Análisis de las Variaciones Anatómicas y Dimensionales del Canal Nasopalatino Mediante Tomografía Computarizada de Haz Cónico / Analysis of the Anatomical and Dimensional Variations of the Nasopalatine Canal by Cone Beam Computed Tomography

El conocimiento anatómico del canal nasopalatino (CNP) es fundamental para la realización de cirugías en el sector anterior del maxilar y así prever posibles complicaciones. El objetivo de este trabajo es evaluar y determinar las variaciones anatómicas y dimensionales del CNP según sexo, edad y estado dental. Este estudio transversal analizó un total de 251 imágenes de TCHC obtenidas de la base de datos del Servicio de Imagenología Oral y Maxilofacial de la Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile. Para evaluar la asociación estadística entre variaciones del CNP con sexo, edad y estado dentario se realizó la prueba T de Student, chi-cuadrado y ANOVA (p0,05). Además, se detectó diferencia significativa entre el estado dentario y la dimensión de la tabla vestibular en relación con el CNP (p<0,01). Se deben considerar las variaciones de CNP para evitar posibles complicaciones durante los procedimientos quirúrgicos.

SUMMARY: Anatomical knowledge of the nasopalatine canal (PNC) is essential for performing surgeries in the anterior sector of the maxilla and thus anticipating possible complications. The objective of this work is to evaluate and determine the anatomical and dimensional variations of the CNP according to sex, age and dental status. This cross-sectional study analyzed a total of 251 CBCT images obtained from the database of the Oral and Maxillofacial Imaging Service of the Faculty of Dentistry of the Andrés Bello University, Viña del Mar, Chile. To evaluate the statistical association between CNP variations with sex, age and dental status, the Student's T test, chi-square and ANOVA (p0.05). In addition, a significant difference was detected between the dental state and the dimension of the vestibular table in relation to the CNP (p<0.01). CNP variations should be considered to avoid potential complications during surgical procedures.

Valoración de las dimensiones del paladar y su relación con alteraciones verticales / Avaliação das dimensões do palato e sua relação com alterações verticais / Assessment of palate dimensions and its relation with vertical alterations

Objetivos: La presente investigación tuvo como objetivo establecer la correlación entre la presencia de maloclusiones a nivel vertical con el índice del paladar y con la altura palatina. Materiales y Métodos: Estudio de tipo transversal. La población de estudio fue conformada por 134 modelos de yeso con dentición mixta, 81 mujeres y 53 hombres, seleccionados por conveniencia y obtenidos desde el 2014 hasta el 2018 del área de clínica de odontopediatría y ortodoncia en la Escuela Nacional de Estudios Superiores Unidad León. La muestra de estudio fue dividida en 3 categorías según la oclusión; mordida abierta (37), mordida profunda (32) y normoclusión (65). Se realizaron mediciones del ancho intermolar y altura del paladar con el uso de un calibrador digital, posteriormente se obtuvo el índice del paladar y se correlacionó con los parámetros expuestos por Korkhaus mediante la prueba estadística de Spearman. Resultados: La prueba estadística de Spearman refleja que no hay correlación entre la magnitud de los valores del índice del paladar propuestos por Korkhaus con la presencia de maloclusiones a nivel vertical. De igual manera las pruebas estadísticas indican que no existe correlación notable entre la altura del paladar y la oclusión en relación vertical. Conclusiones: El resultado obtenido al usar el índice del paladar no fue capaz de corresponder a los parámetros propuestos por Korkhaus como normales, posiblemente al ser usado durante la etapa de la dentición mixta pues durante este periodo suceden cambios constantes relacionados al crecimiento.

Objetivos: Os objetivos a presente investigação buscou valor uma correlação entre a presença de más oclusões em nível vertical com o índice do palato e com a altura palatina. Materiais e Métodos: Estudo do tipo transversal. A população do estudo foi composta por 134 modelos de gesso com dentição mista, 81 mulheres e 53 homens, selecionados por conveniência e obtidos de 2014 a 2018 na área de Odontopediatria e Ortodontia na Escola Nacional de Ensino Superior Unidade de León. A amostra do estudo foi dividida em 3 categorias de acordo com a oclusão; mordida aberta (37), mordida profunda (32) e normoclusão (65). A medida da largura intermolar e da altura do palato foi feita com o uso de um paquímetro digital, o índice de palato foi posteriormente obtido e relacionado aos parâmetros expostos por Korkhaus por meio do teste estatístico de Spearman. Resultados: O teste estatístico de Spearman mostra que não há correlação entre a magnitude dos valores do índice de palato proposta por Korkhaus e a presença de más oclusões verticais. Da mesma forma, os testes estatísticos indicam que não há correlação notável entre a altura do palato e a oclusão na relação vertical. Conclusões: O resultado obtido com o uso do índice de palato não foi capaz de corresponder aos parâmetros propostos por Korkhaus como normais, possivelmente quando usado durante o estágio de dentição mista, porque durante este período há mudanças constantes relacionadas ao crescimento

Purpose: The aim of the present study is to assess the relation between vertical malocclusions with palatal index and palatal height. Materials and Methods: Transversal study. The sample consisted in 134 stone models within mixed dentition, 81 females and 53 males, they were convenience selected and obtained from the pediatric and orthodontic dentistry medical center at the National School for Superior Studies Unit León since 2014 to 2018. The stone models were divided into three categories according to their kind of occlusion: open bite (37), deep bite (32) and normal bite (65). Palatal width and height were measure by using a digital caliper. Subsequently the palatal index was obtained and it was related with the parameters exposed by Korkhaus using the Spearman statistical test. Results: The Spearman statistical test indicated there is no a clearly relationship between palatal index values exposed by Korkhaus with the presence of vertical malocclusions and in the same way there is no a relationship between palatal height and vertical malocclusions.Conclusions: The result obtained by using the palatal index was no able to indicate an agreement with Korkhaus parameters. Probably this disagreement was due to the constant changes that occur during the period of the mixed dentition.

