[Growth disturbances of the temporomandibular joint: causes, diagnosis and treatment]. / Groeistoornissen van het kaakgewricht: oorzaken, diagnose en behandeling.

Growth disturbances of the temporomandibular Joint are characterized by mandibular asymmetry, sometimes with secondary maxillar disturbances. Although the clinical symptoms are sometimes quite severe, patients usually have no pain. There are several growth disturbances, but in this article we discuss three particular causes of facial asymmetry, namely hemimandibular growth defects; overdevelopment, underdevelopment and neoplasms of the mandibular joint. Hemimandibular overdevelopment (hyperplasia) is a growth disorder characterized by progressive asymmetry of the mandibula. Hemimandibular hypoplasia, on the other hand, is a growth disorder involving underdevelopment of the condyle mandibulae due to impingement of the growth center and ankylosing. A pronounced asymmetrical face can cause aesthetic problems and always requires diagnostics, because in addition to the hyperplasia and hypoplasia mentioned above, other causes can explain the asymmetry such as, for example, an osteoarthritis or even a tumor emanating from the base of the skull, mandibula or soft tissues.

3-dimensional analysis of hard- and soft-tissue symmetry in a Chinese population.

BACKGROUND: Facial symmetry severely affects appearance and function. Large numbers of patients seek orthodontic treatment to improve facial symmetry. However, the correlation between hard- and soft-tissue symmetry is still unclear. Our aim was to investigate the hard- and soft-tissue symmetry in subjects with different levels of menton deviation and sagittal skeletal classes with 3D digital analysis and to investigate the relationship between the entire and individual hard- and soft-tissues. METHODS: A total of 270 adults (135 males and 135 females) consisting of 45 subjects of each sex in each sagittal skeletal classification group. All subjects were further classified into relative symmetry (RS), moderate asymmetry (MA) and severe asymmetry (SA) groups based on the degree of menton deviation from the mid-sagittal plane (MSP). The 3D images were segmented into anatomical structures and mirrored across the MSP after establishing a coordinate system. Original and mirrored images were registered by a best-fit algorithm, and the corresponding root mean square (RMS) values and colormap were obtained. The Mann‒Whitney U test and Spearman correlation were conducted for statistical analysis. RESULTS: The RMS increased with greater deviations with regard to the deviation of the menton in most of anatomical structures. Asymmetry was represented in the same way regardless of sagittal skeletal pattern. The soft-tissue asymmetry had a significant correlation with dentition in the RS group (0.409), while in the SA group, it was related to the ramus (0.526) and corpus (0.417) in males and was related to the ramus in the MA (0.332) and SA (0.359) groups in females. CONCLUSIONS: The mirroring method combining CBCT and 3dMD provides a new approach for symmetry analysis. Asymmetry might not be influenced by sagittal skeletal patterns. Soft-tissue asymmetry might be reduced by improving the dentition in individuals with RS group, while among those with MA or SA, whose menton deviation was larger than 2 mm, orthognathic treatment should be considered.

Tratamiento integral de la clase III esquelética severa, mordida abierta y asimetría facial / Comprehensive treatment of severe skeletal class III, open bite and facial asymmetry

Introducción: La cirugía ortognática está especialmente indicada en casos complejos, donde los procedimientos conservadores fracasan o son insuficientes. El diagnóstico, planificación y tratamiento deben estar a cargo de un equipo multidisciplinario que trabaje en estrecha relación. Objetivo: Reportar el trabajo multidisciplinario en el tratamiento ortodóncico quirúrgico de una desarmonía dentomaxilofacial compleja. Presentación de caso: Paciente masculino, 19 años de edad, mestizo, clase III esquelética grave, hiperdivergente con mordida abierta y asimetría del tercio inferior, que recibió tratamiento prequirúrgico descompensador de ortodoncia. Se realizó cirugía ortognática bimaxilar con genioplastia de ascenso. Conclusiones: El tratamiento de las desarmonías dentomaxilofaciales es complejo y necesita la concurrencia de varias especialidades. Para la resolución del presente caso fue necesario el trabajo coordinado y simultáneo de especialistas de ortodoncia, prótesis dental, cirugía maxilofacial, periodoncia, psicología y otorrinolaringología. Se alcanzaron resultados estéticos y funcionales acorde a los objetivos del tratamiento propuestos y hubo estabilidad un año después de la cirugía(AU)

