Short Face Research Articles

Relação entre cefalometria e análise facial na determinação do tipo de face

OBJETIVO: correlacionar os achados cefalométricos com os da análise facial realizada por meio de fotografias para classificar o tipo facial, segundo o sexo. MÉTODOS: participaram 105 adultos leucodermas, 34 (32,4%) homens e 71 (67,6%) mulheres, com idades entre 20 e 40 anos, de uma clínica particular de ortodontia de Belo Horizonte/MG. Os achados da análise cefalométrica para determinação do tipo facial a partir do índice VERT de Ricketts foram comparados com a classificação da face realizada por meio da análise facial clínica baseada na observação de duas fotografias. Para essa análise, participaram três fonoaudiólogos especialistas em motricidade orofacial. RESULTADOS: não houve correspondência satisfatória ao se comparar as duas formas de classificação do tipo facial apresentadas neste estudo. A maioria dos indivíduos masculinos dolicofaciais foi classificada como face média a partir da análise facial, ou seja, quatro entre sete sujeitos (57,14%). Os 11 mesofaciais foram identificados como face média (N=5; 45,45%) ou curta (N=4; 36,36%) e os 16 braquifaciais como face média (N=9; 56,25%) ou curta (N=7; 43,75%). No sexo feminino, observou-se que 11 entre 20, ou seja, 55% dos indivíduos dolicofaciais foram apontados como face média. Dos 26 sujeitos mesofaciais, 16 (61,53%) também foram classificados como face média. Com relação aos 25 braquifaciais, 12 (48%) foram identificados como face curta e 11 (44%), como média. CONCLUSÃO: a classificação do tipo de face apenas a partir da análise facial realizada por meio de fotografias não foi considerada confiável, se utilizada isoladamente, quando comparada à classificação obtida a partir da análise cefalométrica.

Suspected cerebral gigantism diagnosed by dental examination

Cerebral gigantism is an overgrowth disorder that occurs from the prenatal stage through childhood and features such clinical symptoms as advanced bone age, macrocephaly, characteristic facial appearance, and learning difficulties. A 4-year 3-month-old girl was referred to our clinic for consultation regarding anterior crossbite and occlusal pain in the molar region. An intraoral examination showed that the mandible was considerably larger than the maxilla. The dental age of the entire dentition estimated from orthopantomogram images was approximately 1 year ahead of chronological age. Cephalometrics analysis demonstrated maxillary protrusion, prominent mandibular protrusion, and vertically severe short face. The size of maxilla was slightly small, whereas that of mandible was above the average. Since height and body weight were above the 97 percentile, the patient was referred to a pediatrician for a general examination prior to dental treatment and diagnosed with suspected cerebral gigantism. As for occlusal pain in the molar region, we considered that it was caused by excessive occlusal pressure. Following application of splinting and several adjustments, the pain gradually disappeared.

Influência da proporção entre as alturas do ramo mandibular e dentoalveolar posterior na inclinação do plano mandibular

OBJETIVO: avaliar a existência de correlação entre a proporção da altura do ramo mandibular (AR) com a altura dentoalveolar posterior total (ADAPT) e a inclinação do plano mandibular (PM). MÉTODOS: dois examinadores avaliaram 81 telerradiografias laterais de pacientes, com idades a partir de 18 anos, do arquivo do curso de especialização em Ortodontia e Ortopedia Facial da Faculdade de Odontologia da UFBA. As radiografias foram digitalizadas, os pontos marcados e as medidas obtidas através do programa Radiocef 1.0. Mediu-se a inclinação do plano mandibular para caracterizar o padrão vertical da face e dividir as radiografias em três grupos: grupo de face normal (GN), de 22º a 28º, de face curta (GC), menor que 22º, e de face longa (GL), maior que 28º. A inclinação do plano palatino serviu como critério de exclusão, sendo que valores abaixo de -2,5° ou acima de 3,5º foram excluídos. Desta forma, 46 telerradiografias laterais totalizaram a amostra. RESULTADOS: a AR diferiu entre GC e GL, porém não houve diferença estatisticamente significante para as alturas dentoalveolares posteriores. Houve baixa correlação entre a AR e a ADAPT nos grupos, no entanto, a correlação da proporção entre essas alturas com a inclinação do PM mostrou-se estatisticamente significante e negativa. CONCLUSÃO: este é um fator a ser levado em consideração na avaliação do PM, quando do diagnóstico e tratamento das displasias verticais dentofaciais.

