RESUMEN
A análise facial consiste em uma etapa importante do diagnóstico e avaliação dos resultados obtidos na harmonização orofacial. Para avaliação dos resultados de procedimentos estéticos, fotografias são muito utilizadas, porém novas ferramentas são necessárias para facilitar a visualização dos pacientes quanto aos ganhos estéticos. Os scanners faciais 3D surgem como alternativa para tal finalidade. O objetivo deste estudo foi analisar, através de fotografias e escaneamento 3D da face, o ganho de volume labial após intervenção de preenchimento. A paciente apresentava insatisfação com relação aos seus lábios. Durante a avaliação, constatou-se ausência de volume e contorno labial. Antes de iniciar o procedimento, realizou-se protocolo fotográfico e escaneamento facial (E1). Para o procedimento, foi utilizada uma seringa de 1 mL de ácido hialurônico. O escaneamento foi feito no pós-imediato (E2), após 10 dias (E3) e após 40 dias da intervenção (E4). Nesta mesma consulta após 40 dias, foi realizado injeção da segunda seringa de ácido hialurônico escaneamento do pós-imediato (E5). Após 40 dias, a paciente voltou (E6). Após análise comparativa das malhas, foi possível verificar ganho de 3 mm entre E1 e E2. Na comparação do pré (E1) e após 10 dias (E3), verificou-se volumização total de 1,85 mm, demonstrando que quase 40% do volume no pós-imediato é edema. Em E6, após 40 dias da aplicação da segunda seringa, foi possível quantificar ganho de 2,12 mm no lábio superior quando comparado a E1. Pode-se concluir que o escaneamento 3D contribui expressivamente para avaliação dos resultados alcançados em procedimentos estéticos.
Facial analysis is an important stage in the diagnosis and evaluation of the results obtained in orofacial harmonization. To evaluate the results of aesthetic procedures, photographs are widely used, but new tools are needed to facilitate patient visualization of aesthetic gains. 3D facial scanners have emerged as an alternative for this purpose. The aim of this study was to analyze, by means of photographs and 3D facial scanning, the labial volume gain after a filling intervention. The patient was dissatisfied with her lips. During the evaluation, it was observed the absence of lip volume and contour. Before starting the procedure, a photographic protocol and facial scanning (S1) were performed. A 1 mL syringe of hyaluronic acid was used for the procedure. The scanning was done post-immediately (S2), 10 days (S3) and 40 days after the intervention (S4). In the same appointment after 40 days, the second syringe of hyaluronic acid was injected and scanned post-immediate (S5). After 40 days, the patient returned (E6). After comparative mesh analysis, it was possible to verify a 3 mm gain between S1 and S2. In the comparison of pre (S1) and after 10 days (S3), there was a total volumization of 1.85 mm, showing that almost 40% of the volume in the post-immediate period is edema. In S6, 40 days after the application of the second syringe, it was possible to quantify a gain of 2.12 mm in the upper lip when compared to S1. It can be concluded that 3D scanning contributes expressively to the evaluation of the results achieved in aesthetic procedures.
El análisis facial es una etapa importante en el diagnóstico y la evaluación de los resultados obtenidos en la armonización orofacial. Para evaluar los resultados de los procedimientos estéticos, las fotografías son ampliamente utilizadas, pero se necesitan nuevas herramientas que faciliten al paciente la visualización de las ganancias estéticas. Los escáneres faciales 3D han surgido como una alternativa para este fin. El objetivo de este estudio fue analizar, mediante fotografías y escaneado facial 3D, la ganancia de volumen labial tras una intervención de relleno. La paciente estaba insatisfecha con sus labios. Durante la evaluación, se observó la ausencia de volumen y contorno labial. Antes de iniciar el procedimiento, se realizó un protocolo fotográfico y un escaneado facial (S1). Para el procedimiento se utilizó una jeringa de 1 ml de ácido hialurónico. La exploración se realizó inmediatamente después (S2), a los 10 días (S3) y a los 40 días de la intervención (S4). En la misma consulta, a los 40 días, se realizó la inyección de la segunda jeringa de ácido hialurónico tras la exploración inmediata (S5). A los 40 días, la paciente regresó (E6). Tras el análisis comparativo de las mallas, se pudo comprobar una ganancia de 3 mm entre S1 y S2. En la comparación del pre (S1) y después de 10 días (S3), hubo una volumización total de 1,85 mm, demostrando que casi 40% del volumen post-immediato es edema. En S6, 40 días después de la aplicación de la segunda jeringa, fue posible cuantificar una ganancia de 2,12 mm en el labio superior en comparación con S1. Se puede concluir que el escaneo 3D contribuye expresivamente para la evaluación de los resultados alcanzados en procedimientos estéticos.
RESUMEN
OBJECTIVES: The aim of this study was to compare the effect of three different access cavities on the tissue removal, deflection, fracture resistance, and stress distribution of extracted maxillary central incisors. MATERIALS AND METHODS: Forty human maxillary central incisors were randomly assigned in four experimental group (n = 10) including conservative access cavity "CAC," traditional access cavity "TAC," invasive access cavity "IAC," and without access cavity (control group). Cone-beam computed tomography "CBCT" scans were used to evaluate the tissue removal during the different access cavities. All specimens were restored with composite resin (Admira Fusion, Voco, Cuxhaven, Germany) and embedded in acrylic resin blocks after simulating the periodontal ligament using red wax, then the specimens were submitted to the deflection test applying a load of 250 N and to the load-to-fracture test after artificial aging in a mechanical cycling machine (150 N, 5 × 106 cycles, 10 Hz). Lastly, stress distribution was assessed by three-dimensional finite element analysis (3D-FEA), simulating the specimens restoration by two types of composite resins of low and high elastic modulus (8 and 18 GPa respectively) after the access cavities. The data were submitted to Shapiro-Wilk and KS normality tests. Then, they were analyzed by one-way ANOVA and Tukey tests with a significance level (α ≤ 0.05). RESULTS: CBCT scans showed a significant difference of worn tissues in CAC and TAC when compared to the IAC (P < 0.0001). In deflection test, CAC showed lower deformation values than the TAC and IAC. Load-to-fracture test presented no significant difference among the three experimental groups (P = 0.6901). 3D-FEA showed that the more conservative the access cavity, the higher the stress magnitude. CONCLUSIONS: CAC promote less worn tissue; however, this does not improve the stress distribution or fracture resistance of endodontically treated maxillary incisors. CLINICAL RELEVANCE: Clinicians should reconsider the pros and cons of the conservative access cavity.