Late Outcomes of Undiagnosed Unilateral Condylar Hyperplasia and Reoccurrence of Mandibular Asymmetry.

Unilateral condylar hyperplasia (UCH) is a rare cause of asymmetrical mandibular overgrowth because of the presence of an atypical growth in the affected condyle. SPECT (single-photon emission computed tomography) can easily establish the presence of an atypical, prolonged growth exceeding far beyond normal condylar growth and activity. A CT, CBCT, or LDCT (computed tomography, cone-beam computed tomography, or low-dose computed tomography) can confirm the diagnosis by evaluating the scope of bone overgrowth, mandibular basis/ramus asymmetry, tendency to condylar head enlargement, changes in bone density, and occurrence of differences in condylar head shapes, size, and bone structure. In most cases, a condylectomy is the procedure of choice in growing cases of UCH to remove the pathological condyle and reduce asymmetry levels. Sometimes, the growth is very slow and progressive over time, causing slowly growing asymmetry with similar symptoms to any other mandibular asymmetry, and this causes some troublesome procedures in UCH diagnostics, resulting in patients being underdiagnosed; it can even lead to some relapses in mandibular asymmetry and skeletal malocclusion after previously performed orthodontic and surgical treatment of such discrepancies. When the source of asymmetry is not identified in time, possible inadequate treatment protocols can be used. If any relapse of facial and mandibular asymmetry re-occur, SPECT and CT evaluation are necessary to evaluate if condylar hyperplasia is present and to establish what kind of surgical intervention should be used in each case.

Comparative Cranial Geometric Morphometrics among Wistar Albino, Sprague Dawley, and WAG/Rij Rat Strains.

This research utilizes geometric morphometrics to investigate shape variation in the skull, mandible, and teeth among three rat strains: Wistar Albino (WA), Sprague Dawley (SD), and WAG/Rij (WR). Through the analysis of 48 rats using 2D geometric morphometric techniques, significant differences in their skull morphology were identified. This study indicates a shift from a rectangular to an oval cranial shape across strains, with notable size and morphological variances. Particularly, the WR strain's skull shape significantly differs from the SD and WA strains, suggesting distinct ecological or genetic pathways. Compared to the skull, mandible shape differences are less pronounced, but still significant. The WR strain exhibits a distinct mandible shape, potentially reflecting ecological adaptations like dietary habits. The teeth shape of WR rats is the most distinct. SD rats consistently exhibited larger sizes in both skull and mandible measurements, while WR rats were notably smaller. Interestingly, sexual dimorphism was not statistically significant in skull and teeth sizes, aligning with findings from previous studies. However, the mandible showed clear size differences between sexes, underscoring its potential for adaptive or behavioral studies. In summary, this study provides a comprehensive analysis of morphological variations in rat strains, highlighting the intricate interplay of size, shape, and ecological factors. These findings lay a foundation for deeper explorations into the adaptive, ecological, or genetic narratives influencing rat morphology.

Pathological Changes in Early Medieval Horses from Different Archaeological Sites in Poland.

The work is the first comprehensive analysis of equine pathological changes from the Polish territory. The research material was collected from 20 archaeological sites, mainly early medieval settlements, such as strongholds, settlements, towns and horse graves. In the material examined, 186 cases of lesions were found. Of these, 26.9% were lesions of the spine, 39.8% lesions of the limb skeleton and 31.7% lesions of the head including dental pathologies. Most of the lesions in the limbs involved their distal segments. The vast majority of pathological cases can be linked to animal use. It was found that horses in which pathological lesions were observed were used under cover. In one case, the observed cranial trauma was the cause of death associated with injury to the nasal auricles and large vessels and consequent blood loss and possible shock. It was found that, in some of the cases, the horses started to be used early which affected their organs of motion and spine.

A probable case of "lumpy jaw" in early medieval (11th - 12th c.) cattle from a stronghold in Kruszwica, Poland.