Periodontal Parameters in Different Dentofacial Vertical Patterns

To assess periodontal parameters in a Jordanian population in individuals with three different facial types. Forty-five dental students (ages 20-26 years) with short, average, and long face heights were divided into three equal groups. The plaque index, gingival index, gingival thickness, width of keratinized gingiva, and width of attached gingiva were measured in each group. Occlusal factors, including the dynamic occlusion and the presence or absence of premature contacts were recorded. Differences among the three groups were assessed using Student's t-test, chi-square test, and analysis of variance (ANOVA) test. No differences were present in the plaque index, gingival index, gingival attachment, width of attached and keratinized gingiva and gingival thickness between the subjects in the three groups studied. None of the subjects in the long face group had canine guidance dynamic occlusion. There were no differences in the periodontal parameters between the different dentofacial vertical patterns, but there was a difference in the canine guidance dynamic occlusion.

Craniofacial Morphology in Children With Operated Complete Unilateral Cleft Lip and Palate

The objective of the study was to compare the craniofacial characteristics of children with operated unilateral complete cleft lip and palate (UCLP) with those of noncleft children. Lateral and posteroanterior cephalometric radiographs of subjects with UCLP and controls who were matched for sex, age, and ethnic origin were analyzed and compared. There were a total of 21 subjects with UCLP (10 boys and 11 girls) from the Orthodontic Department of Selcuk University and 15 controls (7 boys and 8 girls) from the Orthodontic Department of Ankara University. The nasal bone length in the group with cleft did not differ significantly from that in the control group. Subjects with UCLP included in the study appeared to have shorter faces, smaller mandibulae, greater lateral orbital width, and smaller sella turcicae compared with controls. Unilateral cleft lip and palate affects the intracranial morphology as well as dentofacial structures.

O.361 Aesthetic and surgical consideration in the short face

To determine intraoperative as well as post surgical complications of bilateral sagittal split ramus osteotomy.A retrospective evaluation of 44 case records of BSSRO, performed over a period of five years from January 2010 to Dec 2014, at a single center.Bad split was reported in 3 patients in the series, intraoperative bleeding was encountered in 5 cases, which was controlled by pressure packing. Postsurgical Neuro Sensory Deficit (NSD) was present in 22 patients, which resolved over a period of 6 months–1 year. Severe relapse and bone loss were reported in 1 patient each. Implant removal was done in 3 cases following peri-implantitis. Reoperation was done in 1 case to correct anterior open bite (AOB).Neuro Sensory Deficit (NSD) was the most common immediate post surgical complication following BSSRO. Almost all the cases had neuropraxia of inferior alveolar nerve (IAN) secondary to stretch or compression. Additional care should be taken during incision placement, soft tissue retraction and fixation.

Against the “visible” short scar face lift

According to the author, the short scar face lift seeks to eliminate the retroauricular scar by exerting a vertical pull on the cheek, but residual excess skin frequently remains below the ear lobe. More importantly, this vertical elevation of the cheek creates significant skin excess at the temporal level. To eliminate this excess, a precapillary temporal skin excision is usually performed. A potentially obvious temporal scar is thus created in a very visible part of the face. In this article, the author outlines his views on the drawbacks of the short scar face lift and advocates a different technique, using a vertical retroauricular incision, with the goal of avoiding the disadvantages of the short scar approach.

