner's and Z-Merrifield analysis were then evaluated on lateral cephalometric radiographs of the highest scoring subjects (considered most attractive) and sample t test statistical analysis was done in order to investigate differences between obtained values of the 'attractive' group as compared to standard values given in these analyses.Results: Of 15 parameters compared, significant differences from standard cephalometric values were evident for- vertical lip-chin ratio, lower lip protrusion, mento-labial sulcus and Z- angle. These measurements were smaller in the evaluated population group as compared to orthodontic norms.Conclusion: People of ethnic Telangana origin considered a shorter and less prominent lower lip and chin and a shallower mento-labial sulcus to be more attractive, as compared to standard orthodontic cephalometric norms of Caucasian populations.

Variable negative external pressure-an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea: a pilot study.

To assess variable negative external pressure (vNEP) therapy using a range of pressures and varying collar sizes and shapes to identify combinations that improve the efficacy and comfort of this emerging therapy for obstructive sleep apnea (OSA). This prospective, open-label pilot study included 28 eligible patients (71% men) having documented moderate OSA (apnea-hypopnea index [AHI] 15 events/h ≤ AHI ≤ 30 events/h) at 1 sleep clinic for an overnight, in-lab sleep trial. Each participant tested at least 2 of 6 available vNEP devices during sleep periods ≥ 2 hours. During the assessment of AHI by polysomnography, negative pressures of -20 cm H2O to -35 cm H2O were adjusted to improve each patient's response. Participants' therapeutic preferences were assessed by a questionnaire and interviews. Twenty (71%) of the participants responded to vNEP therapy: excellent response (AHI ≤ 5 events/h) was observed in 14 (50%); 6 (21%) achieved a partial response (AHI ≤ 50% baseline). For the 20 responders, the therapy reduced the fraction of total sleep time when peripheral oxygen saturation < 90% and improved minimum pulse oximetry oxygen saturation. Six patients experienced a minor, self-limited adverse event. Twenty-six participants (93%) stated that they would use vNEP nightly. In this pilot study, vNEP therapy markedly improved AHI and oxygenation in most patients with moderate OSA. The majority of participants found vNEP comfortable and preferable to prevailing OSA therapies. Further development and studies of vNEP are warranted. Registry: ClinicalTrials.gov; Name: Study of Variable Negative External Pressure (vNEP) in Reducing Respiratory Event in Individuals With OSA; URL: https://clinicaltrials.gov/ct2/show/NCT04718142; Identifier: NCT04718142. Kram JA, Pelayo R. Variable negative external pressure-An alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea: A pilot study. J Clin Sleep Med. 2022;18(1):305-314.

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.

Morphology of mandible - A two year digital radiographic study

Mandible is a unique single bone often recovered intact during mass disasters.To assess whether the specific morphological characteristics of mandible in males and females can be used as an aid for sex determination based on radiographs.A two-year retrospective study was conducted in 200 subjects [100 males and 100 females] using digital radiographs. Profile of chin and morphologic differences in the base of the mandible were assessed using digital lateral cephalogram. Mandibular ramus flexure was assessed from digital Orthopantomogram. The obtained data statistically analysed using SPSS software version 20. Descriptive statistics was analysed. Chi square test was done to determine the association between gender and different parameters. The level of significance set at p ≤ 0.05.There is a significant association between chin profile, base of mandible and mandibular ramus flexure with gender. Females have prominent chin compared to males. Males have undulating base of mandible while females have straight base of mandible. Mandibular ramus flexure in males seen at the level of occlusal plane while it is seen above the occlusal plane in females.There is a morphological difference in the mandible of the males and females.

Minimally invasive aesthetic treatment of male patients: The importance of consultation and the lower third of the face.

BackgroundMen worry disproportionately about potential negative consequences of facial aesthetic treatment with injectable therapies, such as side effects or appearing more feminine. Features of the lower third of the face (eg, prominent chin and jaw) are particularly important in perceptions of masculinity. A strategy has been developed for male patients based on an initial consultation emphasizing the safety and masculinizing potential of injectables, followed by treatment with a high G’ hyaluronic acid filler targeting the lower third.AimsTo assess this strategy in routine practice.MethodsThis was a retrospective analysis of male patients with poor definition of the lower third of the face wishing to undergo non‐surgical correction. Initial consultation focused on detailed patient education and facial masculinization with injectables. Individuals were then treated in the lower third using VYC‐25 based on the standardized MD Codes approach. Follow‐up lasted ≤12 months.ResultsForty patients were included (mean age: 40.9 ± 9.6 years). The mean volume of VYC‐25 injected into the lower third was 7.8 ± 1.2 ml. Patient satisfaction was high, as assessed using the FACE‐Q “Satisfaction with outcome” questionnaire (mean Rasch‐transformed score: 88.1 ± 10.3). Complications included the following: soft tissue edema, n = 12 (30.0%); hematoma, n = 6 (15.0%); and telangiectasia, n = 2 (5.0%). All were early, transient, and minor; there were no major or delayed events.ConclusionsThis approach to male subjects was practical and safe despite the large volumes of filler used. Focusing on the lower third may help to reassure patients and deliver results that respect masculine identity.