Estudio morfológico de canales nasopalatinos en población mexicana mediante tomografía computarizada de haz cónico / Morphological study of nasopalatine canal in Mexican population using cone beam computed tomography

La morfología y dimensiones de ciertas estructuras anatómicas varían de población a población, así como de individuo a individuo; el canal nasopalatino (CNP) es una de estas estructuras, este se encuentra ubicado en la línea media del paladar y aloja el nervio nasopalatino y la rama terminal de la arteria nasopalatina. El propósito de este estudio es determinar la morfología y dimensiones promedio del CNP en la población mexicana mediante tomografía computarizada de haz cónico (CBCT). Se analizaron 120 CBCT de manera coronal, transversal y sagital; y se clasificaron siguiendo los parámetros de Bornstein. Para el análisis estadístico se determinó la normalidad de las variables empleando la prueba de Shapiro Wilk y la significancia estadística mediante la prueba de UMann Whitney. Los resultados mostraron diferencias estadísticas significativas en las variables analizadas del canal nasopalatino entre hombres y mujeres. De acuerdo con los datos obtenidos se puede establecer que la morfología del CNP es muy variable y se recomienda realizar un estudio morfológico y dimensional antes de cualquier intervención quirúrgica relacionada con esta zona.

Certain human structures present different dimensions and morphologies in each population and individual, the nasopalatine canal being one of these. It is located in the midline of the palate, and it contains the nasopalatine nerve and the terminal branch of the nasopalatine artery. The purpose of this study was to analyze and record measurements of the nasopalatine duct in Mexican population by Cone Beam Computed Tomography (CBCT). A total of 120 CBCT coronal, transversal and sagittal views were analyzed. The data were classified according to Bornstein´s parameters. The normality of the variables was determined with the Shapiro Wilk test and the statistical significance was determinate by U-Mann Whitney test. A statistically significant difference was found in the evaluated variables of the nasopalatal canal between men and women. The data obtained determined that the morphology of the nasopalatine canal is variable and a morphological and dimensional analysis before any surgical intervention related with the area is recommended.

Premaxilla: up to which age it remains separated from the maxilla by a suture, how often it occurs in children and adults, and possible clinical and therapeutic implications: Study of 1,138 human skulls

ABSTRACT Objective: To evaluate topographic and temporal aspects of premaxillary bone and premaxillary-maxillary suture, since they are fundamental anatomical elements little explored clinically. Methods: 1,138 human dry skulls were evaluated, of which 116 (10.19%) of the specimens were children, and 1,022 (89.81%) were adults. The skulls were photographed and the percentage of premaxillary-maxillary suture opening was determined. Subsequently the data were tabulated and submitted to statistical analysis, adopting a level of significance of 5%. Results: The progression of premaxillary suture closure from birth to 12 years of age was 3.72% per year. In 100% of the skulls up to 12 years, the premaxillary-maxillary suture open in the palatal region was observed, while 6.16% of adults presented different degrees of opening. Conclusions: The premaxilla exists in an independent way within the maxillary complex and the presence of the premaxilla-maxillary suture justifies the success of anteroposterior expansions to stimulate the growth of the middle third of the face, solving anatomical and functional problems.

RESUMO Objetivo: avaliar aspectos topográficos e temporais do osso pré-maxilar e da sutura pré-maxilar/maxilar, por serem elementos anatômicos fundamentais pouco explorados clinicamente. Métodos: foram avaliados 1.138 crânios secos humanos, sendo 116 (10,19%) dos espécimes crianças e 1.022 (89,81%) adultos. Os crânios foram fotografados e determinou-se a porcentagem de abertura da sutura pré-maxilar/maxilar. Posteriormente, os dados foram tabulados e submetidos a análise estatística, adotando-se nível de significância de 5%. Resultados: a progressão de fechamento da sutura pré-maxilar/maxilar do nascimento aos 12 anos de idade foi de 3,72% ao ano. Em 100% dos crânios até 12 anos, observou-se a sutura pré-maxilar/maxilar aberta na região palatina, enquanto 6,16% dos adultos apresentavam diferentes graus. Conclusões: a pré-maxila existe de forma independente dentro do complexo maxilar e a presença da sutura pré-maxilar / maxilar justifica o sucesso de expansões anteroposteriores para estimular o crescimento do terço médio da face, solucionando problemas anatômicos e funcionais.

Evaluation of Palatal Rugae Pattern in Identification and Sex Determination in Indian Children

Objective: To analyse the role of palatal rugoscopy in person identification and sex determination. Material and Methods: The study group consisted of 30 children having mixed dentition within the age range of 8-15 years. Based on the length of the rugae, it was classified as primary (>5mm), secondary (3-5mm) and fragmentary (<3mm) and according to shape, (straight, curve, circular and wavy). Association between rugae patterns and sexual dimorphism were tested and statistically analysed using Chi-square test and stepwise discriminant function analysis with statistical software SPSS version 17.0. Results: Results of the present study indicates that there was higher primary rugae patterns (p>0.05) among boys over girls (boys - 224 and girls - 213) and circular rugae pattern and secondary rugae were more among girls (88) over boys (56) (p<0.05). Converging unification pattern was more among boys (17) over girls (11), whereas diverging pattern was more among girls (19) over boys (13), but there was no difference for wavy and curved patterns between boys and girls. These results were confirmed with standardized canonical discriminant function coefficient test. Conclusion: The present study hypothesizes the uniqueness of the rugae pattern in person identification as no two palates showed similar type of rugae in either of the genders. Palatal rugae revealed a specific pattern in unification among boys and girls. Discriminant function analysis enabled sex determination of individuals.