Triangle-free planar graphs with minimum degree 3 have radius at least 3

We prove that every triangle-free planar graph with minimum degree 3 has radius at least 3; equivalently, no vertex neighborhood is a dominating set. In 1975, Plesnik [3] determined all triangle-free planar graphs with diameter 2. They are the stars, the complete bipartite graphs K2,n, and a third family that can be described in several ways. One can start with the disjoint union K2 +K1 and add vertices of degree 2 joined to either nonadjacent pair of the original triple, or start with C5 and expand two nonadjacent vertices into larger independent sets, or start with K2,n and apply a “vertex split” to one of the high-degree vertices. Each graph in Plesnik’s characterization has a vertex of degree at most 2. Thus his result implies that every triangle-free planar graph with minimum degree 3 has diameter at least 3 (note that no triangle-free planar graph has minimum degree greater than 3). In this note, we strengthen this statement by proving that every triangle-free graph with minimum degree 3 has radius at least 3. That is, it has no vertex whose neighborhood is a dominating set. There are many triangle-free planar graphs with minimun degree 3 and radius equal to 3. Our result can also be related to other past work about distances in triangle-free or planar graphs. Erdős, Pach, Pollack, and Tuza [1] studied the maximum radius and diameter among graphs with fixed minimum degree. They also solved these problems in the family of triangle-free graphs. In contrast, we are seeking the minimum radius when the family is further restricted to planar graphs. For planar graphs, Harant [2] proved an upper bound on the radius when the graph is 3-connected and has no long faces (it is n/6 + q + 3 2 when the graph has n vertices and no face of length more than q). We prove a lower bound on the radius when the graph has no short faces (no triangles), without restriction on connectivity. Mathematics Education Department, Konkuk University, Seoul, Korea, skim12@konkuk.ac.kr Department of Mathematics, University of Illinois, Urbana, IL 61801, west@math.uiuc.edu. This research is partially supported by the National Security Agency under Award No. H98230-06-1-0065.

A Genome Segment on Mouse Chromosome 12 Determines Maxillary Growth

The primary and modifier genes that regulate normal maxillofacial development are unknown. Previous quantitative trait locus (QTL) analyses using the F2 progeny of 2 mouse strains, DBA/2J (short snout/wide face) and C57BL/6J (long snout/narrow face), revealed a significant logarithm-of-odds (LOD) score for snout length on mouse chromosome 12 at 44 centimorgan (cM). We further sought to validate this locus contributing to anterior-posterior dimensions of the upper mid-face at the D12Mit7 marker in a 44-centimorgan portion of chromosome 12. Congenic mice carrying introgressed DNA from DBA/2J on a C57BL/6J background were selected for submental vertex cephalometric imaging. Results confirmed QTLs, determining that short snout length (P < 0.05) and face width relative to snout length (P < 0.01) were present in the 44-cM region of chromosome 12. We conclude that one or more genes contributing to the shape of the maxillary complex are located near 44 cM of mouse chromosome 12.

Facial development, continuous tooth eruption, and mesial drift as compromising factors for implant placement

The replacement of teeth lost by children because of trauma can be an important indication for early implant therapy. Osseointegrated dental implants, like ankylosed teeth, alter position as growth-related changes occur within the jawbones (displacement, remodeling, mesial drift). Facial growth of the child and even of the adolescent, as well as the continuous eruption of the adjacent anterior teeth, create significant risk of a less favorable esthetic and/or functional outcome. For patients with a normal facial profile, the placement of an implant should be postponed until growth is complete. For patients with a short or long face type, further growth, especially the continuous eruption of adjacent teeth, creates a serious risk even after the age of 20 years, as illustrated by some recent clinical studies. This review aims to explain these phenomena and provides some recommendations for implant placement.

The MACS-lift short scar rhytidectomy

The minimal access cranial suspension (MACS) lift, a short scar face lift for the lower and middle third of the face, uses a pure vertical vector, involves no lateral tension, and may be performed with the patient under local anesthesia in 2 to 2.5 hours. According to the authors, the procedure reduces recovery time and morbidity, and results are as stable as more classic, extended face lift techniques.

Characteristics of mandibular advancement surgery dependent on lower facial height differences in study of skeletal Class II patients with long-term stability

We studied patients who underwent mandibular advancement surgery and showed a stabilized occlusal condition at 5 years after surgery. The patients were classified into 2 groups [long face type (LF group: 16 cases), short face type (SF group: 10 cases)] according to immediate presurgery face type. To clarify the characteristics of the operative method formulated based on lower facial height, morphological changes during the 5-year postoperative period were compared between the groups. There was no statistically significant difference in amount of advancement between the two groups, though lower facial height showed a tendency to increase in group SF. The proximal segment was advanced to the anterosuperior position in both groups. To determine postoperative stability, in the LF group, there were no statistically significant differences for lower face height. In the SF group, the condylar axis increased in the period from immediately after to 6 months after surgery. Correlation analysis revealed that the backward rotation of the proximal segment was greater during the first 6 months, as the amount of surgical advancement of the chin was larger. As a result, the chin was advanced during surgery and the proximal segment was advanced toward the anterosuperior position in both groups. In the SF group, the characteristics of the operative design increased the lower facial height.