Introduction: Orthognathic surgery is especially indicated in complex cases, where conservative procedures fail or are insufficient. Diagnosis, planning and treatment should be carried out by a multidisciplinary team that works closely together. Objective: Report the multidisciplinary work in the surgical orthodontic treatment of a complex dentomaxillofacial disharmony. Case presentation: Male patient, 19 years old, mestizo, severe skeletal class III, hyperdivergent with open bite and asymmetry of the lower third, who received presurgical treatment decompensating orthodontics. Bimaxillary orthognathic surgery was performed with ascent genioplasty. Conclusions: The treatment of dentomaxillofacial disharmonies is complex and requires the concurrence of several specialties. For the resolution of this case, the coordinated and simultaneous work of specialists in orthodontics, dental prostheses, maxillofacial surgery, periodontics, psychology and otolaryngology was necessary. Aesthetic and functional results were achieved according to the proposed treatment objectives and there was stability one year after surgery(AU)

Tratamiento ortodóncico-quirúrgico de pacientes con asimetría facial / Orthodontic-surgical treatment of patients with facial asymmetry

Introducción: la asimetría facial es una condición notoria en el tercio inferior de la facie del sujeto y entre los tercios medio y superior, en este último será menos evidente esta condición, de tal manera que podría considerarse como una de las molestias de mayor incidencia en pacientes con necesidades o no de terapia or- todóncica. Objetivo: evaluar mediante una revisión de la literatura los tratamientos ortodóncico-quirúrgicos de pacientes con asimetría facial. Material y métodos: la literatura se seleccionó mediante una búsqueda en las bases de datos electrónicas: PubMed, Scopus, Web of Science. Las palabras clave utilizadas fueron: facial asymmetry, asymmetry, surgical treatment, surgical orthodontic treatment. La búsqueda se restringió a artículos en inglés publicados del año 2011 al 2021. Resultados: después de aplicar los criterios de inclusión y exclusión en total se obtuvieron y revisaron 27 artículos. Se realizó la revisión de literatura del tratamiento ortodóncico-quirúrgico en pacientes con asimetría facial. Conclusión: es preciso el abordaje ortodóntico quirúrgico para la corrección de la asimetría facial, del protocolo dependerá la situación clínica y la elección de tratamiento ortodóntico quirúrgico, lo que brindará mejoras significativas en la simetría facial (AU)

Introduction: facial asymmetry, is a notorious condition in the lower third of the subject's facie and between the middle and upper thirds, in the latter this condition will be less evident; in such a way, it could be considered as one of the discomforts of greater incidence in patients with needs or not of orthodontic therapy. Objective: to evaluate by means of a literature review the orthodontic-surgical treatment of patients with facial asymmetry. Material and methods: the literature was selected through a search in the following electronic databases: PubMed, Scopus, Web of Science. The keywords used were: facial asymmetry, asymmetry, surgical treatment, surgical orthodontic treatment. The search was restricted to articles in English published from 2011 to 2021. Results: after applying the inclusion and exclusion criteria, a total of 27 articles were obtained and reviewed. The literature review of orthodontic-surgical treatment in patients with facial asymmetry was performed. Conclusion: surgical orthodontic approach is necessary for the correction of facial asymmetry, the protocol will depend on the clinical situation, the choice of surgical orthodontic treatment, which will give significant improvements in facial symmetry (AU)

Development of a Cranial Suture Traction Therapy Program for Facial Asymmetry Correction Using the New Delphi Technique.