Comparative Reliability of Rugoscopy and Dactyloscopy for the Predilection of Malocclusion and Dental Caries in Children: A Cohort Study

Objective: To identify specific predominant rugoscopy and dactyloscopy patterns in children associated with malocclusion and dental caries for the predilection of malocclusion and dental caries. Material and Methods: 800 children between 8-16 years were screened and among them, 150 were who met inclusion criteria were selected and divided into 2 Groups. Based on Angle's malocclusion, Group 1 (n = 90) was subdivided into Group 1A (30 - Class I), 1B (30 - Class II) and 1C (30 - Class III). Based on DMFT, Group 2 (n = 60) were subdivided as Group 2A (30 - Caries free) and 2B (30 - Caries active). Both Groups had an equal distribution of boys and girls. Finger and palm prints were analyzed using Cummins and Midlo; rugae patterns were analyzed using Thomas and Kotze classification. The obtained data were subjected to statistical analysis using Chi-square test. Results: Based on dermatoglyphics, predominant loop pattern was observed in all the subgroups of Group 1 (1A, 1B and 1C). Based on rugae pattern, predominant wavy pattern in Group 1A and curved pattern in both 1B and 1C were observed. In Group 2, loop dermatoglyphic pattern and wavy rugae pattern were predominant in Groups 2A and 2B. Atd angle was highest in Groups 1A (41.60) and 2B (42.36). Gender distribution showed curved pattern of palatal rugae in Group 2B (Caries active) females. Statistical significance was seen in dactyloscopy and rugoscopy patterns among both Group I and Group II (p<0.05). Conclusion: The curved rugae pattern in Group 1B and 1C can be considered as a predictor in Class II and Class III malocclusions. Gender differentiation showed predominant curved pattern in females of Group 2B (Caries active).

Miniscrew-assisted rapid palatal expander (MARPE): the quest for pure orthopedic movement

ABSTRACT The midpalatal suture has bone margins with thick connective tissue interposed between them, and it does not represent the fusion of maxillary palatal processes only, but also the fusion of palatal processes of the jaws and horizontal osseous laminae of palatal bones. Changing it implies affecting neighboring areas. It has got three segments that should be considered by all clinical analyses, whether therapeutic or experimental: the anterior segment (before the incisive foramen, or intermaxillary segment), the middle segment (from the incisive foramen to the suture transversal to the palatal bone ) and the posterior segment (after the suture transversal to the palatal bone ). Rapid palatal expansion might be recommended for patients at the final pubertal growth stage, in addition to adult patients with maxillary constriction. It represents a treatment solution that can potentially avoid surgical intervention. When performed in association with rapid palatal expanders, it might enhance the skeletal effects of the latter. Of the various designs of expansion appliances, MARPE (miniscrew-assisted rapid palatal expander) has been modified in order to allow its operational advantages and outcomes to become familiar in the clinical practice.

RESUMO A sutura palatina mediana tem margens ósseas interpostas por tecido conjuntivo denso e não representa apenas a união dos processos palatinos da maxila, mas também a dos processos alveolares das maxilas e das lâminas horizontais dos ossos palatinos. Modificá-la implica em influenciar outras áreas vizinhas. Ela tem três segmentos a serem considerados em todas as análises clínicas, terapêuticas e experimentais: anterior (antes do forame incisivo, ou intermaxilar), médio (do forame incisivo até a sutura transversa com o osso palatino) e posterior (após a sutura transversa com o osso palatino). A expansão rápida da maxila pode ser indicada para pacientes que se encontram no final da fase de crescimento da puberdade, além de pacientes adultos com atresia maxilar, representando uma solução de tratamento, possivelmente evitando uma intervenção cirúrgica. Quando associada a aparelhos de protração maxilar, pode maximizar os efeitos esqueléticos desses. Entre os vários designs de aparelhos disjuntores, ultimamente encontra-se o MARPE (Miniscrew-Assisted Rapid Palatal Expander), que tem sido modificado para que ocorra, na rotina clínica, uma familiarização com suas vantagens operatórias e resultados obtidos.

Ressonância de fala e complicações cirúrgicas após palatoplastia primária com veloplastia intravelar em pacientes com fissura de lábio e palato / Speech resonance and surgical complications after primary palatoplasty with intravelar veloplasty in patients with cleft lip and palate

