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1.
Am J Orthod Dentofacial Orthop ; 159(1): 108-124, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33357748

RESUMEN

This article reports the interdisciplinary treatment of a girl born with a complete bilateral cleft lip and palate. She had congenitally missing maxillary lateral incisors and canines and mandibular incisors, canines, and second premolars in addition to third molars. At age 11 years 2 months, she was treated with rapid maxillary expansion followed by bonding of the maxillary arch. Cranial harvested alveolar bone graft surgery was done at age 17 years 2 months. Mandibular arch treatment was started at age 19 years using single tooth implants initially as orthodontic anchorage devices and secondarily as prosthetic abutments. Teeth were placed in strategic positions for a 4 incisor fixed partial denture cemented on the 2 lateral incisor implants and screw-retained crowns on premolar implants. The maxillary arch was restored with screw-retained crowns on canine implants with lateral incisors in cantilever and pink ceramic. Two years posttreatment records at age 22 years 6 months showed long-term stability with good occlusion, facial balance, and smile esthetics.


Asunto(s)
Labio Leporino , Fisura del Paladar , Adolescente , Adulto , Niño , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Estética Dental , Femenino , Humanos , Incisivo , Maxilar , Adulto Joven
2.
J Oral Rehabil ; 48(1): 73-80, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33006787

RESUMEN

OBJECTIVES: To investigate differential item functioning across the Spanish and English versions of the Orofacial Esthetic Scale (OES). METHODS: OES data were collected from a consecutive sample of a total of 622 adult dental patients (311 English- and 311 Spanish-speaking adults) from HealthPartners dental clinics in Minnesota. We inspected boundary characteristic curves (BCCs) based on item response theory (IRT) in English speakers and Spanish speakers to examine differential item functioning (DIF). Using the Samejima's graded response model, we used the item response theory log-likelihood ratio (IRTLR) approach to test whether DIF was statistically significant. RESULTS: Inspection of the BCCs did not reveal substantial differences in item difficulty and discrimination between English speakers and Spanish speakers. When IRTLR tests were performed for the seven OES items, no item was flagged with significant DIF after P-values were adjusted for multiple comparisons. CONCLUSIONS: Pooling of Orofacial Esthetic Scale (OES) data from English and Spanish-speaking dental patients for analysis and interpretation is supported by the absence of differential item functioning (DIF) across the two language groups.


Asunto(s)
Estética Dental , Lenguaje , Adulto , Humanos , Examen Físico , Psicometría , Encuestas y Cuestionarios
3.
Oral Dis ; 27(1): 64-72, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32343862

RESUMEN

Head and neck cancer treatment can severely alter oral function and aesthetics, and reduce quality of life. The role of maxillofacial prosthodontists in multidisciplinary treatment of head and neck cancer patients is essential when it comes to oral rehabilitation and its planning. This role should preferably start on the day of first intake. Maxillofacial prosthodontists should be involved in the care pathway to shape and outline the prosthetic and dental rehabilitation in line with the reconstructive surgical options. With the progress of three-dimensional technology, the pretreatment insight in overall prognosis and possibilities of surgical and/or prosthetic rehabilitation has tremendously increased. This increased insight has helped to improve quality of cancer care. This expert review addresses the involvement of maxillofacial prosthodontists in treatment planning, highlighting prosthodontic rehabilitation of head and neck cancer patients from start to finish.


