Artificial Intelligence-Based Diagnosis of Obstructive Sleep Apnea Syndrome: A Scoping Review / Diagnóstico Basado en Inteligencia Artificial para el Síndrome Obstructivo de Apnea del Sueño: Una Revisión de Alcance

SUMMARY: To diagnose obstructive sleep apnea syndrome (OSAS), polysomnography is used, an expensive and extensive study requiring the patient to sleep in a laboratory. OSAS has been associated with features of facial morphology, and a preliminary diagnosis could be made using an artificial intelligence (AI) predictive model. This study aimed to analyze, using a scoping review, the AI-based technological options applied to diagnosing OSAS and the parameters evaluated in such analyses on craniofacial structures. A systematic search of the literature was carried out up to February 2024, and, using inclusion and exclusion criteria, the studies to be analyzed were determined. Titles and abstracts were independently selected by two researchers. Fourteen studies were selected, including a total of 13,293 subjects analyzed. The age of the sample ranged from 18 to 90 years. 9,912 (74.56 %) subjects were male, and 3,381 (25.43 %) were female. The included studies presented a diagnosis of OSAS by polysomnography; seven presented a control group of subjects without OSAS and another group with OSAS. The remaining studies presented OSAS groups in relation to their severity. All studies had a mean accuracy of 80 % in predicting OSAS using variables such as age, gender, measurements, and/or imaging measurements. There are no tests before diagnosis by polysomnography to guide the user in the likely presence of OSAS. In this sense, there are risk factors for developing OSA linked to facial shape, obesity, age, and other conditions, which, together with the advances in AI for diagnosis and guidance in OSAS, could be used for early detection.

Para diagnosticar el Síndrome Apnea Obstructiva del Sueño (SAOS) se utiliza la polisomnografía, el cual es un costoso y extenso estudio que exige que el paciente duerma en un laboratorio. El SAOS ha sido asociado con características de la morfología facial y mediante un modelo predictivo de la Inteligencia Artificial (IA), se podría realizar un diagnóstico preliminar. El objetivo de este estudio fue analizar por medio de una revisión de alcance, las opciones tecnológicas basadas en IA aplicadas al diagnóstico del SAOS, y los parámetros evaluados en dichos análisis en las estructuras craneofaciales. Se realizó una búsqueda sistemática de la literatura hasta febrero del 2024 y mediante criterios de inclusión y exclusión se determino los estudios a analizar. Los títulos y resúmenes fueron seleccionados de forma independiente por dos investigadores. Se seleccionaron 14 estudios, incluyeron un total de 13.293 sujetos analizados. El rango edad de la muestra oscilo entre 18 y 90 años. 9.912 (74.56 %) sujetos eran de sexo masculino y 3.381 (25,43 %) eran de sexo femenino. Los estudios incluidos presentaron diagnóstico de SAOS mediante polisomnografía, siete estudios presentaron un grupo control de sujetos con ausencia de SAOS y otro grupo con presencia de SAOS. Mientras que los demás estudios, presentaron grupos de SAOS en relación con su severidad. Todos los estudios tuvieron una precisión media del 80 % en la predicción de SAOS utilizando variables como la edad, el género, mediciones y/o mediciones imagenológicas. no existen exámenes previos al diagnóstico por polisomnografía que permitan orientar al usuario en la probable presencia de SAOS. En este sentido, existen factores de riesgo para desarrollar SAOS vinculados a la forma facial, la obesidad, la edad y otras condiciones, que sumados a los avances con IA para diagnóstico y orientación en SAOS podrían ser utilizados para la detección precoz del mismo.

Deep plane facelift extendido. Técnica de disección diseñada para lograr el máximo reposicionamiento de la región centrofacial, definición del contorno del cuello y la línea mandibular / Extended deep plane face lift. Dissection technique designed to achieve maximum repositioning of the centrofacial region, defi nition of the contour of the neck and jaw line

El lifting de plano profundo es una técnica de rejuvenecimiento facial que nos permite lograr resultados altamente satisfactorios aun en casos de difícil resolución. El conocimiento detallado de la anatomía facial es de primordial importancia para su aprendizaje y perfeccionamiento. Es una técnica que insume mayor tiempo operatorio, ya que requiere una adecuada liberación de ligamentos faciales y cervicales para la correcta movilización de los tejidos y su reposicionamiento sin tensión, pero al mismo tiempo es segura y confi able.

Deep plane lifting is a rejuvenation technique. facial treatment that allows us to achieve highly satisfactory even in cases of diffi cult resolution. He met Detailed understanding of facial anatomy is of primary importance importance for your learning and improvement. It is a technique that requires more operating time, since it requires adequate release of ligaments facial and cervical for the correct mobilization of the tissues and their repositioning without tension, but at the same time time is safe and reliable.

El reposicionamiento malar. Presentación de una técnica original: punto MM / Malar repositioning. Presentation of an original technique: point MM

El envejecimiento facial es una sinergia compleja de cambios texturales de la piel, hiper- o hipoactividad muscular, reabsorción del tejido graso y resorción ósea. El déficit de volumen resultante, la deflación y la posterior caída del tercio medio facial produce una cara menos atractiva y juvenil. Los procedimientos inyectables en región malar son cada vez más populares y solicitados por los pacientes. El conocimiento de la anatomía de la cara media es fundamental para el inyector. La comprensión de la irrigación facial puede ayudar a disminuir la exposición a la aparición de hematomas y complicaciones vasculares severas. Existen múltiples técnicas de inyección propuestas para el tercio medio, en este artículo presentamos una técnica original, simple, segura y eficaz con resultados satisfactorios y riesgo reducido

Facial aging is a complex synergy of textural skin changes, muscle hyperactivity, fat dysmorphism, bone resorption. The resulting volume deficit and deflation of the mid face produces a less attractive and youthful face. Injectable midface procedures are becoming increasingly popular and requested by patients. Knowledge of the anatomy of the midface is critical for the injector. Understanding the irrigation of the face can help decrease the risk of hematoma and severe vascular complications. There are multiple injection techniques proposed for the middle third, in this article we present a simple, safe and effective technique with satisfactory results and lower risk

