Clinical and radiological assessment of rhinomaxillary syndrome in Hansen’s disease

Background: More than four million people today live with Hansen’s disease, and 200,000 new cases are diagnosed every year. Lifetime effects of Hansen’s disease manifest as changes to bones of the face, hands and feet, resulting in physical impairment, secondary complications and facial changes that can be detrimental to quality of life, particularly among the elderly. Aims: This study aimed to perform a detailed characterization of rhinomaxillary syndrome and its clinical manifestations in older persons treated in the past for Hansen’s disease. Methods: This was a cross-sectional study to characterize rhinomaxillary syndrome among older persons (age 60+ years) resident at Pedro Fontes Hospital, Cariacica, Espírito Santo, Brazil. Computed tomography images were examined with three-dimensional reconstructions to assess alterations to maxillofacial bones according to criteria for radiological rhinomaxillary syndrome. Participants were examined to assess facial alterations according to criteria for clinical rhinomaxillary syndrome. Results: Rhinomaxillary syndrome was investigated in 16 participants (ten females and six males), median age 70 (range 60–89) years, age at diagnosis 20 (6–43) years and time since diagnosis 46 (26–70) years. Four participants fully met radiological rhinomaxillary syndrome criteria, four partially. All participants with full radiological rhinomaxillary syndrome presented with facial changes which met criteria for clinical rhinomaxillary syndrome, including “saddle nose” (loss of nasal dorsal height and shortened length of nose, due to cartilaginous and/or bone collapse), concave middle third of the face with sunken nose, maxillary retrognathia and inverted upper lip. Limitations: Clinical histories were incomplete for some participants because records were lost at the hospital over time. Conclusion: Until Hansen’s disease is eliminated from endemic countries, persons affected will continue to present with rhinomaxillofacial alterations caused by Mycobacterium leprae infection. Clinical protocols for assessment and long-term care need to include otorhinolaryngological evaluation, mainly to prevent secondary complications. When rhinomaxillofacial bone changes are suspected, this evaluation should be supported by computed tomography imaging, if available.

Terapia miofuncional, maloclusión y disfunción orofacial: Evaluación fotogramétrica del perfil

RESUMEN: El objetivo de este estudio observacional analítico es determinar el efecto de la Terapia Miofuncional en el perfil facial de voluntarios con maloclusión y disfunción orofacial, mediante fotogrametría. En una muestra de 15 pacientes, se midieron indirectamente mediante fotogrametría en el Software Blue Sky Plan® las siguientes variables cefalométricas: Ángulo Nasolabial, Prominencia Labial y Plano Estético. Se realizó toma de fotografías al comenzar la Terapia Miofuncional (primera sesión) y al finalizarla (décima sesión). Para comparar valores obtenidos en el mismo voluntario en cada variable cefalométrica entre principio y final de terapia, análisis estadísticos fueron realizados. Se determinó que no hay diferencia estadística en valores obtenidos en ninguna de las variables cefalométricas al comparar el inicio con el final de terapia. Por consiguiente, se concluyó que la Terapia Miofuncional no tiene un efecto significativo en estas variables de perfil facial en voluntarios con maloclusión y disfunción orofacial medidas mediante fotogrametría, pese a cambios funcionales percibidos por pacientes y evaluadores. Es fundamental poder realizar un diagnóstico riguroso y posterior derivación a Fonoaudiología, si corresponde, para lograr equilibrio funcional en los pacientes y reducir riesgo de progresión o reaparición de Anomalías Dentomaxilares.

ABSTRACT: This analytical observational study aimed to determine the effect of Myofunctional Therapy on the facial profile in volunteers with malocclusion and orofacial dysfunction, through photogrammetry. Fifteen patients were recruited, and the following cephalometric variables were measured indirectly through photogrammetry in the Blue Sky Plan Software (Blue Sky Bio®): Nasolabial Angle, Lip Prominence and Aesthetic Plane. Previous photographs were taken, at the beginning of Myofunctional Therapy (first session) and the end (tenth session). To compare the values of each variable in a volunteer between the beginning and end of therapy, statistical analyses were performed. There was no statistical difference in the values obtained in any of these variables when comparing the beginning and the end of myofunctional therapy. Therefore, it was concluded that myofunctional therapy does not have a statistically significant effect on these facial profile variables in volunteers with malocclusion and orofacial dysfunction measured by photogrammetry, despite the functional changes perceived by patients and evaluators. However, it is essential to perform a rigorous diagnosis and subsequent referral to speech therapy, if applicable, to achieve functional balance in the patients and reduce progression or recurrence risk of Dentomaxillary Abnormalities.