OBJECTIVE: The purpose of this article is to try to determine the probable cause of the disease from which the study animal suffered. MATERIALS: The skeletal material included a caudal fragment of a cattle mandible. The specimen, exhibiting chronic disease was separated from approximately 10,000 early medieval cattle remains discovered during excavations of the former Kruszwica stronghold. METHODS: The bone was underwent macroscopic, radiological and histopathological examination. RESULTS: Location, macroscopic, microscopic and X-ray images of the lesions within the examined mandible indicate it could have been caused by the actinomycosis. CONCLUSIONS: In the face of infection, no effective therapies were undertaken in the Middle Ages. SIGNIFICANCE: Descriptions of lumpy jaw in the paleopathological literature are rare. This disease, due to its background and course, eliminated animals from breeding for centuries until the era of antibiotics. The case described in our paper is in an advanced stage, but its adult age suggests that efforts were possibly made to keep the cow alive as long as possible, indicating the significant economic importance of the animal. LIMITATIONS: This analysis is limited by the absence of other anatomical elements of the affected animal, which impacts the interpretation of the palaeopathological bone. SUGGESTIONS FOR FURTHER RESEARCH: It is recommended that similar studies are conducted on better preserved and more numerous cattle assemblages.

Functional Anatomy of the Thoracic Limb of the Komodo Dragon (Varanus komodoensis).

Since the Komodo dragon has been included on The International Union for Conservation of Nature (IUCN) Red List of Threatened Species, it is crucial to know in detail its biology as there is a limited availability of research material on these animals-mainly those who died in zoos or whose remains were found in the wild. Anatomy is essential for understanding physiology, identification of diseases, adaptations in the environment, and behavior. In this dissection study, the relationship of individual anatomical structures was analyzed, the anatomy of the active and passive movement system of the thoracic limb was described, photographs were taken, and a radiographic examination was conducted. This species has its own differences, even within closely related lizard species. Varanus komodoensis possesses triceps muscles with three heads, and the wrist is extended with additional bones for greater flexibility of the hand. The muscles of the forelimb are analogous to the hind limb; however, they differ in the mass of individual muscles, especially those predisposed to perform the most important antigravity and locomotive functions.

The CBCT Retrospective Study on Underwood Septa and Their Related Factors in Maxillary Sinuses-A Proposal of Classification.

Introduction. The presence of bone septum in the maxillary sinus is one of the most common anatomical findings. So-called Underwood septa (US) are an atypical bone formation in the maxillary sinuses. Mostly they are quite easily found in CBCT studies and have major importance in sinus lift procedures in dental surgery. Furthermore, the shape, location, and size of the bony septa are important in each maxillary sinus surgery. Material and methods. A retrospective study of 120CBCT scans from the authors' own database was conducted. Results. Approximately 37.5% of each CBCT was associated with the occurrence of US, while just 25% had a full septum, and a total of only 14 patients had a half septa. More females have US, while healthy pneumatized maxillary sinus is most commonly found (82.22%). There is no correlation between the occurrence of silent sinus syndrome (p = 0.174), mucosal thickening (p = 0.325), or retention cyst formation (p = 0.272). Most sinuses are without any opacification in CBCT evaluation (91.11%), while other syndromes are not statistically relevant. Conclusions. It seems that the occurrence of Underwood septa is not statistically related to any clinical, radiological, or pathological condition within the sinus (p > 0.05). Furthermore, a more full or partial appearance of US was found in female patients.

Topography of cranial foramina and anaesthesia techniques of cranial nerves in selected species of primates (Cebidae, Cercopithecidae, Lemuridae) - part I - osteology.

BACKGROUND: Conductive anaesthesia of the nerves around the head is one of the methods of intraoperative pain relief (under deep anaesthesia but before proceeding with the procedure). Performing this procedure on primates is especially challenging for the veterinarian, due to their cranial anatomy and topography, which has more in common with the human skull than with the skulls of other animals. Knowledge of key bony structures, including cranial foramina, is essential for effective anaesthesia of the cranial nerves. RESULTS: In this study, the differences in the topography of the cranial foramina in eight selected species of primates were examined: Angola colobus (Colobus angolensis), Celebes crested macaque (Macaca nigra), L'Hoest's monkey (Allochrocebus lhoesti), baboon (Papio cynocephalus), buff-bellied capuchin (Sapajus xanthosternos), black-and-white ruffed lemur (Varecia variegata), crowned lemur (Eulemur coronatus), and a ring-tailed lemur (Lemur catta) coming from the Wroclaw Zoological Garden (Poland). The cranial nerves running through the foramina have also been described and their anaesthesia techniques against bone points have been tested to relieve post-operative pain in the area of the head supplied by these nerves. CONCLUSION: The tests carried out show differences in the topography of the cranial foramina, and therefore also differences in the methods of injection, so the results obtained in this study may be useful in veterinary medicine, especially for practising veterinarians.