Anatomical Characteristics, Relations, and Clinical Considerations of the Facial Index and Cephalic Index in Young Chileans Aged Between 18 and 21 Years / Características Anatómicas, Relaciones y Consideraciones Clínicas del Índice Facial e Índice Cefálico en Jóvenes Chilenos entre 18 y 21 Años

SUMMARY: Humans throughout history have shown similarities between both their cephalic and facial complexion, among certain ethnic groups, due to genetic and demographic factors. Several studies have demonstrated the different constitutions of specific groups of people in order to generate data of a certain population or group. The present research aims to preliminarily study the existence of possible relations between Cephalic Index and Facial Index among categories of individuals in an odontology student population from a private university in Santiago, Chile. Empirical, descriptive, and cross-sectional study. In this study, 129 students with age range 18-21 were taken as subjects in a non-probabilistic way. Regarding Cephalic Index (CI), the Retzius classification was used, and the Facial Index (FI) was measured considering the maximum height of the face, from nasion to gnathion (Na-Gn), and the maximum width, from right zygion to left zygion (Zr-Zl). In this study, 129 people were taken as sample, 82 females and 47 males. Among women, the most predominant cephalic biotype was brachycephalic (59.8 %), followed by mesocephalic (37.8 %), and dolichocephalic (2.4 %). On the other hand, men's most common biotype was mesocephalic (57.5 %), followed by brachycephalic (36.2 %), and dolichocephalic (6.4 %). Regarding facial biotype, both in female and male subjects the following pattern was shown: euryprosopic (F: 59.7 %, M: 59.6 %), mesoprosopic (F: 26.8 %, M: 29.8 %), and leptoprosopic (F: 13.4 %, M: 10.6 %). Facial parameters of the subjects (odontology students from a Chilean university) tend to be mostly euryprosopic, followed by mesoprosopic and leptoprosopic. Additionally, mesocephalic biotypes tend to be similar to other studies conducted in Chile.

Los seres humanos a lo largo de la historia han mostrado similitudes tanto entre su complexión cefálica como facial, entre ciertos grupos étnicos, debido a factores genéticos y demográficos. Varios estudios han demostrado las diferentes constituciones de grupos específicos de personas para poder generar datos de una determinada población o grupo. La presente investigación tiene como objetivo estudiar preliminarmente la existencia de posibles relaciones entre el Índice Cefálico y el Índice Facial entre categorías de individuos en una población de estudiantes de odontología de una universidad privada de Santiago, Chile, en un estudio empírico, descriptivo y transversal. En este estudio, se tomó como sujetos de forma no probabilística a 129 estudiantes con edades comprendidas entre 18 y 21 años. Respecto al Índice Cefálico (IC), se utilizó la clasificación de Retzius, y el Índice Facial (FI) se midió considerando la altura máxima de la cara, desde nasión hasta gnatión (Na-Gn), y el ancho máximo, desde cigio derecho a izquierdo. cigio (Zr-Zl). En este estudio se tomó como muestra 129 personas, 82 mujeres y 47 hombres. Entre las mujeres, el biotipo cefálico más predominante fue el braquicéfalo (59,8 %), seguido del mesocefálico (37,8 %) y el dolicocéfalo (2,4 %). Por otro lado, el biotipo más común en los hombres fue el mesocefálico (57,5 %), seguido del braquicéfalo (36,2 %) y el dolicocéfalo (6,4 %). Respecto al biotipo facial, tanto en sujetos femeninos como masculinos se mostró el siguiente patrón: euriprosópico (F: 59,7 %, M: 59,6 %), mesoprosópico (F: 26,8 %, M: 29,8 %) y leptoprosópico (F: 13,4 %, M: 10,6 %). Los parámetros faciales de los sujetos (estudiantes de odontología de una universidad chilena) tienden a ser en su mayoría euriprosópicos, seguidos de mesoprosópicos y leptoprosópicos. Además, los biotipos mesocefálicos tienden a ser similares a otros estudios realizados en Chile.

La importancia del conocimiento de la anatomía facial en armonización facial / The knowledge of facial anatomy in facial harmonization

La odontología argentina ha considerado reciente- mente la incorporación de armonización orofacial en odontología, acompañando los cambios que vienen sucediendo en el mundo con respecto a este tema. Países con especialización en armonización orofacial en odontología, como Brasil, 2019 o Venezuela, 2020, son muestra de ello. La evolución de la tecnología, junto con los cambios de paradigmas de la sociedad, ha cambiado aún el con- cepto de tratamiento desde la OMS. Actualmente bus- ca, como beneficio para los pacientes, el bienestar físico mental y social, no solo tratar o prevenir patologías. Acompañando estos conceptos las ciencias se adap- tan también a las necesidades de la población. El conocimiento de la anatomía facial también ha avanzado gracias a la tecnología y volumen de trabajos científicos desarrollados para conocer en profundidad cada una de las estructuras faciales y su relación entre ellas. Para ello ha sido fundamental la preparación actualizada de profesionales que traba- jan abordando tejidos blando de cara y cuello (AU)

Argentine dentistry has recently considered the incorporation of Orofacial Harmonization in Dentistry accompanying the changes that have been happening in the world regarding this issue, countries specializing in Orofacial Harmonization in Dentistry such as Brazil 2019 or Venezuela 2020 are proof of this. The evolution of technology together with the paradigm shifts of society has changed still the concept of treatment from the OMS Looking for a benefit for patients physical mental and social well-being and not only treat or prevent pathologies. Accompanying these concepts, the sciences also adapt to the needs of the population. Knowledge of facial anatomy has also advanced thanks to technology and volume of scientific works developed to know in depth each one of the structures facial features and their relationship between them, being essential the updated preparation of the professionals who work addressing soft tissues of the face and neck (AU)

Pesquisa de novos pontos craniométricos para aumento da precisão em reconstrução facial forense / Ressearch of new craniometric points for more accurate facial reconstruction