Facial profile changes due to bone cement graft to manage the hyperactive muscles of the gingival smile

ABSTRACT Objective: To evaluate facial profile changes promoted by polymethyl methacrylate (PMMA) cement graft to reduce excessive gingival display due to hyperactivity of the elevator muscles of the upper lip during smiling. Methods: Eleven patients (all females, age range: 20 to 43 years) presenting gingival smile that were treated with PMMA cement grafts in a private clinic were selected for this retrospective study. Three angular and ten linear cephalometric facial profile measurements were performed preoperatively (baseline, T1) and at least 6 months postoperatively (T2). Differences between T1 and T2 were verified by Wilcoxon test, and the correlation between the thickness of the graft and facial profile changes was statistically evaluated by Spearman's Coefficient test. The significance level was set at p< 0.05. Results: The nasolabial angle (p= 0.03) and the labial component of the nasolabial angle showed statistically significant differences (p= 0.04), with higher values in T2. No correlations were found between the graft thickness and the statistically significant facial profile changes (p> 0.05). Conclusions: The PMMA bone cement graft projected the upper lip forward, thereby increasing the nasolabial angle without affecting the nasal component. No correlations between the graft thickness and the facial profile changes were detected.

RESUMO Objetivo: Avaliar as alterações do perfil facial promovidas pelo enxerto de cimento de polimetilmetacrilato (PMMA) para redução da exposição gengival excessiva devida à hiperatividade dos músculos elevadores do lábio superior durante o sorriso. Métodos: Onze pacientes (todos do sexo feminino, faixa etária de 20 a 43 anos) com sorriso gengival, tratados com enxerto de cimento de PMMA em clínica privada, foram selecionados para este estudo retrospectivo. Três medidas cefalométricas angulares e dez lineares do perfil facial foram realizadas no pré-operatório (T1) e com pelo menos seis meses de pós-operatório (T2). As diferenças entre T1 e T2 foram verificadas pelo teste de Wilcoxon, e a correlação entre a espessura do enxerto e as alterações do perfil facial foi avaliada estatisticamente pelo Coeficiente de Spearman. O nível de significância foi estabelecido em p< 0,05. Resultados: o ângulo nasolabial (p= 0,03) e o componente labial do ângulo nasolabial apresentaram diferenças estatisticamente significativas (p= 0,04), com maiores valores em T2. Não foram encontradas correlações estatisticamente significativas (p> 0,05) entre a espessura do enxerto e as alterações do perfil facial. Conclusões: O enxerto de cimento ósseo de PMMA projetou discretamente o lábio superior, aumentando o ângulo nasolabial sem afetar o componente nasal. Não foram detectadas correlações entre a espessura do enxerto e as alterações do perfil facial.

Glabellar vertical line as a reference goal for anteroposterior maxillary position

ABSTRACT Objective: The aim of this study was to evaluate the use of glabellar vertical line (GVL) as the anteroposterior maxillary position goal. Methods: A cross-sectional study was conducted assessing 129 participants (20.21 ± 1.99 years): 67 women (20.16 ± 1.99 years), and 62 males (20.26 ± 2.06 years). The facial profile photographs were taken with a posed smile in natural head position. The linear distance from the most facial convexity of the upper central incisor (FA) to the goal anterior-limit line (GALL) and also from FA to GVL were measured and compared. Wilcoxon signed-ranks test was applied. To determine the correlation between the distances, Spearman's correlation coefficient was used. Simple and multiple linear regression were also performed. Results: The GALL-GVL separation was 0.54 ± 1.14 mm (95%CI: 0.34-0.74). A strong correlation between FA-GALL and FA-GVL distances (Spearman's rho=0.983 [95%CI: 0.976-0.988], p< 0.01) was identified. The FA-GVL distance explains almost all the total variation of FA-GALL (R2=95.84%, p< 0.01). The FA-GALL distance can be predicted by using the formula: FA-GALL=0.5+0.9*(FA-GVL). Conclusion: These findings suggest that GVL could be used as an easier-to-use treatment goal to determine the maxillary anteroposterior position, compared to GALL, to improve facial harmony profile goals in cases where the maxillary incisors are properly positioned anteroposteriorly.