Feline Tooth Resorption: A Description of the Severity of the Disease in Regard to Animal's Age, Sex, Breed and Clinical Presentation.

Feline tooth resorption (odontoclastic resorptive lesion) is a common and important issue in veterinary dentistry. This study aimed to analyse the disease's severity and correlation with clinical information in the population of feline patients in Poland in the area of Lower Silesia. An analysis of the clinical charts of 174 cats with dental problems, which were diagnosed as tooth resorption, was conducted. The gender and breed had no influence on the disease severity, but the disease progressed with age. The lesions were mostly encountered within the third and fourth maxillary premolars (107, 108, 207, 208) and mandibular molars (309, 409). No direct correlation was found between the presence or severity of the disease and the clinical signs of affected cats. The study shows that feline tooth resorption is a common issue in feline dentistry and should be taken into account in all cases of animals with any signs of oral disease, including gingivitis and/or dental plaque with preserved appetite. A careful intraoral radiographic examination is essential to avoid false negative results in ambiguous cases.

Anatomical and Surgical Implications of the Usage of Bichat Fat Pad in Oroantral Communication, Maxillary, Palatal, and Related Surgeries-Narrative Review.

The buccal fat pad, also called the Bichat's fat pad (BFP), is an encapsulated fat mass located in the cheek. This type of specialized fat mass can be used both as a pedicular or free graft in various surgeries and approaches. Due to its easy access from the oral cavity approach, it is commonly used for oroantral and palatal fistula closure. The knowledge of its anatomy and surrounding tissues plays a role in its mobilization and suturing onto the desired defect in the palatal or maxillary region. The BFP is mostly associated with the primary approach used for a fistula or bone surgery. Alternatively, the procedure can be performed with a single approach incision, which does not compromise the appearance or the function of the operating or adjacent areas. The most important inclusion criteria for BFP usage and surgical limitations are highlighted. The BFP is used for multiple purposes in reconstructive and oncology surgery and also has its use in esthetic and facial contouring procedures. The amount, volume, and shape of the BFP are mostly associated with the scope of their usage. The aim of the following narrative review is to present the surgical and anatomical implications of fat pads in maxillary and palatal surgeries.

Imatinib-Functionalized Galactose Hydrogels Loaded with Nanohydroxyapatite as a Drug Delivery System for Osteosarcoma: In Vitro Studies.

This study reports an impact of structure (XRPD, FT-IR) and surface morphology (SEM-EDS) of imatinib-functionalized galactose hydrogels, loaded and unloaded with nHAp, on osteosarcoma cell (Saos-2 and U-2OS) viability, levels of free oxygen radicals, and nitric oxide, levels of BCL-2, p53, and caspase 3 and 9, as well as glycoprotein-P activity. It was investigated how the rough surface of the crystalline hydroxyapatite-modified hydrogel affected amorphous imatinib (IM) release. The imatinib drug effect on cell cultures has been demonstrated in different forms of administration-directly to the culture or the hydrogels. Administration of IM and hydrogel composites could be expected to reduce the risk of multidrug resistance development by inhibiting Pgp.

The Temporary Mental Nerve Paresthesia as an Outcome of Dentigerous Cyst Removal during Preparation for Dental Implant Placement: A Case Report.

The usage of xenograft material is widely used in almost all oral cavity bone defects for regenerative and reconstructive purposes. The presented xenograft usage in the following care report enabled good bone defect healing and enabled the preservation of affected premolars. It is quite common to use any possible variations of bone materials to ensure bone defect improved healing. In some cases, the scope of surgeries requires the removal of each cyst within close proximity to various nerves and vessels. The inferior alveolar, infraorbital, lingual, and mental nerves are those most commonly adjacent to most operating sites in jaw bones. The usage of some additional materials such as collagen sponges, bone substitutes, resorbable membranes, or other additional materials are useful in each bone defect reconstruction but should be handled with care, as described in the following case. Before planning their usage, it is important to perform each surgery with close cone beam computed tomography imaging, which is very helpful to establish the scope of each lesion and the proximity of vital structures. There are a lot of factors that might influence any possible nerve damage, especially the different nerve anatomical variations. Even factors including the subperiosteal preparation and compression of adjacent tissues might influence later nerve function. When the lesion is expanding through the buccal cortical plate and when soft tissue fluctuation is present, some special care is needed. Similar to the presented case, a limitation in crushing, blowing, or any irritation of nerve fibers improves later postoperative outcomes. When the wound and surrounding tissues are handled with care, a limited possibility of any damage or paresthesia can occur. When the nerve itself is damaged or cut, loss of function can be permanent. Immediately after or even prophylactic prescription 1-2 days before the surgery of Vitamin B with NSAIDs (Non-steroidal anti-inflammatory drugs) (or other additional supplementary medicaments can improve nerve function in time. Possible nerve damage can be divided into many etiological factors. A quite different situation arises when the nerve is pulled in by the cyst growth into the cyst wall. The presented case report describes the outcomes of a cyst removal from the mandibular basis and treatment modalities.