A estimativa de aparência da face de uma pessoa, partindo de um crânio seco, é chamada de Reconstrução Facial Forense (RFF). Pode ser realizada de maneira digital ou manual, a partir da marcação de pontos cranianos, que possuem diferentes médias de espessura de tecido mole sobreposto. Nas reconstruções digitais o uso de tomografias computadorizadas de feixe cônico (TCFC), que nos permite obter o volume de pacientes sentados, possibilitou um avanço significativo na mensuração das médias de volume dos tecidos moles faciais. Foi desenvolvido um protocolo para medições de tecidos moles a partir de 32 pontos craniométricos (10 sagitais e 11 bilaterais). Este trabalho propõe a inserção de cinco novos pontos cranianos ao protocolo, com medidas a partir dos pontos Mentual (Ml), Supra Canino (sC), Fronto-zigomático (Fz), Ptério (Pt) e Posterior do Ramo Mandibular (prM), com o intuito de aumentar a acurácia das reconstruções. As TCFC foram manipuladas no software Horus® (LGPL 3.0) e mensuradas conforme protocolo adaptado de Beaini et al. (1), obtidas as espessuras de tecido mole a partir dos pontos craniométricos propostos. Foram estudadas 100 TCFC de brasileiros adultos (maiores de 18 anos) que disponibilizaram seus exames para utilização em pesquisas de maneira anônima e que compõe um banco de dados já estruturado e utilizado em pesquisas anteriores. Esse banco de dados contém exames de 50 indivíduos do sexo feminino e 50 do sexo masculino, separados em grupos por sexo e idade. Estatisticamente, foram aplicados testes de normalidade e a diferença entre cada grupo foi testada para obtenção das espessuras médias referentes a cada ponto craniano. Para o ponto Fz, as médias de espessura de tecidos moles foram de 4.56mm para mulheres e 5.14mm para homens. Para o ponto Ml, as médias de ETMF foram de 12.88mm para mulheres e 14.74mm para homens. No ponto prM, as médias de ETMF foram de 18.30mm para homens e 19.69mm para mulheres. No ponto Pt, as médias de ETMF foram de 11.01mm para mulheres e 13.09mm para homens. No ponto sC, as médias de ETMF foram de 10.99mm para mulheres e 12.71mm para homens. A divisão de ETMFs por sexo é justificada, concordando com parcela significativa da literatura, uma vez que quatro 10 dos cinco pontos estudados apresentaram diferenças estatísticas significativas, com as espessuras de indivíduos do sexo masculino sendo maiores que de indivíduos do sexo feminino.

Correlation between vertical dimension of occlusion and different facial measurements among a sample of sudanese adults / Correlación entre la dimensión vertical de la oclusión y diferentes medidas faciales en una muestra de adultos sudaneses

Aim: This study aimed to evaluate the correlation between vertical dimension of occlusion (VDO) and various facial measurements in a sample of Sudanese adults. Material and Methods: A total of 113 dental students (33 males and 80 females) with a mean age of 21.7±1.26 years were enrolled in this study. Different facial measurements including (Eye-Mouth, Eye-Eye, Eye-Ear, and Ear Height) were compared with two different measurements of VDO: N-Gn (from the tip of the nose to the tip of the chin), and Sn-Me (from the base of the nose to the bottom of the chin). Pearson's correlation coefficient test was utilized for the correlation between the measured parameters. A p-value of less than 0.05 was considered significant for all analyses. Results: A significant positive correlation was shown between all measured facial distances and both measured VDO distances. Though, the strongest correlation was seen for the eye-mouth distance (r= 0.725, p<0.001), while the weakest was for ear height (r= 0.254, p= 0.007). A paired t-test revealed a significant longer N-Gn distance than Sn-Me distance. Also, it has been shown that there were no significant differences between right and left sides of the face. Conclusion: The distance measured from the outer canthus of the eye to the angle of the mouth can be used to predict Subnasale-Menton (Sn-Me) distance.

Objetivo: Este estudio tuvo como objetivo evaluar la correlación entre dimensión vertical oclusal (DVO) y varias medidas faciales en una muestra de adultos sudaneses. Material y Métodos: Un total de 113 estudiantes de odontología (33 hombres y 80 mujeres) con una edad media de 21,7 ± 1,26 años se inscribieron en este estudio. Se compararon diferentes medidas faciales que incluyen (ojo- boca, ojo-ojo, ojo-oído y altura de la oreja) con dos medidas diferentes de DVO: N-Gn (desde la punta de la nariz hasta la punta del mentón) y Sn -Yo (desde la base de la nariz hasta la parte inferior del mentón). Se utilizó la prueba del coeficiente de correlación de Pearson para la correlación entre los parámetros medidos. Un valor de p inferior a 0,05 se consideró significativo para todos los análisis. Resultados: Se mostró una correlación positiva significativa entre todas las distancias faciales medidas y ambas distancias DVO medidas. Sin embargo, la correlación más fuerte se observó para la distancia ojo-boca (r=0,725, p<0,001), mientras que la más débil fue para la altura de las orejas (r=0,254, p=0,007). Una prueba de t pareada reveló una distancia N-Gn significativamente más larga que la distancia subnasal-mentón. Además, se ha demostrado que no hubo diferencias significativas entre los lados derecho e izquierdo de la cara. Conclusión: La distancia medida desde el canto externo del ojo hasta el ángulo de la boca puede utilizarse para predecir la distancia subnasal-mentón.