RESUMO Objetivo: o objetivo desse estudo foi avaliar o uso da linha vertical glabelar (GVL) como referência para a posição anteroposterior da maxila. Métodos: esse estudo transversal avaliou 129 pacientes (20,21 ± 1,99 anos), sendo 67 mulheres (20,16 ± 1,99 anos) e 62 homens (20,26 ± 2,06 anos). As fotografias de perfil foram realizadas com os pacientes em sorriso posado e em posição natural de cabeça. As distâncias lineares entre a porção mais convexa da face vestibular do incisivo central superior (FA) e a linha do limite anterior (GALL), e entre a FA e a GVL foram mensuradas e comparadas. Para a análise comparativa, utilizou-se o teste de postos sinalizados de Wilcoxon. O coeficiente de correlação de Spearman avaliou a correlação. Além disso, foi realizada regressão linear múltipla. Resultados: a distância entre GALL e GVL foi de 0,54 ± 1,14mm (95% IC: 0,34-0,74). Uma forte correlação foi identificada entre as distâncias FA-GALL e FA-GVL (Spearman's rho = 0,983 (95%IC: 0,976-0,988), p< 0,01). A distância FA-GVL contempla quase todas as variações de FA-GALL (R2 = 95,84%, p< 0,01). Essa distância pode ser calculada através da fórmula: FA-GALL= 0,5 + 0,9*(FA-GVL). Conclusão: os resultados encontrados sugerem que a GVL pode ser adotada como uma referência de fácil utilização na determinação da posição anteroposterior da maxila, quando comparada à GALL para a melhora do perfil facial nos casos em que os incisivos superiores estão corretamente posicionados.

Facial profile of patients with congenitally missing 2 mandibular incisors and changes of facial profile before and after orthodontic treatment by extraction of 2 maxillary premolars / 吉林大学学报(医学版)

Objective: To analyze the facial profile of the patients with congenitally missing 2 mandibular incisors, and to investigate the changes of facial profile of the patients before and after orthodontic treatment by extraction of 2 maxillary premolars. Methods: The cephalometrics of 64 patients with congenitally missing 2 mandibular incisors were collected. The initial cephalometrics of 64 patients were used to characterize the facial profile. A total of 38 cases among all the 64 patients underwent the orthodontic treatment by extraction of 2 maxillary premolars, and the initial and final cephalometrics were used to compare the changes of facial profile before and after treatment. The cephalometric measurement (including hard tissue and soft tissue items) was performed and the results were analyzed statistically. Results: Compared with the normal values, the overjet, overbite, ANB, U1-NA angle, face angle, Y axis, Pg-NB, face convexity, soft tissue facial angle, H angle, and men to labial sulcus to H-Line in the patients with congenitally missing 2 mandibular incisors were increase d, SNB, L1-NB angle, L1-NB distance, L1-MP, occlusal plane angle, mentolabial sulcus angle were decreased, and the differences were statistically significant (P<0. 05). After orthodontic extraction treatment, the overjet, overbite, U1-NA angle, U1-NA distance, U1-SN, H angle, and subnasale to H-Line of the patients were decreased, the L1-NB angle, L1-NB distance, L1-MP, occlusal plane angle, Pg-NB, and mentolabial sulcus angle were increased; the differences were statistically significant (P<0. 05). Conclusion: The mandibular development is insufficient but the chin development is adequate in the patients with congenitally missing 2 mandibular incisors, with larger overjet and overbite, lingually inclined mandibular incisors, deeper and sharper mentolabial sulcus. After treatment by extraction of 2 maxillary premolars, the overall appearance of the lateral profile of the patients remains unchanged, but the occlusion of anterior teeth is significantly improved.