Effects of treatment with a combined maxillary protraction and chincap appliance in skeletal Class III patients with different vertical skeletal morphologies

Several cephalometric studies and case reports have described the effects of treatment with a maxillary protraction appliance (MPA) and chincap appliance. The purpose of this investigation was to identify differences in the response to treatment with a combined MPA and chincap in skeletal Class III patients with different vertical skeletal morphologies: short- (low mandibular plane angle) and long- (high mandibular plane angle) face types. The cephalograms used in this study were of 42 Japanese girls at the beginning of treatment (T0, mean age 10.1 years) and at removal of the appliance (T1, mean age 11.5 years). The subjects were divided into two groups (short and long face) according to the inclination of the mandibular plane at T0. Total anterior face height, upper and lower face height, occlusal plane, and gonial angle were significantly larger in the long-face group at T0. In both groups, significant increases in SNA, maxillary size (A'-Ptm'), and ANB were noted during treatment. Compared with the long-face group, the short-face group showed greater forward displacement and size increment of the maxillary body, while there were no significant differences in changes in mandibular size or position between the two groups. These results indicate that the vertical dimensions of the craniofacial skeleton are important factors in the orthopaedic effects of a MPA and chincap and the prognosis for skeletal Class III patients.

Adaptation of jaw closing muscles after surgical mandibular advancement procedures in different vertical craniofacial types: a magnetic resonance imaging study

Surgical mandibular advancement influences the biomechanics of the mandible and as a result may provoke relapse. In this study, the adaptation of the masseter (MAS) and medial pterygoid muscles (MPM) after surgical mandibular advancement was evaluated. Of 12 patients with mandibular retrognathia and varying vertical craniofacial morphology, axial and 30 degrees angulated magnetic resonance imaging (MRI) scan series were taken preoperatively and 10 to 48 months postoperatively. Using cluster analysis, subjects were assigned to a long-face (LF) and a short-face (SF) cluster. Subsequently, preoperative and postoperative maximum cross-sectional areas and volumes of the MAS and MPM were compared in these groups. The cross-sectional area and volume of the MAS decreased significantly in both the SF and LF cluster (up to 18%). Although not significantly, this phenomenon tended to be more pronounced in LF patients. The cross-sectional area of the MPM showed less adaptation. The jaw-closing muscles become significantly smaller after surgical mandibular advancement, irrespective of the vertical craniofacial type.

Facial rejuvenation in patients of medium complexion

Gustavo Colon, MD Portia Chiou, MD Onelio Garcia, Jr., MD Volney Pitombo, MD Dr. Colon: I would like to start by posing a general question. Is there any approach that you take differently in a patient of medium complexion—whether Latino/Hispanic, Mediterranean, or another ethnicity with generally thicker skin—with regard to the incisions used for facial rejuvenation procedures? Because one of the things you must warn these patients about is that their scars may be hypertrophic. Dr. Garcia: About 50% of my current practice is Hispanic. I am in south Florida. In the very thick, darker, or olive skinned patients that I see, I do not use hairline incisions. I always keep them behind the hairline, and I shorten the postauricular incision significantly, whenever possible. But when I cannot, because of significant extra skin, I always keep it within the hair. The problems I have seen with hypertrophic scars in these patients have been in the postauricular area. Dr. Colon: Dr. Pitombo, what is your approach? Dr. Pitombo: I limit the problem by limiting the incisions. In other words, I do a short scar face lift. Dr. Colon: And Dr. Chiou? Dr. Chiou: For my patients who have medium complexion skin, I place the scar within the hairline, if possible. Postoperatively, I start patients on active scar massage the week after their sutures are removed. In some instances, I recommend using a particular product, such as Mederma (Merz Pharmaeuticals, Greensboro, NC), which when coupled with scar massage seems to help keep scars flat. Dr. Colon: Is there any difference in your approach to Asian patients? Dr. Chiou: I approach Asian patients in the same way as I approach anyone with a medium complexion. Scarring is a concern, especially in the very early postoperative period. For patients at risk for hypertrophic scarring, …