Asunto(s)
Neoplasias de Cabeza y Cuello , Procedimientos Quirúrgicos Reconstructivos , Estética Dental , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Prostodoncia , Calidad de Vida
4.
Acta Odontol Scand ; 79(1): 19-24, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32432962

RESUMEN

INTRODUCTION: In orthognathic surgery, understanding the patient's motives for treatment is a key factor for postoperative patient satisfaction and treatment success. In countries/systems where orthognathic surgery is funded by public means, patients are referred mainly due to functional problems, although studies of quality of life related changes after treatment indicate that psychosocial and aesthetic reasons might be equal or more important for the patient. There is no available validated condition specific instruments in the Swedish language for quality of life evaluation of patients with dentofacial deformities. Aims/objectives: Cross cultural translation and adaptation of the English-language instrument 'Orthognathic Quality of Life Questionnaire' (OQLQ) into Swedish. Methods: OQLQ was translated into Swedish. A total of 121 patients in four groups were recruited and the Swedish version of the OQLQ (OQLQ-S) was tested by psychometric methods. Reliability was assessed by internal consistency and test-retest reliability. Validity was evaluated by face, convergent and discriminant validity. Results/findings and conclusions: OQLQ-S is reliable and showed good construct validity and internal consistency and can be used in a Swedish speaking population as a complement to clinical variables to evaluate patients with dentofacial deformity.


Asunto(s)
Lenguaje , Calidad de Vida , Estética Dental , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Suecia
5.
J Prosthet Dent ; 125(1): 15-17, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32059856

RESUMEN

Patients with challenging prosthodontic conditions require rehabilitation with a biological, functional, and esthetic approach. When one or more teeth are badly discolored, their restoration is problematic because poor appearance affects not only the crown but also the periodontal tissues. This clinical report describes a complex esthetic rehabilitation with conservative tissue management and ceramic restorations. Subepithelial connective tissue graft surgery and the replacement of a cast metal post with a glass fiber post addressed the problem of a discolored maxillary central incisor. The discolored right maxillary incisor was restored with a combination of a medium-opaque, lithium-disilicate ceramic coping to mask the dark root and to approximate the color of the other incisors. Subsequently, 6 ceramic veneers were placed. A knowledge of the materials' optical properties and adhesion possibilities helped solve this complex problem.


Asunto(s)
Coronas con Frente Estético , Estética Dental , Cerámica , Coronas , Porcelana Dental , Humanos , Incisivo
6.
J Prosthet Dent ; 125(1): 126-136, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32063384

RESUMEN

STATEMENT OF PROBLEM: Implant complications have been reported to occur at high rates and frequencies. Whether these high rates are observed in predoctoral implant programs and whether future dentists are educated to diagnose and treat implant complications is unknown. PURPOSE: The purpose of this study was to analyze and report the results of a survey on US predoctoral curricula related to implant treatment and with an emphasis on diagnosing and treating implant complications. MATERIAL AND METHODS: A 26-question survey was distributed to all (66) US dental schools. In addition to 3 questions regarding descriptive information about each school, 13 questions were used to calculate a curriculum composite score that was used to assess the quality of the school's implant curriculum. The remaining survey topics and number of questions included frequency of complications (2), tracking and types of complications (6), and school-reported student preparedness to identify or treat implant complications (2). A Kruskal-Wallis test was used to evaluate the relationship between the curriculum composite scores and student preparedness to diagnose and treat implant complications. RESULTS: Twenty-eight schools responded to the survey for a response rate of 42.4%, and 23 schools completed the entire survey (completion rate 34.8%). Fifteen schools (65.2%) reported methods of recording implant complications, and 8 of 23 schools (34.8%) reported methods of assessing student knowledge in recognizing implant complications. Only 2 schools reported methods of assessing student preparedness to treat implant complications. Most implant complications were mechanical (64.3%), followed by biological (28.6%) and esthetic (7.1%). The prostheses associated with the most complications were implant overdentures (39.1%), followed by single crowns (34.8%) and fixed partial dentures (4.3%). A positive relational trend was observed between reported student preparedness to recognize and treat implant complications and curriculum composite scores. CONCLUSIONS: Within the limitation of this survey-based study, implant curricula in US dental schools should consider improving the scope of teaching the diagnosis and treatment of implant complications. The implant complications observed at US dental schools showed similar trends to those reported in the literature.