Protocolo fotográfico estandarizado para análisis facial en Posición Natural de Cabeza / Standardized photographic protocol for facial analysis in Natural Head Position

RESUMEN: Introducción: La fotogrametría es el proceso por el que se obtienen medidas a partir de una fotografía. Para realizar una correcta toma fotográfica es de suma importancia estandarizar la técnica con el objetivo de obtener registros confiables y reproducibles. Uno de sus requisitos es definir la posición de la cabeza, ya que una postura incorrecta puede conducir a errores en el diagnóstico y planificación del tratamiento. Objetivo: Establecer un protocolo clínico para estandarizar registro fotográfico y posicionamiento del paciente para fotogrametría facial. Materiales y métodos: Se realizaron fotografías faciales estandarizadas a un total de 163 estudiantes. A 76 estudiantes se les realizaron mediciones faciales directas e indirectas. A 87 estudiantes se les comparó su Posición Natural de Cabeza en 3 momentos del día. Se compararon estadísticamente los resultados. Resultados: Al aplicar un protocolo estandarizado, no hubo diferencia estadística entre las medidas directas e indirectas ni al comparar la posición de la cabeza de cada estudiante. Conclusión: La estandarización del set fotográfico expuesto en este trabajo es válida para realizar registros fiables y útiles como examen complementario utilizando la Posición Natural de Cabeza, que permite mantener una posición confiable y estable en el tiempo.

ABSTRACT: Introduction: Photogrammetry is the process by which measurements are obtained from a photograph. To take a correct photographic shoot, it is very important to standardize the technique in order to obtain reliable and reproducible records. One of its requirements is to define the position of the head. Thus, an incorrect posture can lead to errors in diagnosis and treatment planning. Objective: Establish a clinical protocol to standardize photographic registration and patient positioning for facial photogrammetry. Materials and methods: Standardized facial photographs were taken to a total of 163 students. 76 students had direct and indirect facial measurements. 87 students had their Natural Head Position compared at 3 times of the day. The results were statistically compared. Results: When applying a standardized protocol, there was no statistical difference between direct and indirect measurements, nor when comparing the head position of each student. Conclusion: The standardization of the photographic set exposed in this work is valid for making reliable and useful records as a complementary examination using the Natural Head Position, which allows to maintain a reliable and stable position over time.

Preliminary study on the method of automatically determining facial landmarks based on three-dimensional face template / 中华口腔医学杂志

Objective: To explore the establishment of an efficient and automatic method to determine anatomical landmarks in three-dimensional (3D) facial data, and to evaluate the effectiveness of this method in determining landmarks. Methods: A total of 30 male patients with tooth defect or dentition defect (with good facial symmetry) who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology from June to August 2021 were selected, and these participants' age was between 18-45 years. 3D facial data of patients was collected and the size normalization and overlap alignment were performed based on the Procrustes analysis algorithm. A 3D face average model was built in Geomagic Studio 2013 software, and a 3D face template was built through parametric processing. MeshLab 2020 software was used to determine the serial number information of 32 facial anatomical landmarks (10 midline landmarks and 22 bilateral landmarks). Five male patients with no mandibular deviation and 5 with mild mandibular deviation were selected from the Department of Orthodontics or Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June to August 2021. 3D facial data of patients was collected as test data. Based on the 3D face template and the serial number information of the facial anatomical landmarks, the coordinates of 32 facial anatomical landmarks on the test data were automatically determined with the help of the MeshMonk non-rigid registration algorithm program, as the data for the template method to determine the landmarks. The positions of 32 facial anatomical landmarks on the test data were manually determined by the same attending physician, and the coordinates of the landmarks were recorded as the data for determining landmarks by the expert method. Calculated the distance value of the coordinates of facial anatomical landmarks between the template method and the expert method, as the landmark localization error, and evaluated the effect of the template method in determining the landmarks. Results: For 5 patients with no mandibular deviation, the landmark localization error of all facial anatomical landmarks by template method was (1.65±1.19) mm, the landmark localization error of the midline facial anatomical landmarks was (1.19±0.45) mm, the landmark localization error of bilateral facial anatomical landmarks was (1.85±1.33) mm. For 5 patients with mild mandibular deviation, the landmark localization error of all facial anatomical landmarks by template method was (2.55±2.22) mm, the landmark localization error of the midline facial anatomical landmarks was (1.85±1.13) mm, the landmark localization error of bilateral facial anatomical landmarks was (2.87±2.45) mm. Conclusions: The automatic determination method of facial anatomical landmarks proposed in this study has certain feasibility, and the determination effect of midline facial anatomical landmarks is better than that of bilateral facial anatomical landmarks. The effect of determining facial anatomical landmarks in patients without mandibular deviation is better than that in patients with mild mandibular deviation.

Individual Identification in Facial Appearance Biometrics Based on Macroscopical Comparison / 法医学杂志

Individual identification is one of the research hotspots in the practice of forensic science, and the judgment is usually built on the comparison of the unique biological characteristics of the individual, such as fingerprints, iris and DNA. With the dramatic increase in the number of cases related to video image investigations, there is an increasing need for the technology to identify individuals based on the macroscopic comparison of facial appearance biometrics. At present, with the introduction of computer three-dimensional (3D) modeling and 3D superimposition comparison technology, considerable progress has been made in individual identification methods based on macroscopic comparison of facial appearance biometrics. This paper reviews individual facial appearance biometric methods based on macroscopical comparison, comprehensively analyzes the advantages and limitations of different methods, and puts forward recommendations and prospects for subsequent research.

Clase III esqueletal ­ cuando todas las estrategias son insuficientes: reporte de un caso clínico / Skeletal class III - when all strategies are insufficient: report of a clinical case

Desde la antigüedad la belleza y la armonía facial han sido objetivos que tanto pintores como escultores, médicos y las personas tratan de lograr. Los rostros han sido estereotipados y es así como las caras proporcionadas tanto en alto como en ancho con perfiles que son rectos o levemente convexos son los que se asocian a bondad, generosidad, personas con luz interior, princesas y son las "buenas de las películas". Pero ¿qué sucede con aquellos rostros cóncavos, con tercios inferiores ya largos o cortos?… a ellos les ha tocado la peor parte, son los malos, los oscuros, los "villanos de las películas". Objetivos La finalidad de este trabajo es acercar a los colegas ortodoncistas una opción de tratamiento en clase III esqueletal, cuando el camuflaje ortodóncico no alcanza para resolver el crecimiento alterado entre el maxilar superior y el maxilar inferior (AU)