INTRODUÇÃO: A correção cirúrgica primária do palato é de fundamental importância na reabilitação do indivíduo com fissura labiopalatina e visa tanto a restauração anatômica local, com o fechamento da comunicação existente entre a cavidade nasal e oral, como a restauração funcional do anel velofaríngeo por meio do reposicionamento dos músculos palatinos. Ao longo dos anos, as técnicas de fechamento de palato foram evoluindo progressivamente, utilizando, cada vez mais, o procedimento de reposicionamento da musculatura responsável pelo fechamento do esfíncter velofaríngeo, denominado veloplastia intravelar. Tal procedimento favorece o funcionamento sinérgico da musculatura velar e faríngea, evitando, assim, os sintomas decorrentes da insuficiência velofaríngea. No entanto, apesar de todos os esforços no sentido de conseguir o funcionamento velofaríngeo adequado, intercorrências intraoperatórias e complicações pós-operatórias imediatas e/ou tardias podem contribuir para o insucesso da palatoplastia primária e, consequentemente, levar ao aparecimento de hipernasalidade. MÉTODOS: Sessenta pacientes submetidos à palatoplastia primária com veloplastia intravelar. Intercorrências intraoperatórias e complicações pós-operatórias imediatas e tardias foram investigadas. A presença e localização de fístula ou deiscência do palato foi feita por meio de avaliação clínica. Os pacientes foram submetidos, também, à gravação em áudio de amostra de fala, as quais foram analisadas por três fonoaudiólogas. As intercorrências intraoperatórias e as complicações pós-operatórias foram analisadas de forma descritiva. A associação entre as intercorrências intraoperatórias e complicações imediatas e tardias com a formação de fístulas, bem como a associação entre a ocorrência de fístulas e deiscências com a presença e ausência de hipernasalidade, foram analisadas por meio de Teste de Fisher. RESULTADOS: Verificou-se 5% de intercorrências intraoperatórias, 20% de complicações imediatas e 13,3% de complicações tardias. O índice de fístulas foi de 16,67%. A proporção de hipernasalidade foi de 18,6%. CONCLUSÃO: A palatoplastia com veloplastia intravelar utilizada no presente estudo demonstrou ser uma técnica segura, de fácil execução, eficiente para a fala e com baixos índices de complicações.

INTRODUCTION: The primary surgical correction of the palate is of fundamental importance in the rehabilitation of individuals with labiopalatine cleft and aims for local anatomical restoration and closure of the existing communication between the nasal and oral cavities, such as functional restoration of the velopharyngeal ring through repositioning of the palatine muscles. Palate closure techniques have evolved progressively over the years and increasingly involve repositioning of the muscles responsible for closing the velopharyngeal sphincter, called intravelar veloplasty. This procedure encourages the synergistic operation of the velar and pharyngeal musculature, thereby avoiding the symptoms resulting from velopharyngeal insufficiency. However, despite efforts to achieve adequate velopharyngeal function, intraoperative events and immediate postoperative and/or late complications may contribute to primary palatoplasty failure and consequently lead to hypernasality. METHODS: Sixty patients underwent primary palatoplasty with intravelar veloplasty. Intraoperative events and immediate and late postoperative complications were investigated. The presence and location of palatal fistula or dehiscence was assessed by clinical evaluation. The patients also made an audio recording of their speech that was analyzed by three speech therapists. The intraoperative events and postoperative complications were descriptively analyzed. The association between intraoperative events and immediate and late postoperative complications with the formation of fistulae as well as that between the occurrence of fistulae and dehiscences and the presence and absence of hypernasality was analyzed using Fisher's exact test. RESULTS: Overall, there was a 5% incidence of intraoperative events, 20% incidence of immediate complications, and 13.3% incidence of late complications. Fistulae and hypernasality were found in 16.67% and 18.6% of cases, respectively. CONCLUSION: Palatoplasty with intravelar veloplasty is a safe and easily implemented technique that is efficient for speech and has low complication rates.

Verificação da praticabilidade e da unicidade na queiloscopia e na palatoscopia como métodos de identificação humana / Checking the feasibility and uniqueness in cheiloscopy and palatoscopy as human identification methods

Introdução: Na odontologia forense, a cavidade oral tem um importante papel devido a sua anatomiaúnica. A queiloscopia e a rugoscopia são métodos de identificação seguros e acurados. Objetivos: Osobjetivos da presente pesquisa foram: a) avaliar a praticabilidade das técnicas empregadas; b) avaliar aunicidade das amostras; c) traçar um perfil das rugas palatinas e sulcos labiais de alunos do curso deOdontologia da UERN. Materiais e métodos: Foram feitas moldagens no palato com o auxilio demoldeiras de estoque e alginato. Modelos de estudo foram feitos com gesso tipo III. Para a obtenção dasimpressões labiais, foram utilizados um batom de cor vermelha, uma folha de papel de cor branca e umaplaca de vidro. Para classificar as impressões labiais foi utilizado o sistema de classificação de Suzuki eTsuchihashi. Para a classificação das rugas palatinas foi o utilizado o sistema de Martin dos Santos.Resultados: Ao todo foram coletadas 60 amostras, sendo 30 impressões labiais e 30 modelos comimpressões das rugas palatinas. As rugas palatinas do tipo sinuosa foram as mais encontradas. Os sulcoslabiais com maior ocorrência foram dos tipos bifurcados. Conclusões: A queiloscopia e a palatoscopiasão técnicas de identificação humana aplicáveis, porém é necessário que mais estudos sejam realizadospara que as mesmas sejam utilizadas com mais frequência entre os órgãos de investigaçõescompetentes. As técnicas mostraram-se exequíveis e as amostras singulares. Foi encontrada uma maiorocorrência de rugas palatinas sinuosas e uma predominância de sulcos labiais bifurcados.

Introduction: In forensic dentistry, the oral cavity plays a very important role because of the uniqueanatomy. The cheiloscopy and palatoscopy are self and accurate methods of identification. Objectives:The objectives of this research were: a)assess the feasibility of techniques b) assess the uniqueness ofthe sample c) draw a profile of wrinkles and furrows lip palate of students of Dentistry, UERN. Methods:Impressions on the palate were made with stocks trays and alginate and making the study model wasmade with plaster type III. To obtain the lip prints were used lipstick red color, a sheet of white paper and aglass plate. To sort the lip prints it was used the classification system of Suzuki and Tsuchihashi. For theclassification of palatal rugae was the system used Martin dos Santos. Results: Altogether 60 sampleswere collected, with 30 lip prints and 30 models with palatal rugae. The palatal rugae winding type werefound with higher occurrence. The highest occurrence labial furrows were bifurcated type. Conclusions:The cheiloscopy and palatoscopy are applicable human identification techniques, but it is necessary thatmore studies be conducted so that they are used more frequently among competent organs ofinvestigations. The techniques were feasible and the samples were singular. A higher occurrence ofwinding palatine rugae and a predominance of bifurcated labial grooves were found.