Asunto(s)
Implantes Dentales , Facultades de Odontología , Curriculum , Implantación Dental , Implantes Dentales/efectos adversos , Educación en Odontología , Estética Dental , Humanos , Prostodoncia , Encuestas y Cuestionarios
7.
J Prosthet Dent ; 125(1): 146-150, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32089363

RESUMEN

STATEMENT OF PROBLEM: Guidelines for planning esthetic outcomes are sparse. The present study evaluated the most noticeable characteristics of the celebrities with the most esthetic smiles. PURPOSE: The purpose of this observational study was to assess the smiles of celebrities based on descriptive esthetic smile criteria and to compare male and female celebrity smiles based on dentally esthetic smiles. MATERIAL AND METHODS: An internet search for the "most beautiful celebrity smile ranking" was conducted in 2019, resulting in 50 celebrities that had been voted for having the most beautiful smiles. A second search was conducted to locate images of the identified individuals with the whole face and a broad smile. RESULTS: The most frequent characteristics of the studied variables were a normal smile line (70.7%), incisal edges parallel to the lower lip (56.1%), maxillary anterior incisal edges touching the lower lip (48.8%), a smile width of 10 teeth (53.7%), a facial midline coincident with the maxillary dental midline (51.2%), and average buccal corridors (78%). Statistically significant differences between men and women were only found in the smile arch (P<.01). CONCLUSIONS: Celebrities voted as having the most beautiful smiles comply with most of the characteristics described as esthetically pleasing, except for midline deviations. The general population is influenced by factors other than the individual's smile.


Asunto(s)
Estética Dental , Diente , Femenino , Humanos , Labio , Masculino , Maxilar , Sonrisa
8.
J Oral Maxillofac Surg ; 79(1): 237-248, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32890473

RESUMEN

PURPOSE: Oncological patients who undergo bilateral subtotal maxillectomies develop functional and esthetic sequelae that require immediate reconstruction. The purpose of this study is to evaluate the primary reconstruction of maxillary defects with fibula flap and dental implants assisted by virtual surgical planning (VSP) and to assess the postoperative outcomes compared with standard surgery. MATERIAL AND METHODS: A retrospective study was designed between January 2016 and April 2020 with 12 oncologic patients who underwent subtotal bilateral maxillectomy. Six consecutive patients were treated by standard surgical procedure (SS) at the beginning of the study. In 2018, the VSP was implemented, and 6 consecutive patients were treated using this technique. All patients were rehabilitated with Ticare implants and implant prostheses. Anatomic position of the bone, bone apposition, change of vertical distance, and horizontal shift, the operative and ischemia time, the esthetic results, and the functional rehabilitation were evaluated and compared. RESULTS: The position of the bone in anatomical position was 100% in the VSP group vs 66% in the SS group. The bone apposition was 100% in the VSP group vs 83.3%. The change of vertical distance and the horizontal shift were lower in the VSP group (P < .05). The ischemia time and operative time were shorter in the VSP group (P < .05). A good esthetic result was achieved in 83.3% in the VSP group vs 33.3% in the SS group; 81 dental implants and 1 zygomatic implant were placed. The success rate was 95% in the VSP group and 92.6% in the SS group. All patients were rehabilitated with implant prosthesis. CONCLUSIONS: VSP improves the accuracy of midface reconstruction (class IIC defect) with a better anatomical position of the bone, a higher rate of bone contact, and a lower change in vertical distance compared with standard surgery. It significantly improves the esthetic result, reduces ischemia time, and operation time.