Beauty and facial harmony have been, since the beginning of humanity, a target for artists, painters, sculptores, and even people and doctors to accomplish. There is a stereotype of beauty: faces with proportional dimensions both in height and length, with straight profiles or somehow convex are associated with kindness, generosity and inner beauty. We can see this in movies where the heroes, the princesses, the "good guys" are portrayed with these types of faces. And what happens with people with concave faces, long or short inferior thirds? They are doomed to be the evil, the dark and "the villains" (AU)

Morphometric evaluation, locational relationship, and surgical significance of the maxillofacial region landmarks / Evaluación morfométrica, relación de ubicación e importancia quirúrgica de los puntos de referencia de la región maxilofacial

SUMMARY: The aim of this study was to examine the localization of the landmarks in the maxillofacial region and their relations with each other and to evaluate them morphologically and clinically. Our study included 41 dry adult human skulls of unknown age and sex of Anatolian population. Statistical analysis of the data obtained in our study was performed with SPSS v.20.0 software (IBM Corp., Armonk, NY, USA). Statistical significance was accepted as P ? 0.05. Whereas the mean right supraorbital depth (SOD) value was significantly greater than the mean left SOD value (p 0.05). Correlation values in our study varied between -0.156 and 0.612. The highest correlation value was obtained in the positive direction between the orbital height (OH) and supraorbital foramen-infraorbital foramen (SOF-IOF) measurements (r = 0.612, p < 0.001). We believe that measurements of the orbit, SOF, and IOF and our data on their localizations, along with the relationships that we observed in our study will allow surgeons to avoid damaging the neurovascular bundles during surgical interventions and local anesthesia procedures in the frontal, periorbital, and maxillofacial regions.

RESUMEN: El objetivo de este estudio fue examinar la localización de los hitos en la región maxilofacial y sus relaciones entre sí y evaluarlos morfológica y clínicamente. Nuestro estudio incluyó 41 cráneos humanos adultos secos de edad y sexo desconocidos de la población de Anatolia. El análisis estadístico de los datos obtenidos en nuestro estudio se realizó con el software SPSS v.20.0 (IBM Corp., Armonk, NY, EE. UU.). La significación estadística se aceptó como P ? 0,05. Mientras que el valor medio de la profundidad supraorbitaria derecha (SOD) fue significativamente mayor que el valor medio de la SOD izquierda (p 0,05). Los valores de correlación en nuestro estudio variaron entre -0,156 y 0,612. El mayor valor de correlación se obtuvo en la dirección positiva entre las medidas de altura orbitaria (OH) y foramen supraorbitario-foramen infraorbitario (SOF-IOF) (r = 0,612, p <0,001). Creemos que las mediciones de la órbita, SOF e IOF y nuestros datos sobre sus localizaciones, junto con las relaciones que observamos en nuestro estudio, permitirán a los cirujanos evitar dañar los haces neurovasculares durante las intervenciones quirúrgicas y los procedimientos de anestesia local en la zona frontal, periorbitaria. y regiones maxilofaciales.

Morfología ósea facial en cirugía ortognática. ¿existe tendencia hacia el avance facial? / Facial morphology in orthognathic surgery: is there a facial advance trend?

RESUMEN: El objetivo de esta investigación fue determinar los movimientos preferidos en maxila y mandíbula para obtener normalidad en morfología facial utilizando técnicas de superimposición en análisis 3D. Se realizó un estudio descriptivo para evaluar el desplazamiento óseo bimaxilar y del hueso hioides en sujetos clase facial tipo II y clase facial tipo III sometidos a cirugía ortognática. Para la superimposición se utilizó como puntos fijos Nasion - Silla - Porion y la sutura cigomática-maxilar. Estos puntos se superpusieron en CBCT pre quirúrgico y postquirúrgico y se evaluó el desplazamiento de la espina nasal anterior, Punto A, Punto B, mentón y del hueso hioides. Para la evaluación y comparación de las variables continuas antes y después de la cirugía ortognática se utilizó la prueba T de Student. Para la correlación entre las variables, se utilizó el Test de Spearman considerando un valor p<0,05 como diferencia significativa. 44 sujetos de entre 18 y 40 años de ambos sexos, fueron incluidos en esta investigación. En el 90 % de los sujetos se realizó un movimiento sagital de avance de la maxila. El movimiento sagital de avance mandibular se realizó en el 100 % de los sujetos con clase facial tipo II, mientras que el 100 % de los sujetos con clase facial tipo III se realizó se le retroceso mandibular. El hueso hioides presentó un avance en 26 de los 27 sujetos con clase facial tipo III. Es posible concluir que existe una tendencia al avance maxilar independiente de la deformidad facial.

ABSTRACT: The objective of this research was to determine the preferred movements in the maxilla and mandible to obtain normality in facial morphology using superimposition techniques in 3D analysis. A descriptive study was carried out to evaluate bimaxillary bone displacement and hyoid bone in subjects facial class II and facial class III undergoing orthognathic surgery. were used as fixed points for superimposition: Nasion (N) - Silla (S) - Porion (Po) and the zygomatic-maxillary suture (Z). These points were superimposed in pre-surgical and post- surgical CBCT and was evaluated to displacement of the anterior nasal spine, Point A, Point B, Chin and the hyoid bone. For the evaluation and comparison of continuous variables before and after orthognathic surgery, was used the Student's t test. For the correlation between the variables, the Spearman test is used, considering a p value <0.05 as a significant difference. 44 subjects between 18 and 40 years old of both sexes were included in this research. A 90% of subjects a was performed a maxillay sagittal movement. The sagittal movement of mandibular advancement was performed in 100% with facial class type II, while 100 % of the subjects with with facial class type III had a mandibular recession. The hyoid bone advanced in 26 of the 27 subjects with facial class type II. It is possible to conclude that there is a tendency for maxillary advancement, independent of facial deformity.