Caninos superiores retenidos por palatino: radiografía panorámica para evaluar ubicarlos en el arco dentario / Palatally impacted upper canines: panoramic radiography to assess their location in the dental arch

Los caninos superiores permanentes, estadísticamente, se encuentran entre las piezas dentarias que con más frecuencia quedan en retención ósea,después de los terceros molares.Sin embargo, los caninos, estética, funcionalmente, y para mantenimiento de las relaciones contactantes,a la hora de valorarlos en boca, desempeñan una función más importante que los terceros molares. Por eso la importancia de poder ubicarlos en el arco dentario. Cuando los ortodoncistas, sobre todo los menos experimentados, se enfrentan a la decisión de conservar los caninos que se encuentran en posiciones deretención ósea palatina, son muchos los interrogantes que se le plantean sobre su posible ubicación con éxito, en el arco dentario. Frecuentemente está la duda de cuál es el límite de la posición de retención para intentar su acomodamiento. Proponemos un simple trazado que se puede hacersobre la ortopantomografia panorámica, marcando dos líneas tangentes a la pared externa delas fosas nasales que se continuarán con los ejes longitudinales de los caninos retenidos de ambos lados. Si queda constituida una figura geométrica de apariencia de un rombo, significa que el extremo de la raíz se encuentra próximo a la posición que anatómicamente le pertenece (fosa canina del maxilar superior), existiendo una alta probabilidad de concluir con éxito su ubicación en el arco dentario.

Statiscally, permanent upper canines are the mostfrequently impacted teeth, after third molars.Upper canines though, have more significancethan third molars aesthetically, functionally andin maintaining contacting relations;thus the importance of bringing them inthe correct position within the dental arch.When an Orthodontist, particularly those lessexperienced, are faced with the decision ofmaintaining canines impacted in the palatal bone;many questions linger regarding the possibilitiesof successful relocation into the dental arch.Frequently, the question lays in the limitationsof moving it from its impacted positionto the correct one.We propose a simple tracing of theOrthopantomogram (OPG), marking twotangent lines to the lateral wall of the nasal cavitycontinuing on the long axis of the impactedcanines of both sides. If the result is a geometricfigure resembling a rhombus, it means thatthe radicular apex is close to the correctanatomical position (maxillary canine fossa),indicating high probabilities of successfullypositioning the impacted tooth.

Facial height in Japanese-Brazilian descendants with normal occlusion

OBJECTIVE: The aim of this study was to determine the standards of facial height in 30 young (14-year-old) Japanese-Brazilian descendants with normal occlusion, and assess whether sexual dimorphism is evident. METHODS: The cephalometric measurements used followed the analyses by Wylie-Johnson, Siriwat-Jarabak, Gebeck, Merrifield and Horn. RESULTS: Results showed dimorphism for total anterior facial height (TAFH), lower anterior facial height (LAFH), anterior facial height (AFH), total posterior facial height (TPFH) and upper posterior facial height (UPFH) measurements. CONCLUSIONS: The standards of facial heights in young Japanese-Brazilian descendants with normal occlusion were observed. Sexual dimorphism was identified in five out of thirteen evaluated variables at this age range. .

INTRODUÇÃO: o objetivo desse estudo foi obter os valores médios de normalidade das alturas faciais anterior e posterior de 30 jovens mestiços nipo-brasileiros, descendentes de xantodermas e leucodermas, com oclusão normal, com idade média de 14 anos, e verificar a presença ou ausência de dimorfismo entre os sexos. MÉTODOS: elaborou-se um estudo cefalométrico com as mensurações advindas das análises de Wylie e Johnson, Siriwat e Jarabak, Gebeck, Merrifield e Horn. RESULTADOS: os resultados revelaram a presença de dimorfismo entre os sexos para as variáveis AFAT, AFAI, AFA, AFPT e AFPS. CONCLUSÕES: um padrão cefalométrico específico, das alturas faciais anterior e posterior, para os jovens mestiços nipo-brasileiros com oclusão normal, descendentes de xantodermas e leucodermas, foi apresentado e um dimorfismo entre os sexos para cinco das treze variáveis avaliadas foi verificado nessa faixa etária média. .

Transverse effects on the nasomaxillary complex one year after rapid maxillary expansion as the only intervention: A controlled study

The aim of this study was to assess by means of cone-beam computed tomography (CBCT) scans the transverse effects on the nasomaxillary complex in patients submitted to rapid maxillary expansion (RME) using Haas expander in comparison to untreated individuals. This prospective controlled clinical study assessed 30 subjects (18 boys and 12 girls) with mixed dentition and during pubertal growth. The treated group was submitted to RME with Haas expander, retention for six months and a six-month follow-up after removal. The control group matched the treated group in terms of age and sex distribution. CBCT scans were taken at treatment onset and one year after the expander was activated. Maxillary first molars (U6) width, right and left U6 angulation, maxillary alveolar width, maxillary basal width, palatal alveolar width, palatal base width, right and left alveolar angulation, palatal area, nasal base width, nasal cavity width and inferior nasal cavity area on the posterior, middle and anterior coronal slices were measured with Dolphin Imaging Software(r) 11.5, except for the first two variables which were performed only on the posterior slice. All transverse dimensions increased significantly (P < 0.05) in the treated group in comparison to the control, except for alveolar angulation and inferior nasal cavity area (P > 0.05). Results suggest that increase of molar, maxillary, palatal and nasal transverse dimensions was stable in comparison to the control group one year after treatment with RME.