Gingiva-derived Stromal Cells Isolated from Cats Affected with Tooth Resorption Exhibit Increased Apoptosis, Inflammation, and Oxidative Stress while Experiencing Deteriorated Expansion and Anti-Oxidative Defense.

Gingiva-derived mesenchymal stromal cells (GMSCs) are multipotent cells characterized by multilineage differentiation potential, proliferative expansion, and unique immunomodulatory ability, making them attractive as a new treatment of periodontal regeneration. In this study, GMSCs obtained from the gingiva of healthy cats (HE) as well as from cats affected by tooth resorption (TR) were isolated and characterized. Feline GMSCs (fGMSCs) from HE patients exhibited fibroblast-like morphology, developed cellular body, specific growth pattern, high expansion, and proliferative potential as well as reduced senescence signature. fGMSCs demonstrated high s-100 and IL-10 positive cells, while simultaneously having low activity of IL-1. Moreover, high activity of ki-67 combined with reduced senescence markers were noted. In comparison, GMSCs from cats with TR exhibited enlarged nuclei and flat, irregular shape along with increased expression of CD44, s-100 and CD45 and downregulation of CD73. GMSCs from TR cats showed lower ability to form colonies, increased incidence of apoptosis, higher number of senescent cells, and reduced cell migration. Upregulation of pro-inflammatory cytokines was also noted in the TR group along with lower expression of mTOR and miR-17 and upregulation of miR-378. Mitochondrial dynamics, biogenesis and antioxidant properties are also negatively impacted in this group. Collectively, our findings suggest that GMSCs isolated from the gingiva of cats affected with TR have deteriorated functionality caused by impaired proliferation and growth and possibly mediated via mitochondrial dysfunction. fGMSCs or their EV's should be further investigated for their role in the pathophysiology of TR in cats.

Interactions of N-Mannich Bases of Pyrrolo[3,4-c]pyrrole with Artificial Models of Cell Membranes and Plasma Proteins, Evaluation of Anti-Inflammatory and Antioxidant Activity.

Despite the widespread and easy access to NSAIDs, effective and safe treatment of various inflammatory disorders is still a serious challenge because of the severe adverse effects distinctive to these drugs. The Mannich base derivatives of pyrrolo[3,4-c]pyrrole are potent, preferential COX-2 inhibitors with a COX-2/COX-1 inhibitory ratio better than meloxicam. Therefore, we chose the six most promising molecules and subjected them to further in-depth research. The current study presents the extensive biological, spectroscopic and in silico evaluation of the activity and physicochemical properties of pyrrolo[3,4-c]pyrrole derivatives. Aware of the advantages of dual COX-LOX inhibition, we investigated the 15-LOX inhibitory activity of these molecules. We also examined their antioxidant effect in several in vitro experiments in a protection and regeneration model. Furthermore, we defined how studied compounds interact with artificial models of cell membranes, which is extremely important for drugs administered orally with an intracellular target. The interactions and binding mode of the derivatives with the most abundant plasma proteins-human serum albumin and alpha-1-acid glycoprotein-are also described. Finally, we used computational techniques to evaluate their pharmacokinetic properties. According to the obtained results, we can state that pyrrolo[3,4-c]pyrrole derivatives are promising anti-inflammatory and antioxidant agents with potentially good membrane permeability.

Macroanatomical, Histological and Microtomographic Study of the Teeth of the Komodo Dragon (Varanus komodoensis)-Adaptation to Hunting.