Background and Objectives: We aimed to develop a cranial suture traction therapy program, a non-surgical therapeutic method for facial asymmetry correction. Materials and Methods: Six experts, including rehabilitation medicine specialists, oriental medical doctors, dentistry specialists, five experts, including Master's or doctoral degree holders in skin care and cosmetology with more than 10 years of experience in the field, 4 experts including educators in the field of skin care, a total of 15 people participated in the validation of the development of the cranial suture traction therapy program in stages 1 to 3. Open questions were used in the primary survey. In the second survey, the results of the first survey were summarized and the degree of agreement regarding the questions in each category was presented. In the third survey, the degree of agreement for each item in the questionnaire was analyzed statistically. Results: Most of the questions attained a certain level of consensus by the experts (average of ≥ 4.0). The difference between the mean values was the highest for the third survey at 0.33 and was the lowest between the second and third surveys at 0.47. The results regarding the perceived degree of importance for each point of the evaluation in both the second and third stages of the cranial suture traction therapy program were verified using the content validity ratio. The ratio for the 13 evaluation points was within the range of 0.40-1.00; thus, the Delphi program for cranial suture traction therapy verified that the content was valid. Conclusions: As most questions attained a certain level of consensus by the experts, it can be concluded that these questions are suitable, relevant, and important. The commercialization of the cranial suture traction treatment program will contribute to the correction and prevention of facial dislocations or asymmetry, and the developed treatment will be referred to as cranial suture traction therapy (CSTT).

Does positional plagiocephaly affect the need for orthodontic treatment, and the mandibular and occlusal symmetry? / La plagiocéphalie positionnelle a-t-elle des répercussions sur le besoin de traitement orthodontique et sur la symétrie mandibulaire et occlusale ?

Introduction: Positional plagiocephaly (PP) is characterized by an asymmetrical flatness of the posterior part of the skull which may involve the frontal part of the skull and the face. The aim is to assess whether children and adolescents with PP have more occlusal and skeletal asymmetries and whether the need for orthodontic treatment is greater than in the healthy population. Material and Method: A comparative cross-sectional epidemiological study was carried out. One hundred children and adolescents were included: 50 in the PP group and 50 in the control group. The need for orthodontic treatment was assessed by the Index of Orthodontic Treatment Need (IOTN). The mandibular and dental asymmetries were measured on lateral cephalometry by two indexes: index of mandibular asymmetry (IMA) and index of dental asymmetry (IDA) respectively. Chi and Student independence tests were performed with a threshold of 5%. Results: The tests are significant for IMA (p = 0.02) and IOTN (p = 0.000012). IDA is insignificant. Discussion: Orthosurgical treatment of mandibular laterognathies by mandibular recentering sometimes creates mandibular asymmetry, while the shift is basal. We must be able to act early on the vault of the skull to hope to obtain a consecutive effect on the base and therefore on the position of the glenoid cavities. Management by manual therapy and early cranial orthosis could be estimated. Conclusion: The need for orthodontic treatment is significantly greater in PP. Unlike mandibular asymmetry, dental asymmetry is not significantly greater than in the control group, testifying to the adaptive capacities of the organism.

Introduction: Les plagiocéphalies positionnelles (PP) sont caractérisées par un aplatissement asymétrique de la partie postérieure du crâne pouvant impliquer la partie frontale du crâne et la face. L'objectif de cet article était d'évaluer si les enfants et les adolescents atteints de PP ont davantage de dissymétries occlusales et squelettiques, et si le besoin de traitement orthodontique est plus important que dans la population saine. Matériel et méthode: Une étude épidémiologique transversale comparative a été menée. Cent enfants et adolescents ont été inclus : 50 dans le groupe PP et 50 dans le groupe témoin. Le besoin de traitement orthodontique a été évalué par l'Index of Orthodontic Treatment Need (IOTN). La dissymétrie squelettique et dentaire a été évaluée radiologiquement par deux indices : l'Index of Mandibular Asymmetry (IMA) et l'Index of Dental Asymmetry (IDA). Des tests d'indépendance du Chi et Student ont été effectués avec un seuil de 5 %. Résultats: L'IMA (p = 0,02) et l'IOTN (p = 0,000012) sont significatifs. L'IDA est non significatif. Discussion: Le traitement ortho-chirurgical des latéromandibulies par recentrage mandibulaire crée parfois une dissymétrie mandibulaire, alors que le décalage est basal. Il faudrait pouvoir agir précocement sur la voûte du crâne pour espérer obtenir un effet consécutif sur la base et donc sur la position des cavités glénoïdes. Une prise en charge par thérapies manuelles et orthèse crânienne précoce pourrait être évaluée. Conclusion: Le besoin de traitement orthodontique est significativement plus important en cas de PP. Contrairement à la dissymétrie mandibulaire, la dissymétrie dentaire n'est pas significativement plus importante que dans le groupe témoin, témoignant des capacités adaptatives de l'organisme.