OBJETIVO: avaliar, por meio de tomografias computadorizada de feixe cônico (TCFC), as dimensões transversais do complexo nasomaxilar de pacientes submetidos à expansão rápida da maxila (ERM) e sem intervenção. MÉTODOS: este estudo clínico prospectivo e controlado avaliou 30 indivíduos (18 meninos e 12 meninas) durante o período de crescimento puberal e dentição mista. O grupo tratado foi submetido à ERM com expansor de Haas, permanecendo 6 meses em contenção e sendo acompanhados por mais 6 meses após a remoção. O grupo controle foi acompanhado durante o mesmo tempo. Foram realizadas TCFC ao início e um ano após a fase ativa. Com o programa Dolphin Imaging 11.5, a largura entre os primeiros molares superiores (U6), angulação dos U6 direito e esquerdo, largura maxilar alveolar, largura maxilar basal, largura alveolar do palato, largura basal do palato, angulação alveolar direita e esquerda, área palatina, largura da base nasal, largura da cavidade nasal e área da cavidade nasal inferior foram obtidas em cortes coronais posterior, médio e anterior, com exceção das duas primeiras medidas, que foram obtidas apenas no corte coronal posterior. RESULTADOS: todas as medidas foram significativamente (p < 0,05) maiores no grupo da ERM, com exceção da angulação alveolar e da área da cavidade nasal, as quais não foram significativas (p > 0,05) entre os grupos. Os resultados sugerem que, um ano após a ERM, a dimensão transversal na cavidade nasal, maxila, palato e região dos molares são maiores do que em indivíduos não tratados. O protocolo de ERM utilizado foi eficaz na manutenção da dimensão transversal durante período de acompanhamento. .

Rapid maxillary expansion effects: An alternative assessment method by means of cone-beam tomography

INTRODUCTION: This study aims to develop a method to assess the changes in palatal and lingual cross-sectional areas in patients submitted to rapid maxillary expansion (RME). METHODS: The sample comprised 31 Class I malocclusion individuals submitted to RME and divided into two groups treated with Haas (17 patients) and Hyrax (14 patients) expanders. Cone-beam computed tomography scans were acquired at T0 (before expansion ) and T1 (six months after screw stabilization). Maxillary and mandibular cross-sectional areas were assessed at first permanent molars and first premolars regions and compared at T0 and T1. Mandibular occlusal area was also analyzed. RESULTS: Maxillary cross-sectional areas increased in 56.18 mm2 and 44.32 mm2 for the posterior and anterior regions. These values were smaller for the mandible, representing augmentation of 40.32 mm2 and 39.91 mm2 for posterior and anterior sections. No differences were found when comparing both expanders. Mandibular occlusal area increased 43.99mm2 and mandibular incisors proclined. Increments of 1.74 mm and 1.7 mm occurred in mandibular intermolar and interpremolar distances. These same distances presented increments of 5.5 mm and 5.57 mm for the maxillary arch. CONCLUSION: Occlusal and cross-sectional areas increased significantly after RME. The method described seems to be reliable and precise to assess intraoral area changes. .

INTRODUÇÃO: o presente estudo teve como objetivo desenvolver um método para avaliar as mudanças nas áreas transversais palatinas e linguais em pacientes submetidos à expansão rápida da maxila (ERM). MÉTODOS: a amostra foi composta por 31 indivíduos com má oclusão Classe I de Angle, submetidos a ERM e divididos em dois grupos, tratados com expansores tipo Haas (17 pacientes) e de Hyrax (14 pacientes). Tomografias computadorizadas de feixe cônico foram adquiridas em T0 e T1 (antes da expansão e seis meses após a estabilização do parafuso). Áreas transversais da maxila e mandíbula foram avaliadas nas regiões de primeiros molares permanentes e pré-molares e comparadas entre T0 e T1. A área oclusal mandibular também foi analisada. RESULTADOS: as áreas transversais maxilares aumentaram 56,18mm2 e 44,32mm2 para regiões posterior e anterior, respectivamente. Esses valores foram menores para mandíbula, representando aumentos de 40,32mm2 e de 39,91mm2 para as seções anterior e posterior. Não foram encontradas diferenças quando se comparam os dois expansores. A área oclusal mandibular aumentou 43,99mm2 e incisivos inferiores vestibularizaram. Incrementos de 1,74mm e 1,7mm ocorreram entre as distâncias intermolares e interpré-molares inferiores. Essas mesmas distâncias apresentaram incrementos de 5,5mm e de 5,57mm para maxila. CONCLUSÃO: as áreas transversais avaliadas e oclusal de mandíbula aumentaram significativamente após a ERM. O processo descrito parece ser um método confiável e preciso para avaliar as mudanças das área intrabucais propostas. .

Palatal rugae for the construction of forensic identification / Rugas palatinas en identificación forense

This study aims to explore the role of palatal rugae pattern in forensic identification by coding of palatal rugae characteristics, and to construct a forensic identification system for oral palatal rugae. One hundred models were included in this study for a systemic coding of palatal rugae pattern based on the shape, quantity, location, and distribution of palatal rugae. Among the involved 100 models, palatal rugae types varied among individuals and palatal rugae pattern was different between men and women, even between two sides in the same individual. Palatal rugae pattern can be used for forensic identification of oral soft tissue and this study proposes a new means for the identification by coding of palatal rugae pattern based on the shape, quantity, location and distribution.