Self-perception of profile among orthodontic patients: a preliminary study / 中华医学美学美容杂志

Objective To make a preliminary study on self-perception of profile among orthodontic patients.Methods A total of 226 orthodontics patients (79 males and 147 females with average age of 19.3 years) were enrolled in this study.All the patients were treated in the Department of Orthodontics,Sun Yat-sen University Hospital of Stomatology during May to August 2016.Self-perception of profile was investigated in the patients.They were asked whether they had ever noticed their own profile and to choose from among various photos the one that most resembled their own profile.Then profile photos of patients were taken and measured.Differences between self-perception profile and actual profile were compared using paired t test.Results There were 147 patients (41 males and 106 females) answered that they had noticed their own profile.Difference was significant between patients' actual profile and self-perception profile (P＜0.05).Difference was significant between male patients' actual profile and self-perception profile (P ＜0.05).Difference was not significant between female patients' actual profile and self-perception profile (P ＞ 0.05).Compared with male patients,difference was smaller between female patients' actual profile and self-perception profile.Conclusions Compared with male patients,female patients put more emphasis on their own profile.Patients' self-perception of their own profile is not accurate.Female patients' self-perception of their own profile is more accurate than male patients.

Study on soft tissue changes of angle class Ⅱ division Ⅰ mandibular retraction patients during mixed dental period with MRC functional correction / 口腔疾病防治

Objective @#To observe the changes of soft tissue in patients with Angle class Ⅱ division Ⅰ malocclusion during mixed dentition treated with MRC functional appliance.@* Methods @# Twenty patients with Class Ⅱ division Ⅰ malocclusion of Angle were treated with functional MRC. The facial features before and after treatment were measured by software and the results were analyzed statistically. @*Results@#The patients′soft tissue profiles were improved significantly before and after treatment, The OE-Prn-Pos angle, OE-N′-B′ angle, OE-N′-Pos angle, OE-Prn-N′angle, Cm-Sn-UL angle, and N′-Sn-Pos angle increased significantly (P < 0.05). The OE-Sn-UL angle, and Sn-N′-B′ angle decreased significantly (P < 0.05); the distance between the lateral soft tissue line and the middle Sn-H line, UL-E line and LL-E line were significantly different (P < 0.05). The distances were all reduced, and the difference was statistically significant (P < 0.05).@* Conclusion @#The application of an MRC functional appliance can improve the relationship among nasolabial soft tissue, upper and lower lip soft tissue, and chin-lip soft tissue, thus improving the protrusion profile of patients.

Consideraciones para el incremento de dimensión vertical de oclusión. Reporte de un caso / Considerations for the increase of occlusal vertical dimension. Report of a case

RESUMEN La dimensión vertical de oclusión (DVO) está representada por la distancia entre dos puntos, que no se pierde; sin embargo, puede verse aumentada o disminuida. Depende en buena medida de la dentición presente. Entidades patológicas como la atrición severa pueden influir su condición. La ruta clínica para llegar a la determinación de realizar un incremento de DVO es un proceso meticuloso, parte de un diagnóstico certero, cuantificación de la misma, así como la vía para realizar el procedimiento. Existen múltiples métodos para la terapéutica del incremento de DVO: dispositivos removibles o fijos. La elección del plan de tratamiento será con base en las particularidades de cada paciente. No existe tratamiento universal sino uno ideal para cada situación específica. Este caso describe las consideraciones previas al aumento de DVO en un paciente masculino de 68 años con atrición generalizada. Se evaluó la magnitud de la reducción de DVO, perfil facial y estética mediante análisis fotográfico y video; el esquema oclusal y la estructura dental presente. La literatura propone calcular con diferentes métodos el restablecimiento de la DVO; antes de elegir alguno se requiere definir y especular qué tanto se encuentra disminuida, para ello no basta un análisis estático o de simple apreciación, debe considerarse el aspecto facial, así como la dinámica mandibular. El incremento de la DVO en una sola intención, mediante restauraciones provisionales, mantenidas dentro de los parámetros de comodidad, es un excelente recurso para ejecutarla, el paciente experimenta una fase de adaptación favorable y sin complicaciones sintomáticas.

ABSTRACT Occlusal vertical dimension (OVD) is represented by the distance between two points, which is not lost, however, can be increased or decreased. Depends to a good extent on the present dentition. Pathological entities such as severe attrition can influence their condition. Clinical route to arrive at the determination to perform an increase of OVD is a meticulous process, part of a correct diagnosis, quantifi cation of the same, as well as the way to perform the procedure. There are multiple methods for this treatment: removable or fi xed devices. Choice of treatment will be based on the particularities of each patient. There is no universal treatment but an ideal for each specific situation. This case describes the considerations prior to the increase of OVD in a 68-year-old male patient with generalized attrition. Magnitude of OVD reduction, facial and aesthetic profi le was evaluated by means of photographic and video analysis; the occlusal scheme and the dental structure present. Literature consulted proposes to calculate with different methods the reestablishment of OVD, before choosing one it is necessary to defi ne and to speculate how much it is diminished, for it is not enough a static analysis or of simple appreciation must consider the facial aspect, as well as the mandibular dynamics. Increasing OVD in a single intention, through provisional restorations, maintained within the parameters of comfort, is an excellent resource to execute it, the patient undergoes a phase of favorable adaptation and without symptomatic complications.