Cephalofacial differences between males 18 years of age and 20-30 years of age / Diferencias cefalofaciales entre hombres de 18 años y de 20-30 años

SUMMARY: The human skull is comprised of many flat and irregular bones, divided into two groups: cranial and facial bones. The size, shape and growth of the human skull are the product of many interrelated internal and external factor interactions. The purpose of the present study was to explore the systematic differences in cephalofacial size and shape classification between two measured groups of different ages and different period of done measurements. Five cephalofacial variables and four cephalofacial indexes were measured on 795 entities of the Kosovo Albanian population in two different timelines; 401 male entities aged 20-30 years old were measured during the timeline 1997-1999, while 394 male entities aged 18 years old were measured during the timeline 2016-2018. The gained data were analyzed in terms of basic descriptive statistical parameters and the percentage of distribution of results. The most pronounced differences between the age groups of 18 year-olds and the age group of 20-30 year-olds, are mainly emphasized in the morphological height of the face, total facial index and transverse cephalic index. While in other dimensions, the distribution of results is very similar. Differences between groups can be justified by the age at which the growth of the cephalofacial bones ends and the influence of external factors such as nutritional and socio-economic factors.

RESUMEN: El cráneo humano está compuesto por huesos planos e irregulares, divididos en dos grupos: huesos craneales y faciales. El tamaño, la forma y el crecimiento del cráneo humano son el producto de muchas interacciones de factores internos y externos interrelacionados. El propósito del presente estudio fue explorar las diferencias sistemáticas en la clasificación de tamaño y forma cefalofacial entre dos grupos de diferentes edades y en diferentes períodos de mediciones. Se midieron cinco variables cefalofaciales y cuatro índices cefalofaciales en 795 entidades de la población albanesa de Kosovo en dos líneas de tiempo diferentes. Se midieron 401 entidades masculinas de 20 a 30 años. Durante el periodo 1997-1999 se medieron 401 entidades masculinas de 20 a 30 años, mientras que 394 entidades masculinas de 18 años se se midieron durante el periodo 2016-2018. Los datos obtenidos se analizaron en términos de parámetros estadísticos descriptivos básicos y el porcentaje de distribución de los resultados. Las diferencias más pronunciadas entre los grupos de edad de 18 años y el grupo de 20-30 años, se enfatizan principalmente en la altura morfológica de la cara, índice facial total e índice cefálico transversal. Mientras que en otras dimensiones, la distribución de resultados es muy similar. Las diferencias entre grupos pueden estar asociadas a la edad en la que finaliza el crecimiento de los huesos cefalofaciales y la influencia de factores externos, tal como aspectos nutricionales y socioeconómicos.

Does body mass index affect soft tissue facial anthropometric measurements? / ¿El índice de masa corporal afecta las mediciones antropométricas faciales de tejidos blandos?

SUMMARY: This study aims to test the effect of body mass index on certain facial soft tissue measurements. Three hundred Arab Iraqi young adults with different body mass indexes were randomly selected from the population in Basrah city. Different horizontal and vertical soft tissue measurements were obtained using different calipers. Sex differences were verified by an independent sample t-test, while the effect of different body mass index categories was evaluated by one way ANOVA and Tukey tests. Obese males showed significantly higher mean values for weight, nose width, face width, head circumference, and lower facial third length (p≤0.001). Obese females shared these parameters with obese males in addition to mouth width. Regarding sex differences, nearly all measurements were significantly higher in males than in females. Obese individuals had wider faces, noses and mouths; larger head circumferences and facial indexes; and longer lower facial third lengths. Moreover, they possessed smaller inner canthal widths as well as upper and middle facial thirds in comparison to normal and overweight subjects.

RESUMEN: Este estudio tuvo como objetivo probar el efecto del índice de masa corporal en determinadas medidas de tejidos blandos faciales. Trescientos adultos jóvenes iraquíes con diferentes índices de masa corporal fueron seleccionados al azar de la población de la ciudad de Basora. Se obtuvieron diferentes medidas de tejidos blandos horizontales y verticales utilizando diferentes calibradores. Las diferencias de sexo se verificaron mediante una prueba t independiente, mientras que el efecto de diferentes categorías de índice de masa corporal se evaluó mediante pruebas ANOVA y Tukey de una vía. Los hombres obesos mostraron valores medios significativamente más altos de peso, el ancho de la nariz, el ancho de la cara, la circunferencia de la cabeza y la longitud del tercio inferior del rostro (p≤0,001). Las mujeres obesas comparten estos parámetros con los machos obesos además del ancho de la cavidad oral. Con respecto a las diferencias de sexo, casi todas las medidas fueron significativamente más altas en hombres que en mujeres. Las personas obesas tenían caras, narices y bocas más anchas; circunferencias más grandes de la cabeza e índices faciales; y longitudes de tercio inferior facial más largas. Además, se observaron anchos cantales mediales más pequeños, así como tercios faciales superior y medio en comparación con sujetos normales y con sobrepeso.

Determinación de Valores de Armonía del Perfil Facial en la Población Chilena / Determination of harmony values of the facial profile in the Chilean population

El realizar un tratamiento ortodóntico sólo en base a referencias de tejidos duros, puede llevar a resultados estéticos desfavorables, debido a la gran variabilidad que existe en los tejidos blandos que los recubren. Arnett et al. (1999) presentaron un análisis basado en los tejidos blandos y determinó normas que definen un rostro armónico. Sin embargo, éstas normas se obtuvieron de pacientes norteamericanos y puede que no reflejen los conceptos estéticos de nuestra población. El objetivo del presente trabajo fue determinar valores de armonía facial para la población chilena, utilizando el análisis cefalométrico de tejidos blandos presentado por Arnett et al., y compararlos con los valores previamente establecidos para la población caucásica. Se analizaron 200 fotografías y se clasificaron los perfiles en balanceados y no balanceados según el criterio de un grupo de especialistas. Posteriormente se analizaron las telerradiografías correspondientes a los perfiles clasificados, con el análisis cefalométrico de tejidos blandos. Los valores de las diferentes variables fueron analiza dos separadamente por sexo, clase esqueletal y biotipo facial, y se determinaron las diferencias entre las variables presentadas por Arnett et al. y las obtenidas en el presente estudio. Para ello se utilizaron pruebas de significancia estadística como el test t y otros no paramétricos. Sólo se encontró diferencias significativas en dos variables respecto de las normas sugeridas por Arnett et al., correspondientes a un menor espesor del labio inferior en ambos sexos, y una mayor prominencia del pómulo en mujeres chilenas, por lo que consideramos que los valores de armonía de Arnett et al., pueden ser también aplicados como parámetro estético para la población chilena.