The present study aimed to characterize the macrostructure and microstructure of the mandibular teeth of the Komodo dragon (Varanus komodoensis) and the methods it uses to obtain food. Examinations were performed using a stereoscopic microscope, autofluorescence method, histological method and computed microtomography. A detailed macro- and micro-structural description of V. komodoensis mandibular teeth were made. The mandibular teeth are laterally flattened along their entire length and the dental crown is hooked caudally. The part of the nasal margin of the tooth crown is irregular, while the caudal margin of the tooth is characteristically serrated, except for the tooth base area. There are longitudinal grooves on the lingual and vestibular surfaces up to the lower third of the tooth height. The mandibular tooth is surrounded by a cuff made of the oral mucosa, containing the opening of the venom gland. In the histological structure of the tooth, the enamel covering the tooth crown and the dentin under the enamel are distinguished. The inside of the tooth, except its basal part, is filled with the tooth chamber, while the inside of the lower part of the tooth is filled with plicidentine, which corresponds to external furrows on the enamel. The plicidentine arrangement resembles a honeycomb. A small amount of dentine folds reach up to the tooth apex. Characteristic features of the structure of the mandibular teeth in V. komodoensis may indicate their significant role, in addition to the venom glands, in obtaining food in the natural environment of this species.

Search for immunomodulatory compounds with antiproliferative activity against melanoma.

BACKGROUND: Melanoma is a highly aggressive neoplasm with a high degree of malignancy and rapid acquisition of resistance by cancer cells. METHODS: Biological studies of a series of isoxazole compounds with immunomodulatory properties were preceded by in silico analysis. The assay evaluated the viability of NHDF and A375 cell cultures after the administration of isoxazole compounds after a 24-hour incubation period in the MTT test. Analyzes of ROS and NO scavenging, P-glycoprotein activity, and properties were performed. The levels of Caspase 3 and Caspase 9 were measured using ELISA to assess which pathways induced apoptosis by the tested compounds. On the chip, the synergistic effect of doxorubicin and the most active compound from the MM9 series on cells of the A375 melanoma line was determined. RESULTS: All tested N'-substituted derivatives of 5-amino-N,3-dimethyl-1,2-oxazole-4-carbohydrazide with immunomodulatory activity show multidirectional antitumor activity on A375 melanoma lines with an affinity for P-glycoprotein, induction of free radical formation and generation of DNA damage leading to the death of cancer cells, as well as formation of complexes with DNA Topoisomerase II. Most of the tested compounds show pro-apoptotic activity. The most active compound in the series induces apoptosis in three distinct pathways and acts synergistically with doxorubicin. CONCLUSIONS: The most active compound with immunomodulatory properties showed multidirectional antitumor activity against cells of the A375 melanoma line and also had a synergistic pro-apoptotic effect with doxorubicin, which may result in a reduction of this cytostatic dose with increased effectiveness.

Battle wound as a probable cause of the death of an early medieval horse in Ostrów Lednicki, Poland.

OBJECTIVE: In this paper we interpret a pathology observed in an early medieval horse skull discovered near the abutment of the eastern Gniezno bridge in Ostrów Lednicki in Poland. We consider the possible cause of the observed damage in the context of the armed invasion of the Czech prince Brzetyslaw and a battle of Ostrów Lednicki. MATERIALS: A skull of a 10-year-old male horse dated to the 11th century. METHODS: The skull was examined macroscopically and through computed tomography. Metric analysis was performed using digital callipers and the shoulder height was calculated. RESULTS: A penetrating lesion through the left frontal and nasal bones was observed. The floor and roof of the left conchofrontal sinus were destroyed along with the dorsal ethmoturbinates of the ethmoid labyrinth. CONCLUSIONS: The observed damage was most likely a result of trauma, which caused a fatal haemorrhage rather than sudden death. Considering the historical context and the area where the skull was discovered, it could be a battle wound. SIGNIFICANCE: This case is a rare example of an unhealed peri-mortem lesion in an animal skeleton that can be associated with an immediate cause of death. LIMITATIONS: The lack of a complete skeleton does not allow a complete analysis of horse's condition and circumstances associated with its death. SUGGESTIONS FOR FURTHER RESEARCH: Identification of the tool or weapon that was used to deliver the blow.

Morphology of the pattern of branching of the aortic arch (Arcus aortae) in Syrian hamsters (Mesocricetus auratus).