Angular photogrammetric analysis of the soft-tissue facial profile of Indian adults

Soft-tissue analysis has become an important component of orthodontic diagnosis and treatment planning. Photographic evaluation of an orthodontic patient is a very close representation of the appearance of the person. The previously established norms for soft-tissue analysis will vary for different ethnic groups. Thus, there is a need to develop soft-tissue facial profile norms pertaining to Indian ethnic groups. Aim and Objectives: The aim of this study is to establish the angular photogrammetric standards of soft-tissue facial profile for Indian males and females and also to compare sexual dimorphism present between them. Materials and Methods: The lateral profile photographs of 300 random participants (150 males and 150 females) between ages 18 and 25 years were taken and analyzed using FACAD tracing software. Inclusion criteria were angles Class I molar occlusion with acceptable crowding and proclination, normal growth and development with well-aligned dental arches, and full complements of permanent teeth irrespective of third molar status. This study was conducted in Indian population, and samples were taken from various cities across India. Descriptive statistical analysis was carried out, and sexual dimorphism was evaluated by Student's t-test between males and females. Results: The results of the present study showed statistically significant (P < 0.05) gender difference in 5 parameters out of 12 parameters in Indian population. Conclusion: In the present study, soft-tissue facial measurements were established by means of photogrammetric analysis to facilitate orthodontists to carry out more quantitative evaluation and make disciplined decisions. The mean values obtained can be used for comparison with records of participants with the same characteristics by following this photogrammetric technique.

Influential factors of esthetic evaluation of mandibular prominence in orthodontic patients / 中华医学美学美容杂志

Objective To explore the influential factors of esthetic evaluation of mandibular prominence by orthodontic patients from two dimensions (ideal value and tolerance range).Methods 226 orthodontic patients were investigated by an electronic questionnaire of esthetic evaluation of mandibular prominence.Binary logistic regression was adopted to analyze the influential factors.Results The tolerable boundary value for female mandibular retrognathism was affected by age (OR1.360) and orthodontic history (OR2.849).The tolerable boundary value for female mandibular prognathism and male mandibular retrognathism were found to be affected by orthodontic history (OR2.557 and 2.845,respectively).The tolerable boundary value for male mandibular prognathism was affected by age (OR1.347) and orthodontic history (OR2.310).The ideal value of male mandibular prominence was affected by age (OR1.420).Conclusions Orthodontic patients' esthetic evaluation of mandibular prominence is influenced by age and treatment condition,but not by sex,education level,marital status and personal profile.

Factors Influencing Facial Profile Evaluation / 中国医科大学学报

Objective To characterize differences within facial profile esthetic evaluations among three groups of evaluators and the influences of sagittal or vertical skeletal patterns on facial profile esthetics. Methods A total of 114 silhouettes,from the pre?or post?treatment facial profiles of 57 patients,were scored by three groups of evaluators(professionals,patients'parents,and laypersons)to characterize differences within facial es?thetics evaluation among evaluators. The highest?scoring 30 silhouettes and the lowest?scoring 30 silhouettes were selected as the high score group and the low score group,respectively. Sixteen indices of the relative lateral cephalometric films were measured. Data were analyzed by SPSS 21.0. Results Facial profiles following orthodontic treatment scored higher than pre?treatment(P<0.05). There were significant differences between professionals and laypersons in facial profile scoring. Different sagittal skeletal patterns had no effect on esthetic evaluation ,but lower facial height significantly influenced whether a patient received a high or low esthetic score(P<0.05). Conclusion Orthodontic treatment can improve the fa?cial profile significantly,and lower facial height is the most sensitive index for facial profile evaluation in our study. However,all three evaluator groups have different esthetic standards that don't overlap. Notably,the expectations of laymen are higher than those of orthodontists.