[Preliminary study on the effect of combined invisible orthodontic and orthognathic treatment in 24 skeletal Class â ¢ patients with facial asymmetry].

PURPOSE: To evaluate the clinical effect of combined orthodontic and orthognathic treatment with invisible aligner technique without brackets in skeletal Class Ⅲ patients with facial asymmetry. METHODS: A total of 24 skeletal Class Ⅲ patients with facial asymmetry treated with combined orthodontic and orthognathic treatment during the past 4 years were reviewed. Patients in the experimental group(n=12) were treated with invisible aligner technique without brackets, while patients in the control group(n=12) were treated with traditional fixed orthodontic technique for pre- and post-operative orthodontic treatment respectively. The cephalometric parameters and satisfaction questionnaire scores of the two groups before and after treatment were compared and analyzed with SPSS 20.0 software package for t test and Wilcoxon rank sum test, respectively. RESULTS: After treatment, the cephalometric parameters of SNA, SNB, ANB, U1-SN and L1-MP values were changed significantly(P＜0.05), but there was no significant difference between the values of experimental group and the control group(P＞0.05). The scores of aesthetics, comfort, portability, masticatory and speech function in the experimental group were significantly higher than those in the control group(P＜0.05). The satisfaction scores of the two groups were both 8.8±0.5(P＞0.05). CONCLUSIONS: Skeletal Class Ⅲ patients with facial asymmetry could obtain good clinical effect by using invisible aligner technique. The patients were satisfied with the aesthetics, comfort and the effect of combined invisible orthodontic and orthognathic treatment.

Three-Dimensional Quantification of Facial Asymmetry in Children with Positional Cranial Deformity.

BACKGROUND: The extent of facial involvement in positional plagiocephaly is only little investigated so far. Investigation methods that take into account the challenging anatomical conditions and growth of infants' faces are desirable. In this study, the authors established a new three-dimensional photogrammetry quantification method evaluating pretherapeutic and posttherapeutic facial asymmetry in positional plagiocephaly. Furthermore, a facial asymmetry index was established and evaluated. METHODS: Three-dimensional photographs of 100 children undergoing treatment with head orthoses were analyzed by constructing a standardized interindividual coordinate system. Defining landmarks, section planes, and point coordinates with a computer-aided design software, both sides of the faces were compared. Facial asymmetry was quantified by measuring differences between left and right sides and pretherapeutic and posttherapeutic changes in each patient. The facial asymmetry index was calculated by putting the absolute differences in relation with the coordinates of the nonaffected side. RESULTS: Present results indicate that positional plagiocephaly results in a distinct facial asymmetry (range, -3.8 to 9.6 mm) in nearly all spatial directions and facial regions. Helmet therapy led to a significant reduction (p < 0.05) of intraindividual facial asymmetry (median change in facial asymmetry index, -1.9 to 3.1 percent). However, no correlation of the Cranial Vault Asymmetry Index and facial asymmetry (Spearman rank correlation coefficient, ρ = -0.09 to 0.47) has been seen. According to these results, severe occipital deformation does not necessarily provoke distinct facial asymmetry. CONCLUSIONS: Present three-dimensional photogrammetry method allows the longitudinal quantification of facial involvement in positional plagiocephaly. Asymmetry has been determined in all facial regions. The facial asymmetry decreased through helmet therapy but was not eliminated completely.

Treatment of hemifacial microsomia using conventional orthodontic techniques: Report of a case with long-term follow-up.

BACKGROUND AND OVERVIEW: The authors successfully treat a case of hemifacial microsomia involving unilateral condylar hypoplasia using conventional orthodontic techniques followed by long-term retention. CASE DESCRIPTION: A girl aged 10 years and 2 months received a diagnosis of hemifacial microsomia resulting from unilateral condylar hypoplasia. During a growth period, premature incisal contact was abolished. After her growth was complete, she received conventional orthodontic treatment with preadjusted edgewise appliances. After 27 months of multibracket treatment, acceptable occlusion with a class I canine and molar relationship was achieved. The occlusion remained stable throughout the 15-year retention period, although there was a slight facial change. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Early orthodontic management only can have some limitations but could be one of the treatment options for hemifacial microsomia.

Determination of Facial References for Esthetic Restorative Treatment.