The branching patterns of the aortic arches of 28 adult male and female Syrian hamsters (SH) were thoroughly examined under a stereomicroscope for the first time by using latex injection and corrosion casting to determine their general arrangements and morphological variations as well as their differences and similarities to other rodents and rabbits. Three major arteries, namely, the brachiocephalic trunk (BC), left common carotid artery (CC) and left subclavian artery (SA), originating from the aortic arch (AR), were uniformly noted in SH. The BC was consistently divided into the right SA and the right CA. SA in SH normally releases the internal thoracic, deep cervical, dorsal scapular, vertebral, superficial cervical and supreme intercostal arteries. The costocervical trunk typically consisted of supreme intercostal and internal thoracic arteries and a common trunk for dorsal scapular and deep cervical arteries. To comprehend the comparative morphology of the pattern of branching of AR more completely, our results were compared with previous studies in rodents and rabbits. (1) The general morphology of the great arteries from AR in SH was similar to that in mole rats, rats, mice, porcupines, and gerbils but was essentially different from that in rabbits, guinea pigs, red squirrels, ground squirrels, pacas and chinchillas. (2) The typical pattern of the branching of the subclavian arteries in SH was similar to that in guinea pigs, rats, and rabbits but was different from that of the reported rodents regardless of the origins of the bronchoesophageal and internal thoracic arteries and the composition of the costocervical trunk.

Horses in the Early Medieval (10th-13th c.) Religious Rituals of Slavs in Polish Areas-An Archaeozoological, Archaeological and Historical Overview.

Knowledge about horses from early medieval (10th-13th c.) Poland has been largely based on historical and archaeological data. Archaeozoological information has only been used to a limited extent. Therefore, this article aims to present the current state of knowledge on this subject, drawing on archaeozoological data from studies of horse bones. Apart from confirming earlier reflections regarding the sacred significance of the horse, additional information was obtained about specific individuals who were the subject of magical treatments. It turned out that sites with horse skeletons and skulls are few compared to the familiar presence of horse remains among kitchen waste. This contrasts with the neighbouring regions, where horses were buried more frequently among the Germans, Scandinavians and Prussians. Some new data have been obtained thanks to taphonomic analyses, which demonstrated that horse skulls of apotropaic status were not only exposed to public viewing but were also deposited under stronghold ramparts. Horses suffering from infectious diseases could also be buried under such ramparts. Considerations in the article lead to conclusions that horses were used in religious rituals as sacrificial animals, apotropaic deposits, as fortune-telling animals and cosmological figures.

Effect of a Single and Triple Dose of Levamisole on Hematological Parameters in Controlled Inflammation Model.

This study aimed to evaluate the impact of single and triple administration of levamisole on the dynamics of hematological parameters during experimental pleuritis. The experiment was performed on female Buffalo rats. Rats were randomly assigned to two equal groups that received 1 and 3 doses of levamisole every 2, 24 and 48 h, respectively. Following the experiment, blood samples for the measurement of hematological parameters were collected. The study group receiving three doses of levamisole observed a significant reduction of red blood cell count at 48 h post administration and an increase in mean corpuscular volume compared to the control inflammation group. The administration of a single dose of levamisole results in a significant increase in hematocrit at 72 h, an increase in white blood cell count at 24 h and 72 h, and an increase in neutrophil count at 72 h compared to the control inflammation group. Administration of a single and triple dose of levamisole showed statistically significant modification of some hematological parameters and thus modulates the inflammatory process. In the lungs, this results in a reduction in leukocyte infiltrations around the bronchi and blood vessels.

Methods of Definitive Correction of Mandibular Deformity in Hemimandibular Hyperplasia Based on Radiological, Anatomical, and Topographical Measurements-Proposition of Author's Own Protocol.

In order to fully evaluate and establish the degree of bone overgrowth, various radiological studies are essential in the careful planning of the amount of surgical excision. In the presented paper, the authors use self-designed anatomo-topographical reference points for planning the surgeries. Routine panoramic radiographs and low-dose computed tomography based on anatomical landmarks help in measuring the proportions of mandibular bone overgrowth with the following preoperative anatomical landmarks: (Go-Go), (Go(Right)-Gn), (Go(Left)-Gn), and (Me−Gn). Measurements taken at selected points and landmarks (gonion-gnathion/gnathion-menton) are easy to conduct. In the authors' proposal, the main key factor is total chin correction, which is necessary in cases of severe overgrowth; when F0 > C and Go-Gn>, there is >7 mm of vertical bone overgrowth, and the mandibular canal is positioned <5 mm from the inferior mandibular border­MIB. Larger overgrowths (>7 mm) have a greater outcome on the final symmetry than smaller overgrowths. As no guidelines are known, the authors present their own proposal.