Preliminary study on the application of prenatal ultrasound for fetal facial profile line / 中华医学超声杂志（电子版）

Objective To evaluate the fetal profile (FP) line with two-dimensional and three dimensional ultrasound, to explore the changes of fetal facial profile with gestational age,and to analyze the manifestation of FP line for abnormal chromosomal fetuses. Methods FP line, which was defined as the line that passes through the anterior border of mandible and the nasion, was test on the facial mid-sagittal plane. Firstly, from April 2013 to January 2014, FP line was analyzed in 439 normal fetuses of Peking Union Medical College Hospital at 11-38 weeks of gestation. According to the relationship between FP line and fetal frontal bone,it was divided into three types: the FP line passed anteriorly, across or posteriorly to the frontal bone, respectively. When the FP line passed posteriorly to the frontal bone, the distance (F distance) between the FP line with the frontal bone was measured. Secondly, 26 pathological fetuses (21 trisomy 21 fetuses with 13-33 weeks' gestation and 5 trisomy 18 fetuses with 21-31 weeks' gestation) were analyzed respectively. Results No cases with a FP line passed anteriorly to the frontal bone were found in all of normal fetuses. Most commonly seen was that FP line passed across to the frontal bone (92.26%). The FP line passed posteriorly to the frontal bone in up to 7.74%, and the mean F distance was 0.24 cm (range, 0.10-0.51 cm). In 21 fetuses of trisomy 21, 14 cases showed the FP line passed across to frontal bone, and 4 cases showed the FP line passed posteriorly frontal bone with the F distance from 0.23 cm to 0.55 cm. Three cases with sloping forehead with FP line passed anteriroly to frontal bone. As to 5 cases of trisomy 18, 2 cases showed FP line passed across to frontal bone, and 3 cases with micrognathia had FP line passed anteriroly to frontal bone. Conclusions No cases with a FP line passed anteriorly to the frontal bone were found in normal fetuses. The FP line, as a reference line for forehead and mandible abnormality, may be a useful tool to detect second trimester profile abnormalities such as sloping forehead and retrognathia.

Correlation analysis of facial profile in patients with skeletal Class Ⅱ malocclusion and changes of hard and soft tissue after orthodontic treatment combined with orthognathic surgery / 口腔疾病防治

Objective @#To investigate the effect of orthodontic and orthognathic treatment on patients with skeletal Class Ⅱ malocclusionby studying the changes of soft and hard tissues in maxillofacial region, to analyze the correlation between soft and hard tissues in patients with skeletal classⅡ in order to provide reference and guidance for combination therapy.@*Methods @#23 patients with skeletal classⅡmalocclusion treated by combined orthodontic and surgical treatment were selected, 21 parameters that can reflect the soft and hard tissue and the facial appearance were recorded in the imaging data before and after orthodontic-orthognathic treatment, The correlation between the soft and hard tissue of the patients before treatment was analyzed.@*Results @#There were significant differences between the before and after orthodontic-orthgnathic treatment in the 19 of above mentioned parameters, except for ANS-Me/N-Me(%) and Pg-Pg′ (mm). By analyzing the correlation between the hard tissue index and the soft tissue profile of the patients before treatment, it can be found that the facial aesthetics is influenced by many hard tissue parameters.@*Conclusion @# The effect of orthodontic and orthognathic technique in the treatment of skeletal ClassⅡ malocclusion is considerable. Hard tissue profile of patients with skeletal ClassⅡ malocclusion forms the basis and support of soft tissue profile. At the same time, soft tissue has some independence. However, the exact quantitative relationship remains to be further studied.

Diagnostic value of nuchal translucency thickness and facial profile ultrasonic markers for trisomy 21 syndrome in the first-trimester fetuses / 中华超声影像学杂志