Asunto(s)
Implantes Dentales , Colgajos Tisulares Libres , Reconstrucción Mandibular , Procedimientos Quirúrgicos Reconstructivos , Estética Dental , Peroné/cirugía , Colgajos Tisulares Libres/cirugía , Humanos , Estándares de Referencia , Estudios Retrospectivos
9.
J Oral Rehabil ; 48(1): 81-94, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32989781

RESUMEN

AIM: To review the literatures concerning the effect of the single-implant mandibular overdenture (SIMO) on patient-reported outcome measures (PROMs) and masticatory function in the fully edentulous patients. MATERIALS AND METHODS: Electronic databases (PubMed, Cochrane Library, EMBASE and Web of Science) were searched, complemented with manual resources. Prospective studies published in English up to February 2020 reporting the effect of SIMO on PROMs and masticatory function in the edentulous patients were included. This review focused on oral health-related quality of life (OHRQoL), satisfaction and masticatory function outcomes. RESULTS: Of 1157 initially screened articles, 9 randomised controlled trials (RCTs) and 8 prospective studies involving 551 subjects fulfilled the inclusion criteria. Two RCTs were graded as high risk of bias or some concern, while others were low risk. All prospective studies had adequate representativeness and assessment, but only one study had a controlled cohort. In general, the edentulous patients restored with SIMOs had improved OHRQoL and general satisfaction compared to those with conventional complete dentures (CCDs), but the outcome of masticatory function was controversial. Compared with two-implant mandibular overdenture (TIMO), SIMO showed no significant differences regarding general satisfaction and satisfaction with speech, comfort, chewing ability, aesthetics and social life. Conflicting results were observed in OHRQoL and satisfaction with retention and stability. Better masticatory performance was observed in TIMO group than SIMO group. CONCLUSION: Within the limitation of this review, SIMO is featured with better OHRQoL and satisfaction than CCD. SIMO and TIMO rendered similar patient satisfaction, but TIMO had better masticatory performance.


Asunto(s)
Prótesis de Recubrimiento , Boca Edéntula , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos , Mandíbula , Masticación , Medición de Resultados Informados por el Paciente , Satisfacción del Paciente , Calidad de Vida
10.
Clin Oral Investig ; 25(1): 255-264, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32533264

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate and compare the effects of the immediate and delayed loading of strategic mini-implants (MIs) on the satisfaction of patients with removable partial dentures (RPDs). MATERIALS AND METHODS: In this multi-center randomized clinical trial, strategic MIs were inserted under 79 RPDs in 76 participants. Two questionnaires, one for the upper jaw and one for the lower jaw, were given before surgical intervention and 2 weeks, 4 months, 4.5 months, 1 year, 2 years, and 3 years after implant insertion. To estimate the loading effect (immediate vs. delayed) in terms of the odds ratio, an ordinal logistic regression model was used. The Wilcoxon matched-pairs signed-rank test, which was corrected for clusters in the patient population, was used to evaluate changes in patient satisfaction. RESULTS: After 4 months, a statistically significant difference in favor of the immediate loading group was recognized in terms of the overall satisfaction score. The patient satisfaction scores recorded after 4.5 months and 1, 2, and 3 years showed substantial improvements compared with the scores recorded before implant insertion in both groups. At the item level, substantial improvements were noted in the following domains: general satisfaction, RPD retention, stability, support, eating, speaking, and aesthetics. CONCLUSIONS: Strategic MIs improved the satisfaction of patients with RPDs during the medium-term follow-up period. An earlier improvement in the satisfaction of patients with RPDs was seen after immediate loading of the MIs as compared with delayed loading. CLINICAL RELEVANCE: Inserting MIs under existing RPDs can improve patients' satisfaction with their RPDs in several domains.


Asunto(s)
Implantes Dentales , Dentadura Parcial Removible , Carga Inmediata del Implante Dental , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos , Mandíbula/cirugía , Satisfacción del Paciente
11.
J Prosthet Dent ; 125(1): 182-188, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32111395