Este estudio tuvo como objetivo explorar el patrón de rugas palatinas en la identificación forense mediante la codificación de las características de éstas. Además se elaboró un sistema de identificación forense. Fueron incluidos cien modelos para una codificación sistemática del patrón de rugas palatinas basado en su forma, cantidad, ubicación y distribución. En todos los modelos se identificó una variación entre los individuos y en el patrón entre hombres y mujeres. El patrón de rugas palatinas puede ser utilizado para la identificación forense de tejido blando oral y este estudio propone un método nuevo para codificarlas.

Morphological characterization of the nasopalatine region in human fetuses and its association to pathologies

The nasopalatine region is composed of structures such as the vomeronasal organ and nasopalatine duct. The nasopalatine duct may provide the communication of the mouth to the nasal cavity in human fetuses and can be obliterated in an adult human. Knowledge on the development of the nasopalatine region and nasopalatine duct in humans is necessary for understanding the morphology and etiopathogenesis of lesions that occur in this region. Objective The aim of the present study was to describe the morphological aspects of the nasopalatine region in human fetuses and correlate these aspects with the development of pathologies in this region. Material and Methods Five human fetuses with no facial or palatine abnormalities were used for the acquisition of specimens from the nasopalatine region. After demineralization, the specimens were histologically processed. Histological cuts were stained with methylene blue to orient the cutting plane and hematoxylin-eosin for the descriptive histological analysis. Results The age of the fetuses was 8.00, 8.25, 9.00 and 9.25 weeks, and it was not possible to determine the age in the last one. The incisive canal was observed in all specimens as an opening delimited laterally by the periosteum and connecting oral and nasal cavity. The nasopalatine duct is an epithelial structure with the greatest morphological variation, with either unilateral or bilateral occurrence and total patent, partial patent and islet forms. The vomeronasal organ is a bilateral epithelized structure located alongside the nasal septum above the incisive canal in all the fetuses. Conclusions The incisive canal, nasopalatine duct and vomeronasal organ are distinct anatomic structures. The development of nasopalatine duct cysts may occur in all forms of the nasopalatine duct. .

Os benefícios da overdenture maxilar sobre implantes sem cobertura palatina - relato de caso / The benefits of maxillary implant-retained overdenture without palatine cover - case report

A prótese total convencional é o tipo de tratamento mais comum para maxilas edêntulas. No entanto, os pacientes estão buscando melhor qualidade de vida, principalmente no que diz respeito à retenção e a estabilidade quando se trata de rebordos atróficos e, além disso, buscam o conforto proporcionado pela ausência da resina no palato. Esse desenho é possível através da overdenture sem cobertura palatal. O objetivo desse trabalho foi descrever um caso clínico solucionado por meio de uma prótese total maxilar com cobertura parcial de palato. Conclui-se que com o advento dos implantes osseointegrados é possível este desenho protético, e que a quantidade e posição dos implantes é um aspecto de suma importância a ser considerado para o sucesso desta modalidade de reabilitação

The conventional total denture is the most common treatment to edentulous jaws. However, patients are looking for better quality of life, particularly regarding retention and stability in cases of atrophic ridges, and searching for the comfort provided by the absence of resin on the palate. This design is possible through the overdenture without palate coverage. The aim of this study was to describe a clinical case solved usig a maxillary complete denture with partial coverage of palate. It was concluded that, with the advent of osseointegrated implants this prosthetic design is possible, and that the number and position of the implants is a very important aspect to be considered for the success of this type of rehabilitation

Prevalence of Snoring and High Risk of Obstructive Sleep Apnea Syndrome in Young Male Soldiers in Korea

There are little information on prevalence of obstructive sleep apnea syndrome (OSAS) and clinical features in the young military population. The purpose of this study was to estimate the prevalence of snoring and high risk of OSAS in young male soldiers in Korea and to identify the risk factors of OSAS. A total of 665 participants (aged 20-23 yr) who visited the Armed Forces Ildong Hospital for regular physical examination were enrolled. All participants completed the Berlin Questionnaire and underwent a physical examination. The participants with high risk for OSAS completed portable sleep monitoring. The prevalence of snoring and high risk of OSAS in young male soldiers in Korea was 13.5% and 8.1%, respectively. The prevalence of high arched palate, tongue indentation, long uvula, large tonsil and retrognathia was significantly higher in the high risk OSAS group. High arched palate, long uvula or low lying soft palate, tonsil size III or IV, Epworth Sleepiness Scale score > 10 and obesity (BMI > 27 kg/m2) were found to independently predict OSAS. For early identification and treatment of young soldiers with OSAS in a military environment, a precise screening by questionnaire and physical examination is needed.

Palatoglossus muscle neuroanatomy: a review

The palatoglossus muscle is classically described as an extrinsic muscle of the tongue. However, this descriptionis not consensus among the researchers, is one that sometimes it is not considered a muscle of the tongue.Thus, the objective of this study is to discuss some neuroanatomical aspects of palatoglossus muscle that mayhelp explain this aspect. Furthermore, this study shall be useful for clinicians, surgeons and academics thatmanipulate and keep particular interest for this anatomical site.