Performing an orthodontic treatment based only on hard tissue references can lead to unfavorable aesthetic results due to the great variability that exists in soft tissues that cover them. In 1999, W.Arnett, presented an analysis based on soft tissues and determined norms that define a harmonious face. However, these standards that were obtained from North Americans and Chilean aesthetic concepts could be different. The aim of the study was to determine the values of facial harmony for the Chilean population, using the cephalometric analysis of soft tissues presented by Arnett, and compare them with the values previously established for the Caucasian population. In this study 200 photographs were analyzed, and the profiles were classified in balanced and unbalanced according to the criteria of a group of specialists. Subsequently, teleradiographs corresponding to the classified profiles were analyzed, with the cephalometric analysis of soft tissues. The values of the different variables were analyzed separately by sex, skeletal class and facial biotype, and the differences between the variables presented by Arnett et al., and those obtained in the present study. For this purpose, statistical significance tests such as the t test and other non- parametric tests were used. There were only significant differences in two variables: inferior lip variables in both sexes, and a greater prominence of the cheekbone in Chilean women, therefore we consider that the values of harmony of Arnett, can also be applied as an aesthetic parameter for the Chilean population.

Cephalometric changes during aging in subjects with normal occlusion

Abstract Objective To assess craniofacial changes from early adulthood to the seventh decade of life in individuals with normal occlusion. Methodology The sample comprised lateral cephalograms of 21 subjects with normal occlusion (11 male, 10 female), taken at 17 (T1) and 61 years of age (T2). Anteroposterior and vertical maxillomandibular relationships, and dentoalveolar and soft tissue changes were analyzed. Interphase comparisons were performed using paired t-tests. Differences between sexes, and subgroups with and without tooth loss were evaluated using t-tests (p<0.05). Results Maxillary and mandibular anterior displacement, and facial and ramus height increased from T1 to T2. Maxillary molars showed significant mesial angulation. Maxillary and mandibular molars, and mandibular incisors developed vertically during the evaluation period. Soft tissue changes included a decrease of the nasolabial angle, upper and lower lip retrusion, decrease of upper lip thickness and increase of the lower lip and soft chin thickness. Maxillary incisor exposure by the upper lip decreased 3.6 mm in 40 years. Males presented counterclockwise rotation of the mandible, whereas females showed mandibular clockwise rotation and backward displacement of the chin. The group with tooth loss showed a greater increase of the posterior facial height and ramus height. Conclusion We observed aging changes in dentoskeletal structures and soft tissue, as well as sexual differences for craniofacial changes during the maturational process. Subjects with multiple tooth losses showed a greater increase in mandibular ramus height.

Mandibular orthopedic advancement in different facial patterns and distinct stages of skeletal maturation

ABSTRACT The Herbst appliance can be very effective in treatment of Class II patients with mandibular retrognathism. Because of the continuous action in a full-time basis, treatment time using it normally takes from six to ten months, and is usually followed by a second phase of full fixed appliances, in order to obtain both occlusal refinement and long term stability. Despite Herbst appliance's effectiveness in the occlusal and dentoalveolar perspectives, its facial results may differ among patients with different growth patterns, as well as in distinct stages of skeletal maturation. In the current paper, two patients with different facial patterns are presented, who were treated under the same protocol, using Herbst and full fixed appliances in different skeletal maturation stages, and both dentoalveolar and facial results are compared and discussed.

RESUMO Um número significativo de pacientes que procuram o tratamento ortodôntico apresenta má oclusão de Classe II acompanhada pelo retrognatismo mandibular. Abordagens ortopédicas para avanço mandibular são comumente utilizadas enquanto houver crescimento facial remanescente e, nesses casos, o estágio de maturação esquelética deve ser avaliado para definir a melhor época de intervenção terapêutica. Após concluída a fase ortopédica, normalmente é realizada uma segunda fase ortodôntica para refinamento oclusal, com o intuito de oferecer maior estabilidade das correções em longo prazo. No presente artigo, serão discutidos os resultados do avanço mandibular ortopédico considerando-se diferentes estágios de crescimento.

McNamara analysis cephalometric parameters in White-Brazilians, Japanese and Japanese-Brazilians with normal occlusion

ABSTRACT Introduction: McNamara's Jr. cephalometric analysis is a tool to diagnose dental and skeletal discrepancies and is widely used, guiding diagnosis for surgical procedures to be performed or for the use of functional devices. Few studies have shown that different ethnic groups have different cephalometric patterns. Thus, single characteristics should be respected to support the diagnosis and to help the treatment plan for different ethnic groups and their different patterns of miscegenation. Objective: Obtain normal values for McNamara's cephalometric analysis for adolescent Japanese-Brazilian descents with normal occlusion, as well as to compare this sample with similar samples of White-Brazilian and Japanese. Methods: Lateral headfilms from 40 White-Brazilian, 33 Japanese and 32 Japanese-Brazilian descents were selected. The three groups were composed by individuals with normal occlusion, well-balanced profiles and were separated by sex. The data were statistically analyzed with ANOVA, t-test, ANCOVA and MANCOVA tests. Results: White-Brazilian males had significantly greater nasolabial angle than Japanese males. Japanese-Brazilian displayed an intermediate value between White-Brazilian and Japanese. Conclusion: White-Brazilian, Japanese and Japanese-Brazilian present different cephalometric characteristics of McNamara analysis. Japanese males have a significantly more acute nasolabial angle than White-Brazilian subjects.