New short time face turning method for testing the machinability of PM steels

The production of sintered structural components by powder metallurgy (PM) route is basically done by uniaxial cold pressing of metal powders in closed dies followed by sintering at temperatures in the range of 1120–1300 °C in H/N atmospheres (solid phase sintering). The machinability of PM steels is tested by different methods for the various cutting processes. Compared to wrought steels, PM steels exist in an almost unlimited variety of microstructures. This fact complicates creation of a uniform solution for testing and characterizing the problems in machinability of PM steels. Simple and easy methods can be appropriate as a first approach to the machining problem especially for industrial practice and for the research. The short time face turning method using common small ring-shaped specimens as test pieces is presented here as a new method for testing the machinability of PM steels. The method was tested on Fe–C and Distaloy type materials. The critical number of cutting passes up to a tool flank wear of VB = 0.3 mm, critical time, critical volume of removed material, surface finish and morphology of the chips were the criteria for checking the technical effectivity of the method applied. The results attained show that the face turning test method used here is simple and easy and can fulfil many requirements for assessing the machinability of PM steels in turning.

A case of achondroplasia with severe pulmonary hypertension due to obstructive sleep apnea

Achondroplasia is the most common skeletal dysplasia in children. Achondroplasic patients have a short cranial face and midface hypoplasia. They often have sleep-related respiratory disturbances that lead to hypoxemia caused by midfacial hypoplasia, a small upper airway, hypotonia of airway muscles, or brain stem compression. It has been well described that obstructive sleep apnea can cause pulmonary hypertension (PH) through the mechanism of chronic hypoxemia. However, severe PH due to obstructive-type sleep disorder is rare in patients with achondroplasia. In this report, we describe a 5-year-old girl with achondroplasia whose severe PH was caused by upper-airway obstruction and was resolved gradually after adenotonsillectomy.

Racial variations in cephalometric analysis between Whites and Kuwaitis.

The objective of this study is to determine whether (1) Kuwaiti adolescents differ from Caucasian adolescents with respect to their cephalometric values; (2) sex plays a role in the differences between the two groups; and (3) a need exists to develop cephalometric standards for the Kuwaiti population. Standardized cephalometric films were obtained from 36 Kuwaiti females and 32 Kuwaiti males between the ages 11 and 14 years. Only subjects with Class I molar occlusion and a positive overjet of no more than 4 mm were selected. Each subject was age matched with White cephalometric values. Intraexaminer error, paired, and two-sample t-tests were made. The results show that there were significant differences between the Kuwaiti population and the Caucasian population for the majority of the variables tested (P < .01). Sex produced no significant effect on any of the variables studied. The Kuwaiti population has fuller lips, more facial convexity, greater dental protrusion, a more retruded and smaller mandible, and shorter posterior face height than the Caucasian population.

Evaluation of Ectodermal Dysplasia

This case series report outlines possible cranio-maxillofacial deformation consequences associated with ectodermal dysplasia (ED) and embryonic malformations, including dental agenesis. Also described are the oral aspects and rehabilitation. A total of 14 ED patients (7 males and 7 females, aged 5-45 years) underwent clinical examination before assessment and treatment. Lateral cephalometric radiography, Steiner's analysis, and respiratory capacity tests were performed. Most of the patients had sparse or absent hair, a short face with an unusual facial concavity, a maxillary retrusion, and a relative mandible protrusion. Depending on age and orthopedic abnormalities, patients were treated with prosthodontic and orthodontic approaches or implant treatment. Therapists should take a comprehensive and multidisciplinary approach with these patients to improve their dental, masticatory, growth, and orthognathic conditions, as well as esthetic appearance.

Ortho-Surgical Correction of Short Face Syndrome - A Case Report

Ortho-Surgical Correction of Short Face Syndrome - A Case Report