Estudo da difusão da articaína nos tecidos orais / Articaine diffusion in oral tissues

Objetivo: Avaliar a difusão do anestésico articaína a 4% com adrenalina 1:100.000 em dentes maxilares e mandibulares, injetado através do bloqueio do nervo alveolar superior posterior (NASP). Método: Foram realizados 50 procedimentos anestésicos do bloqueio do NASP em voluntários e avaliou-se a sensibilidade da mucosa através do teste pin-prick e a sensibilidade pulpar através do teste elétrico pulp tester. As estruturas avaliadas foram: mucosa palatal posterior (túber), mucosa palatal anterior, mucosa jugal, mucosa vestibular de molares, língua, lábio inferior, primeiro pré-molar inferior (1PMI), incisivo lateral inferior (ILI), primeiro molar inferior (1MI), primeiro pré-molar superior (1PMS), incisivo lateral superior (ILS), primeiro molar superior (1MS). Resultados: Foi observado que, ao analisar a insensibilidade mucosa, a efetividade da articaína em insensibilizar as estruturas testadas quando administrada através do bloqueio do NASP foi crescente com o decorrer do tempo e que os 1MS e 1PMS tiveram um tempo de latência inferior às demais unidades dentárias testadas. Observou-se que a insensibilidade pulpar foi crescente com o decorrer do tempo e que os 1MS e 1PMS tiveram um tempo de latência inferior às demais unidades dentárias testadas. O ILS e as unidades dentárias inferiores 1MI e 1PMI necessitaram de um tempo de latência de 4 minutos para começarem a apresentar insensibilidade pulpar. Os ILI apresentaram o maior índice de insucesso de anestesia pulpar (74%) e o insucesso da anestesia do 1MS foi de 6%, a menor entre os dentes testados. Conclusões: Os resultados sugerem haver uma difusão da articaína no sentido ântero-posterior na maxila e a difusão vestíbulo-palatal da droga. A articaína quando administrada através do bloqueio do NASP suprime a necessidade da anestesia do palato.

Objective: The purpose of this research was to evaluate the diffusion of 4% articaine with 1:100,000 adrenaline injected through posterior superior alveolar (PSA) nerve block in maxillary and mandibular teeth. Method: Fifty PSA nerve block procedures were performed in volunteers. The sensitivity of the mucosa was evaluated by the pin-prick test and pulp sensitivity was assessed by electric pulp testing. The following structures were evaluated: posterior palatal mucosa (tuber), anterior palatal mucosa, cheek mucosa, molar buccal mucosa, tongue, lower lip, mandibular first premolar (MD1PM), mandibular lateral incisor (MDLI), mandibular first molar (MD1M), maxillary first premolar (MX1PM), maxillary lateral incisors (MXLI) and maxillary first molar (MX1M). Results: The analysis of mucosa numbness and pulp numbness revealed that the efficacy of PSA nerve block with articaine to desensitize the tested structures increased with time and that the MX1M and MX1PM had shorter latency periods than the other tooth groups. The MXLI and MD1M and MD1PM required 4 minutes to start pulp numbness. MDLI showed the highest failure rate of pulpal anesthesia (74%) and MX1M had the lowest failure rate among all test (around 6%). Conclusion: The results suggest an anterior-posterior diffusion of articaine in the maxilla and a bucco-palatal diffusion of the drug. PSA nerve block with articaine eliminates the need for anesthesia of the palate.

Palatal rugae patterns of Urhobos in Abraka, South-Southern Nigeria / Patrones de rugas palatinas de los Urhobos en Abraka, Sur-Sur de Nigeria

Human identification is a major task undertaken in forensic sciences. Palato-rugoscopy is based on the principle that no two palates are the same. The study of palatine rugae and the study of fingerprints are sometimes complementary as they operate in similar methods based on same scientific basis. The study intends to describe the shape and gender distribution of the palatine rugae and their prevalence in the studied population. The study sample consisted of 84 subjects, 42 males and 42 females of Urhobo ethnic and cultural background, between 17 and 30 years old, with full complement of maxillary teeth, drawn purposively from Abraka. The prevalence of palatal rugae shapes was: line (27.2 percent), sinuous (21.1 percent), angle (18.1 percent), polymorphhic (15.5 percent), point (7.5 percent), curve (6.2 percent), circle (4.2 percent). The total number of palatal rugae shape in the overall sample was 520, with females being slightly higher (51.5 percent) having mean of 6.38 (SD 1.45) than males (48.5 percent) having mean of 6 (SD 1.72). However, the difference between male and female was not statistically significant. The individualized pattern of palatal rugae makes it a reliable guiding tool in forensic identification.

La identificación humana es la principal tarea de las ciencias forenses. La palatorugoscopía se basa en el principio de que no hay dos paladares iguales. El estudio de los pliegues palatinos y el estudio de las huellas dactilares son en ocasiones complementarios, ya que operan con los mismos métodos, basados en las mismas bases científicas. Este estudio pretende describir la forma y la distribución por sexo de las rugas palatinas y su prevalencia en la población estudiada. La población de estudio consistió en 84 sujetos, 42 hombres y 42 mujeres de origen étnica y cultural Urhobo, entre 17 y 30 años de edad, con dotación completa de los dientes superiores, realizado en Abraka. La prevalencia de las diferentes formas de rugas palatinas fue: lineal (27,2 por ciento), sinuosa (21,1 por ciento), angular (18,1 por ciento), polimórfica (15,5 por ciento), en punto (7,5 por ciento), curva (6,2 por ciento) y circular (4,2 por ciento). El número total de formas de rugas palatinas en la muestra fue de 520, ligeramente superior en mujeres (51,5 por ciento) con una media de 6,38 (DE 1,45) que los hombres (48,5 por ciento), con una media de 6 (DE 1,72). Sin embargo, la diferencia entre hombres y mujeres no fue estadísticamente significativa. El patrón individualizado de las rugas palatinas es una herramienta de guía confiable para la identificación forense.