RESUMEN

STATEMENT OF PROBLEM: The durability of adhesive bonding systems to dentin is of importance for restoration longevity; therefore, new adhesive systems should be tested in vitro with long-term artificial aging before clinical application. PURPOSE: The purpose of this in vitro study was to investigate the bonding durability of 3 dual-polymerizing resins and 1 autopolymerizing resin to human dentin with their specific self-etching primers or adhesives. MATERIAL AND METHODS: Acrylic resin tubes filled with composite resin were bonded to human dentin disks using either an autopolymerizing resin system (Panavia 21) or dual-polymerizing resin systems (Panavia V5, RelyX Ultimate, and Variolink Esthetic DC) together with the system-specific primer or adhesive. Tensile bond strength was tested after 3 days of water storage or after 150 days of water storage with 37 500 thermocycles (5 °C to 55 °C). The failure mode was evaluated by using a light microscope. In addition, representative specimens were examined by using a scanning electron microscope. RESULTS: After 3 days, the median tensile bond strengths ranged from 18.8 to 29.1 MPa. After artificial aging for 150 days, the median tensile bond strengths ranged from 14.7 to 25.6 MPa. The dual-polymerizing resins showed significantly higher bond strength than the autopolymerizing resin (P≤.05). Artificial aging with thermocycling had no statistically significant influence on tensile bond strength for the adhesive resin systems tested (P>.05). The failure mode was mainly adhesive for the autopolymerizing resin, whereas it was mainly cohesive for the dual-polymerizing resins. CONCLUSIONS: The 3 tested dual-polymerization resin systems provided durable bond strengths to dentin which were higher than those of the autopolymerizing resin.


Asunto(s)
Recubrimiento Dental Adhesivo , Recubrimientos Dentinarios , Resinas Compuestas , Cementos Dentales , Análisis del Estrés Dental , Dentina , Estética Dental , Humanos , Ensayo de Materiales , Cementos de Resina , Resistencia a la Tracción
12.
Am J Orthod Dentofacial Orthop ; 159(1): 53-58, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33221094

RESUMEN

INTRODUCTION: To assess the esthetic subjective effect of malocclusions in the anterior segment on children in the mixed dentition. METHODS: A cross-sectional study was carried out with a population-based sample of 787 children aged 8-10 years in the late mixed dentition (n = 787). Orthodontic Aesthetic Subjective Impact Score determined the esthetic subjective effect. For assessing the malocclusions in the anterior segment (anterior crowding, anterior spacing, diastema, anterior open bite, and anterior maxillary overjet), the following Dental Aesthetic Index criteria were used. Sex, family income, and education level were used as control variables. The variables were analyzed using a simple logistic regression model, estimating crude odds ratios. The variables with P <0.20 in the simple analyses were tested in multiple regression models, estimating adjusted odds ratios with the respective 95% confidence intervals. RESULTS: Increased overjet was 1.54 (95% CI: 1.08-2.17) times more likely to cause greater esthetic concern (P <0.05), especially in girls (P <0.05). CONCLUSIONS: Increased overjet negatively affected children's esthetic self-perception in the mixed dentition.


Asunto(s)
Maloclusión , Mordida Abierta , Niño , Estudios Transversales , Dentición Mixta , Estética Dental , Femenino , Humanos
13.
Am J Orthod Dentofacial Orthop ; 159(1): 81-85, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33229184

RESUMEN

INTRODUCTION: This study aimed to associate 2 indexes for evaluating malocclusion in the mixed dentition. METHODS: A population-based cross-sectional study was conducted involving 743 children aged 8-10 years, divided into early and late mixed dentition. The Dental Aesthetic Index (DAI) and criteria proposed by Grabowski were used to evaluate malocclusion. Associations between the DAI (outcome variable) and the other independent variables (gender, race, and mixed dentition stage) were analyzed using logistic regression models. Simple logistic regression models were constructed, estimating the crude odds ratios with the respective 95% confidence intervals (CIs). The variables with P < 0.20 in the simple analyses were tested in multiple logistic regression models, estimating adjusted odds ratios with the respective 95% CIs. RESULTS: We found that 84.01% (185/220) of the diagnoses were coincidental between the Grabowski Index and DAI in patients without malocclusion. In contrast, 59.80% (439/734) of the patients were diagnosed by both indexes (Grabowski and DAI) with malocclusion. Children with malocclusion, diagnosed by the Grabowski Index, were 5.85 (P = 0.0001 and 95% CI: 4.08-8.39) times more likely to show malocclusions when diagnosed by the DAI. CONCLUSIONS: DAI and the criteria proposed by Grabowski were expressed differently in relation to malocclusion in the mixed dentition. This study suggests the importance of specific criteria for the evaluation of malocclusion at this stage of development.