Although it is generally accepted that a prosthetic restoration must take into account the gingiva, smile, and patient's face, it is often difficult to determine precisely what facial references must be considered. The purpose of this study was to determine the correct vertical and horizontal facial reference planes in esthetic prosthetic treatment. Using photographic analysis of 160 individuals, the different facial reference planes (interpupillary, intermeatic, intercommissural, and incisal edge lines; facial midline; and Camper and Frankfort planes) were compared to the ideal prosthetic reconstruction axis. Additional measurements, including the human eye's ability to perceive parallelism, were recorded. Most participants (64%) exhibited facial asymmetry. Asymmetry was horizontal (difference between widths of the right and left sides; 52.4%), vertical (difference between heights of the right and left sides; 6.9%), or mixed (4.7%). The interpupillary line is the main horizontal reference in 88.4% of situations, with the intercommissural line the second most important. In the profile view, the horizontal plane was on average 6.5 degrees above the Camper plane and 9 degrees below the Frankfort plane. The human eye's ability to perceive parallelism between two lines was found to be limited to differences of approximately 1 degree. During anterior tooth reconstruction, it is necessary to take into account the right horizontal and vertical esthetic references. Knowledge of the biometric facial parameters in natural dentition is necessary to define the right reconstruction axes based on the facial symmetry or asymmetry.

Camouflage treatment for skeletal Class III patient with facial asymmetry using customized bracket based on CAD/CAM virtual orthodontic system.

When considering camouflage orthodontic treatment for Class III malocclusion with skeletal facial asymmetry, it is crucial to preserve the favorable compensated posterior occlusion. Once the inclination of the compensated occlusion is changed during orthodontic treatment, unstable occlusion, such as crossbite or scissor bite may occur. A 23-year-old female patient had anterior spacing with Class III malocclusion and a mandibular asymmetry. A nonsurgical approach was adopted. The treatment objectives were to establish a Class I molar relationship with compensated inclination of the posterior dentition and to correct the midline deviation. To achieve these goals, the computer-aided design/computer-aided manufacturing (CAD/CAM) orthodontic system plus customized brackets was applied, and miniscrews were used to distalize the left mandibular dentition for midline correction. The results suggested that the CAD/CAM-based customized brackets can be efficiently used in camouflage treatment to achieve a correct final occlusion.

Treatment of the mandibular shift in an adult woman and the diagnostic value of joint space index: a case report.

BACKGROUND: Mandibular deviations are common clinical complaints. The orthodontic or orthognathic treatment of mandibular deviations is tricky because a comprehensive diagnosis, especially a functional one, is difficult to make. A inaccurate diagnosis may lead to a compromised and unstable treatment outcome. CASE PRESENTATION: This article describes the diagnosis and treatment of a woman with a mandibular deviation and facial skeletal asymmetry. By eliminating the disharmony of the arch form with elastics and bite turbos, her esthetic and functional outcomes improved. Cone-beam CT (CBCT) and Joint Space Index (JSI) analyses served as the diagnostic approaches and outcome evaluation methods before and after treatment. CONCLUSIONS: A condyle position displacement could be an indication of functional deviation. JSI analysis is a quantitative and convenient choice to compare condyle relative positions.

Is the Quad Helix more efficient to correct mandibular asymmetry before age 7? A retrospective comparative study.

INTRODUCTION: Unilateral posterior crossbite (UPCB), often from dysfunctional and para-functional causes, leads to positional mandibular asymmetries that can develop at a very young age into skeletal mandibular deviation; hence the interest of early maxillary expansion. The purpose of this retrospective study was to compare the impact of maxillary expansion by Quad Helix (QH) on mandibular skeletal asymmetry correction before and after 7 years of age. MATERIALS AND METHODS: All children with UPCB and skeletal mandibular asymmetry, who were treated by QH in the orthodontic department of Montpellier between February 2017 and August 2018 and had a radiography file at baseline (T0) and 12 months later (T1) were retrospectively included. The patients were divided into two groups according to age: under 7 years of age with QH adjusted on second primary molars (early group G1) and over up to 13 years old with QH adjusted on first permanent molars (late group G2). The differences between the right and left sides of the mandible in corpus length ΔL (main eligibility criterion) and ramus height ΔH (secondary criterion) were compared between groups. X2 test, Fisher's exact test and Wilcoxon rank-sum tests were used for baseline comparisons. A multifactorial analysis allowing adjustment on possible confounding factors was used with R software. RESULTS: Out of 67 patients files only 40 were completed and analysed: 13 in G1 and 27 in G2. These groups were comparable at baseline except for the age parameter. Taking into account the initial severity of asymmetry, the analysis of covariance showed a significant intergroup difference with higher correction in the early group of the corpus asymmetry (+1.0; P=0.008). On the contrary, no significant differences were observed between the groups in the ramus asymmetry correction. CONCLUSIONS: Within the limits of this retrospective study, the early unilateral posterior occlusion correction by QH can better reduce both positional and contour mandibular asymmetries in patients under 7 years of age.