RESUMO Introdução: A análise cefalométrica de McNamara Jr. é uma ferramenta amplamente utilizada para o diagnóstico das discrepâncias dentárias e esqueléticas, principalmente porque fornece um diagnóstico que orienta os procedimentos cirúrgicos a serem realizados ou a utilização de aparelhos funcionais. Estudos têm demonstrado que diferentes grupos étnicos apresentam padrões cefalométricos distintos. Portanto, as características próprias dos indivíduos devem ser respeitadas, para suportar o diagnóstico e facilitar o plano de tratamento, entre as diferentes etnias e seus diferentes padrões de miscigenação. Objetivo: Determinar os valores médios de normalidade das grandezas cefalométricas relacionadas à análise de McNamara em jovens mestiços nipo-brasileiros, com oclusão normal, descendentes de japoneses e brasileiros, e comparar os resultados das variáveis com amostras de jovens brasileiros leucodermas e xantodermas que apresentem as mesmas características. Métodos: Foram selecionadas 40 telerradiografias de jovens leucodermas, 33 de xantodermas e 32 de nipo-brasileiros. As três amostras foram constituídas de indivíduos com oclusão normal e face bem balanceada, e foram divididas por sexo. Os dados foram estatisticamente analisados utilizando ANOVA, teste t, ANCOVA e MANOVA. Resultados: Os leucodermas apresentaram o ângulo nasolabial significativamente maior, comparados aos japoneses, no sexo masculino; enquanto os nipo-brasileiros apresentaram um valor intermediário entre os leucodermas e xantodermas. Conclusão: Os grupos de leucodermas, xantodermas e nipo-brasileiros apresentaram diferentes características cefalométricas da análise de McNamara. Os xantodermas no sexo masculino tiveram o ângulo nasolabial significativamente mais agudo, quando comparados com os leucodermas.

Cone beam computed tomography evaluation of the relationship between atlantodental interval and skeletal facial morphology in adolescents / Avaliação por tomografia computadorizada de feixe cônico da relação entre o intervalo atlantodental e a morfologia esquelética facial em adolescentes

Abstract Introduction: In the pediatric population, computed tomography examination of the upper cervical spine plays an important role in the diagnosis of neurological injuries involving that region. Due to the interconnected nature of the craniofacial structures, a structural change in one is expected to also cause changes in the other structures. Objective: The aim of this study was to evaluate relationships between atlantodental interval, cervical vertebral morphology, and facial structure in healthy adolescents using cone beam computed tomography. Methods: Thirty subjects aged 14-20 years (10 males, mean age: 17.2 years; 20 females, mean age: 17.9 years) were included in the study. The anterior, lateral and posterior atlantodental intervals, and vertical and anteroposterior dimensions of the first and second cervical vertebrae were evaluated from cone beam computed tomography images. Facial morphology was evaluated using 7 parameters on lateral cephalometric cone beam computed tomography images and 6 parameters on posteroanterior images. The Mann-Whitney U test and Wilcoxon test were used for statistical analyses. Results: Comparisons between males and females showed that most parameters were larger in males, with significant differences in vertical facial dimensions (anterior lower face height: p= 0.05; anterior upper face height: p= 0.001), (distance between the most internal point of the frontozygomatic suture and midsagittal reference plane; p= 0.01), (the distance between the deepest point of the right alveolar maxillar process and midsagittal reference plane; p= 0.001), and C2 vertebral dimensions. The anterior and lateral atlantodental interval values correlated with maxilla position relative to the mandible angle, and the anterior atlantodental interval correlated with lower anterior facial height (p= 0.05). Dimensional measurements of the C1 and C2 vertebrae were correlated with both anterior facial heights and some posteroanterior parameters. Conclusion: Sagittal, vertical, and transverse facial dimensions and positions were strongly associated with C1 and C2 vertebral dimensions, and the maxillomandibular relationship may affect atlantodental interval. Therefore, including craniofacial features in assessment of the atlantodental area and vertebral distances in adolescents may be beneficial.

Resumo Introdução: Na população pediátrica, a tomografia computadorizada da coluna cervical alta tem um importante papel no diagnóstico de lesões neurológicas que envolvem essa região. Devido à natureza interconectada das estruturas craniofaciais, espera-se que uma mudança estrutural em uma delas também cause alterações nas outras estruturas. Objetivo: Avaliar as relações entre o intervalo atlantodental, a morfologia vertebral cervical e a estrutura facial em adolescentes saudáveis com a tomografia computadorizada de feixe cônico. Método: Trinta indivíduos entre 14 e 20 anos (10 homens, média de 17,2 anos; 20 mulheres, média de 17,9 anos) foram incluídos no estudo. O intervalo atlantodental anterior, lateral e posterior e as dimensões vertical e anteroposterior da primeira e segunda vértebras cervicais foram avaliados a partir de imagens de tomografia computadorizada de feixe cônico. A morfologia facial foi avaliada utilizando-se sete parâmetros em imagens de tomografia computadorizada de feixe cônico cefalométricas laterais e seis parâmetros em imagens posteroanteriores. O teste U de Mann-Whitney e o teste de Wilcoxon foram utilizados para as análises estatísticas. Resultados: As comparações entre homens e mulheres mostraram que em sua maioria os parâmetros foram maiores no sexo masculino, com diferenças significantes nas dimensões faciais verticais (altura facial anterior inferior: p = 0,05; altura facial anterior superior: p = 0,001), distância entre o ponto mais interno da sutura fronto-zigomática e plano de referência médio-sagital; p = 0,01distância entre o ponto mais profundo do processo alveolar do maxilar direito e o plano de referência médio-sagital; p = 0,001) e as dimensões do corpo vertebral C2. O intervalo atlantodental anterior e lateral correlacionaram-se com o ângulo da posição da maxila em relação à mandíbula e o intervalo atlantodental anterior correlacionou-se com altura facial anterior inferior (p = 0,05). Medidas das dimensões das vértebras C1 e C2 foram correlacionadas com as alturas faciais anteriores e alguns parâmetros póstero-anteriores. Conclusão: As dimensões e posições faciais sagitais, verticais e transversais foram fortemente associadas às dimensões dos corpos vertebrais C1 e C2 e a relação maxilomandibular pode afetar o intervalo atlantodental. Portanto, incluir características craniofaciais na avaliação da área atlantodental e das distâncias vertebrais em adolescentes pode ser benéfico.