Objective To retrospectively assess the diagnostic value of nuchal translucency (NT) thickness and facial profile ultrasonic markers [including frontomaxillary facial (FMF) angle,and the ratio of prenasal thickness to nasal bone length (PT/NBL)] for trisomy 21 syndrome in first-trimester fetuses.Methods Ultrasonograhic images of 35 fetuses with trisomy 21 syndrome and 70 gestational age matched normal fetuses were analyzed in first-trimester.NT,FMF angle and the PT/NBL ratio were measured retrospectively in stored images from digital database between January 2012 and December 2015.The diagnostic value of NT,FMF angle and PT/NBL ratio were compared with different combinations.Results (1) The mean NT was significantly higher in the trisomy 21 group than that in controls (t =7.401,P =0.00).The NT above 2.5mm was observed in 20 trisomy 21 fetuses (57.1％) and in 3 normal fetuses (4.3％).(2) The mean FMF angle was significantly higher in the trisomy 21 group than that in controls (t =-5.283,P =0.00).The FMF angle above the 95th percentile (93.6°) was observed in 13 trisomy 21 fetuses (37.1％) and in 1 normal fetus (1.4％).(3) The mean PT/NBL ratio was significantly higher in the trisomy 21 group than that in controls (t =-7.826,P =0.00).The PT/NBL ratio above the 95th percentile (0.93) was observed in 19 trisomy 21 fetuses (54.3％) and in 4 normal fetuses (5.7％).(4) The sensitivity and Youden index for trisomy 21 increased gradually,which were 57.1 ％ and 0.528 by using NT,and 74.3％ and 0.686 by using NT and FMF angle,and 91.4％ and 0.828 by using NT,FMF angle and PT/NBL ratio.There were significant differences in the detection rates of trisomy 21 among the three strategies,while the diagnostic specificity of the three strategies were more than 90％.Conclusions The three parameters are significantly increased in trisomy 21 fetus in first-trimester.First,increased NT was most commonly detected,followed by increased PT/NBL ratio,and increased FMF angle again.Detection rates for trisomy 21 fetuses in first-trimester by ultrasound screening can be significantly improved if combination of all three parameters rather than just one parameter are performed.

Evaluation of the facial dimensions of young adult women with a preferred facial appearance / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the facial dimensions of young adult women with a preferred facial appearance and compare the results with those from the general population. METHODS: Twenty-five linear, nine angular, and three area measurements were made and four ratios were calculated using a sample of standardized frontal and lateral photographs of 46 young adult women with a preferred facial appearance (Miss Korea group) and 44 young adult women from the general population (control group). Differences between the two groups were analyzed using multivariate analysis of variance (MANOVA). RESULTS: Compared with the control group, the Miss Korea group exhibited a significantly greater facial height, total facial height (TFH; trichion-menton), facial width (tragus right-tragus left), facial depth (tragus-true vertical line), and trichion-nasion/TFH ratio and smaller subnasale-menton/TFH and facial width/TFH ratios. Furthermore, the control group had smaller intercanthal and interpupillary widths. CONCLUSIONS: The Miss Korea group exhibited longer, wider, and deeper faces compared with those from the general population. Furthermore, the Miss Korea group had larger eyes, longer but less protruded noses, longer and more retruded lower lips and chins, larger lip vermilion areas, and smaller labiomental angles. These results suggest that the latest trends in facial esthetics should be considered during diagnosis and treatment planning for young women with dentofacial abnormalities.

A preliminary study to find out maximum occlusal bite force in Indian individuals.

Purpose: This preliminary hospital based study was designed to measure the mean maximum bite force (MMBF) in healthy Indian individuals. An attempt was made to correlate MMBF with body mass index (BMI) and some of the anthropometric features. Methodology: A total of 358 healthy subjects in the age range of 18-47 years (mean age = 26.66 ± 6.83) were selected following the selection criteria. Demographic details along with general physical and facial parameters such as height, weight, facial form, facial profile, arch form, and palatal contour were recorded in a predesigned proforma. The maximum bite force was recorded on both (right and left) sides using a specially designed piezoelectric transducer based device. Results: The MMBF in Indian individuals was found to be 372.39 ± 175.93 Newton (N). Males had significantly higher (P = 0.000) MMBF (448.47 ± 191.82 N) as compared to females (296.31 ± 116.79 N). Facial form (P = 0.001) and palatal contour (P = 0.000) showed a significant relationship with MMBF. Subjects having square facial form (421.34 ± 187.32 N) showed significantly higher MMBF as compared to other facial forms, that is, square tapered (358.86 ± 143.56 N; P = 0.038), ovoid (338.40 ± 163.02 N; P = 0.000) and tapered (349.22 ± 184.82 N; P = 0.028). Subjects with flat palatal contour showed significantly higher MMBF when compared to high (P = 0.002) and medium palatal (P = 0.002) contour. Though facial profile was not significantly related to MMBF, it was significantly higher in subjects having concave facial profile when compared to convex (P = 0.045) and straight (P = 0.039) facial profile. BMI and arch form showed no significant relationship with MMBF. Conclusion: The MMBF is found to be affected by gender and some of the anthropometric features like facial form and palatal contour.