Different approaches for management of Class III siblings: A long-term follow-up of two case reports.

Class III malocclusion can be varied in presentation and progression. This report describes the presentation, course of treatment and long-term follow-up of two siblings with Class III malocclusion. Two cases discussed in this report were different in their presentation. Sibling 1, a 19-year-old male patient had developed skeletal Class III malocclusion with severe maxillomandibular discrepancy, showing both components of maxillary hypoplasia and mandibular prognathism & asymmetry with average growth pattern. Sibling 2, a 13-year-old male patient had developed a Class III malocclusion with maxillary retrognathism with vertical growth pattern. An insight into the similarities and dissimilarities in the presentation, course of treatment and long-term follow-up of the two cases is provided. The two cases were successfully managed with entirely different treatment approaches. Sibling 1 underwent maxillary advancement with Le Fort I surgery and mandibular set back and rotation with bilateral sagittal split osteotomy which was preceded by pre-surgical orthodontic treatment with extraction of upper first premolars for orthodontic decompensation. Sibling 2 was treated with skeletally anchored facemask therapy followed by fixed mechanotherapy. Acceptable clinical outcome with long-term stability of the treatment results was observed in the two siblings. Orthognathic surgery may be completely avoided later if early orthopaedic treatment to advance the maxilla is initiated at an appropriate age.

European College of Orthodontics. Commission of Titularisation. Clinical case No. 191101.

DATE OF BIRTH: 29/07/1993; gender: female. PRE-TREATMENT DOCUMENTS: 19 years 2 months old: 29/07/1993. DIAGNOSIS: Skeletal class II with mandibular laterognathia and retrusion, hypodivergent facial pattern; class II division 1, transverse maxillary deficiency with left unilateral posterior cross bite; missing teeth before treatment: 18 28 38 48. TREATMENT PLANNING: Orthosurgical treatment (bimaxillary surgery); Bimaxillary lingual fixed appliances. DURATION OF ACTIVE TREATMENT: 2 years. POST-TREATMENT DOCUMENTS: 22 years 5 months old; 09/01/2015. POST-RETENTION DOCUMENTS: 05/01/2016; 23 years 5 months old. RETENTION PERIOD: 3 years.

Hemifacial Microsomia Caused by First and Second Brachial Arch Syndrome Treated with Orthodontic Approach: A Case Report.

AIM AND OBJECTIVE: To present a growing patient with unilateral mandibular hypoplasia and microtia involved in the first and second branchial arch syndrome (FSBAS) treated with functional appliance. BACKGROUND: The FSBAS comprises several developmental facial hypoplasia in ear and maxillofacial bones, resulting in hemifacial microsomia. Treatment for hemifacial microsomia varies greatly depending on the grade of mandibular deformities. Functional appliance treatment during growth period is available for mild to moderate mandibular deformities. However, there are few reports of hemifacial microsomia treated with functional appliance. CASE DESCRIPTION: The patient, an 8-year-and-5-month-old girl, had a chief complaint of mandibular deviation. She had been diagnosed with the FSBAS at birth. Her facial profile was straight and panoramic radiograph indicated that the mandibular ramal height of the affected side was about 60.4% compared to the unaffected side. The occlusal cant was 6°, and the right maxilla and mandible showed severe growth deficiency. At the age of 10 years, functional appliance with expander was used; for 2 years 6 months, the maxillomandibular growth was controlled and from panoramic radiograph, the ramus height of the affected side was increased to 65.0% compared to the unaffected left mandibular ramus. At the age of 12 years and 8 months, multibracket treatment was initiated. After 32 months of active treatment, proper occlusion with functional Class I canine and molar relationships was obtained, although facial asymmetry associated with the difference of ramus heights still existed. The resulting occlusion was stable during 1.5-year retention period. CONCLUSION: Our results indicated the importance of orthopedic treatment during growth period in the patient with hemifacial microsomia involving the FSBAS. CLINICAL SIGNIFICANCE: This report proposes an efficacy of conventional orthodontic treatment for growing patients with hemifacial microsomia involved in the FSBAS.

La ortodoncia y la cirugía ortognática como aliadas en el tratamiento / Orthodontics and orthognathic surgery as treatment allied

¿Qué es la estética? Es más que un concepto frívolo. Tiene que ver con la armonía facial, la autoestima, la autoimagen, la percepción de belleza. Es un concepto que involucra al individuo en su totalidad, en su ser, que va más allá de frivolidad estética. Muchos pacientes que vienen a la consulta no expresan inicialmente su real demanda. Expresan problemas funcionales, pero su real preocupación, en la mayor parte de los casos, es estética. Pueden manifestar que no pueden comer bien, masticar un alimento o que no respiran bien o sesean, pero su motivación principal es estética y tiene que ver con su propia autoestima. Las funciones de respiración, deglución, fonación, masticación, oclusión deben estar entre los objetivos a conservarse o restituirse por parte del especialista, pero el tratamiento sería un fracaso si no atendemos la demanda, a veces no bien explicitada, por el paciente y que responde a su profunda necesidad real. Para la OMS, la salud puede definirse como el estado completo de bienestar físico, mental y social. Nuestro objetivo, como agentes de salud, será poder satisfacer la demanda explícita o encubierta con la mayor estética y la mayor funcionalidad (AU)

What is aesthetics? It is more than a frivolous concept. It has to do with facial harmony, self-esteem, self-image, the perception of beauty. It is a concept, which involves the individual as a whole, in his being, which goes beyond aesthetic frivolity. Many patients who come to the office do not initially express their real demand. They express functional problems, but their real concern, in most cases, is aesthetic. They may state that they cannot eat well, chew a food or that they do not breathe well or sedate, but their main motivation is aesthetic and has to do with their own self-esteem. The functions of breathing, swallowing, phonation, chewing, occlusion should be among the objectives to be retained or restored by the specialist, but the treatment would be a failure if we do not meet the demand sometimes not well explained by the patient and responding to their Deep real need. For WHO, health can be defined as the complete state of physical, mental and social well-being. Our goal, as health agents, will be to be able to meet the explicit or covert demand with the greatest aesthetics and functionality (AU)

Make-Up Therapy for Patients With Facial Nerve Palsy.

OBJECTIVES: To investigate the effectiveness of make-up therapy for patients with facial nerve palsy. METHODS: Seven female patients with facial nerve palsy who received specialist make-up therapy were enrolled. The objective of the make-up therapy was to obtain a symmetrical facial appearance. RESULTS: Overall score for the Facial Clinimetric Evaluation (FaCE) scale was significantly improved after make-up therapy. There was a tendency for symptoms of depression to be improved among patients after make-up therapy. CONCLUSION: Make-up therapy to improve the symmetry of facial appearance could afford a noninvasive and low-cost treatment for patients with facial nerve palsy, especially in terms of patient quality of life and psychological condition.

[Archwire segmentation: a solution to the problems involved in treating atypical cases]. / La segmentation de l'arc, une réponse aux difficultés de traitement de cas atypiques.

INTRODUCTION: Asymmetrical orthodontic cases frequently prove very difficult to correct. Anchorage mini-screws are often needed to treat these cases when the malocclusion is of maxillary origin. Nonetheless, a precise biomechanical assessment must be made to avoid undesirable sideeffects resulting from the mechanics used. Whether one uses a continuous or a segmented archwire, adverse events can occur and must be planned for in order to contain them. MATERIALS AND METHODS: The authors will first give an overview of the possible undesirable effects using the continuous arch technique and the principles underlying the segmented archwire technique. Various clinical cases will also be described to support their argument. CONCLUSION: The advantage of the segmented techniques lies in the precision and speed of the movements obtained in the three dimensions of space. However, they can also present major drawbacks. In practice, these techniques seem best-suited to complex atypical cases, and particularly cases involving asymmetry of the frontal and transverse planes.