Facial profile parameters and their relative influence on bilabial prominence and the perceptions of facial profile attractiveness: A novel approach / 대한치과교정학회지

OBJECTIVE: To evaluate the relative importance of bilabial prominence in relation to other facial profile parameters in a normal population. METHODS: Profile stimulus images of 38 individuals (28 female and 10 male; ages 19-25 years) were shown to an unrelated group of first-year students (n = 42; ages 18-24 years). The images were individually viewed on a 17-inch monitor. The observers received standardized instructions before viewing. A six-question questionnaire was completed using a Likert-type scale. The responses were analyzed by ordered logistic regression to identify associations between profile characteristics and observer preferences. The Bayesian Information Criterion was used to select variables that explained observer preferences most accurately. RESULTS: Nasal, bilabial, and chin prominences; the nasofrontal angle; and lip curls had the greatest effect on overall profile attractiveness perceptions. The lip-chin-throat angle and upper lip curl had the greatest effect on forehead prominence perceptions. The bilabial prominence, nasolabial angle (particularly the lower component), and mentolabial angle had the greatest effect on nasal prominence perceptions. The bilabial prominence, nasolabial angle, chin prominence, and submental length had the greatest effect on lip prominence perceptions. The bilabial prominence, nasolabial angle, mentolabial angle, and submental length had the greatest effect on chin prominence perceptions. CONCLUSIONS: More prominent lips, within normal limits, may be considered more attractive in the profile view. Profile parameters have a greater influence on their neighboring aesthetic units but indirectly influence related profile parameters, endorsing the importance of achieving an aesthetic balance between relative prominences of all aesthetic units of the facial profile.

The effect of western adaptation of Hispanic-Americans on their assessment of Korean facial profiles / 대한치과교정학회지

OBJECTIVE: To determine Korean facial profile preferences based on lip position as assessed by Hispanic-Americans of varying western adaptation levels and to determine whether the age and sex of the rater had any influence. METHODS: For this study, 132 Hispanic-Americans and 68 Caucasians of varying age, sex and western adaptation levels volunteered to rate their preference of Korean male and female facial silhouettes having lips ranging from retruding to protruding. The Hispanic-Americans were also asked to complete a Bidimensional Acculturation Scale questionnaire to determine their western adaptation status: low-acculturated Hispanics (LAH; lesser western-adapted Hispanic participants) or high-acculturated Hispanics (HAH; higher western-adapted Hispanic participants). RESULTS: The LAHs preferred significantly more retruded lip positions (p 0.05). CONCLUSIONS: The results of this study suggest that Hispanic-Americans prefer a flatter Korean lip profile. It would be prudent for orthodontists to offer patients the option of altering lip profile through orthodontic and/or orthognathic surgery treatments.

Fotogrametría del perfil facial en ortodoncia / Photogrammetry of facial profile in orthodontics

Se incorporaron dos sencillos elementos en las fotografías del perfil facial en ortodoncia. La aplicación de un sello, automático, de tinta común con una escala preestablecida de aplicación fácil, ágil y reproducible, directamente sobre la piel del paciente, para otorgar mayorprecisión en la comparación de imágenes en el tiempo; como así también, la utilización de un plano de referencia denominado plano lefraconformado por dos puntos que unen ojo y oído, permitiendo evaluar los cambios producidos en el rostro por medio de la superposición fotográfica. Al finalizar el presente trabajo se concluyo que la utilización del sello y la superposición sobre el plano lefra permiten asimilar eltamaño de las fotografías y a su vez dar una zona referencial estable, facilitando la comparación entre el pre y post tratamiento.

Two simple elements were incorporated in the photographs of facial profile in orthodontics. The application of a seal, automatic, common ink on a prescribed scale of easy, fast and reproducible application, directly on the skin of the patient profile, which gives more accurate comparison of images in time; as well as the use of a reference plane called lefra plane, which consists of two points linking eye and ear, allowing to evaluate the changes in the face by means of photographic superimposition. Upon completion of this work, was concluded that the use of the seal and the overlay on the lefra plane allow to assimilate the size of the photographs and in turn provide a stable reference area to facilitate the comparison between pre and post treatment.