Asunto(s)
Dentición Mixta , Maloclusión , Niño , Estudios Transversales , Estética Dental , Humanos , Maloclusión/diagnóstico , Maloclusión/epidemiología
14.
Compend Contin Educ Dent ; 41(10): 536-542, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33350844

RESUMEN

Digital dental technology has revolutionized the workflows in the dental laboratory and clinical environment. Although the novelty of digital dentistry can be alluring, clinicians should bear in mind that the overall outcome is what matters most rather than the path taken to achieve that outcome. Combining analog and digital pathways can serve to amplify each one and thus enhance the result. This article presents two case examples where an analog excursion in an otherwise digital workflow saved time and reduced cost compared to a dogmatic digital approach. In one case, an alternative workflow is presented to produce implant fixed complete dentures, and in the other case composite was used to generate the pink esthetic component for a complete denture, which could be fixed or removable.


Asunto(s)
Diseño Asistido por Computadora , Estética Dental , Flujo de Trabajo
15.
Facial Plast Surg ; 36(5): 505-516, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33368075

RESUMEN

South East Asian noses have a characteristic ala and columella disproportion and mostly manifest as hanging ala. Simultaneous correction during rhinoplasty is recommended to achieve a good aesthetic result. Since hanging ala is a common feature, a classification system is presented as a guide for surgical management. The classification is based on the frontal view showing the alar rim connecting to the columella lobule area simulating the wings of a gull in gentle flight. A mild deformity has the gull's wing in the horizontal direction. A moderate deformity has the gull's wing in a slight inferior direction. A severe hanging deformity has the gull's wing in the inferior direction, ending below the columella lobule area, and this is mostly accompanied by retracted columella. There are various techniques for the surgical correction of hanging ala. The author has made a modification of the internal approach called "sail excision" using the groove within the lateral nasal vestibule as a landmark. The author terms this area as the vestibular groove. Sail excision involves removal of a triangular portion of tissue anterior to this vestibular groove. Another aesthetic deformity noticed in South East Asian noses is that the alar rim base is lower than the columellar base. In correcting hanging ala with involvement of the alar rim base, the sail excision is extended posteriorly following the vestibular groove as its guide to the amount to be excised. To enhance the overall aesthetic outcome, the acute columella labial angle seen in South East Asian noses has to be made fuller through surgery. This is accomplished using septal extension graft for tip projection, with preservation of the posterior angle of the caudal septum. Plumping grafts are used as filler material in the premaxillary area.


Asunto(s)
Estética Dental , Rinoplastia , Grupo de Ascendencia Continental Asiática , Humanos , Tabique Nasal/cirugía , Nariz/cirugía
16.
Facial Plast Surg ; 36(5): 554-562, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33368079

RESUMEN

Although not as prevalent as in Caucasian rhinoplasty, correction of a hump nose also poses a significant problem for East Asian rhinoplasty. The hump noses in East Asians can be classified as generalized humps, isolated humps, and relative humps with a low tip. Appropriate management of the Asian hump nose demands a good understanding of the anatomical characteristics unique to East Asians. As the East Asians generally prefer to have a nose with a prominent tip and well-augmented nasal dorsum, the concept of redistribution is significant in managing convex dorsum of the East Asians. Hump reduction should be done in a conservative and incremental manner, including careful removal of the bony cap and cartilaginous hump. Tip augmentation using a septal extension graft is an essential maneuver to achieve an aesthetically pleasing tip height, which has a tremendous impact on the overall aesthetic outcome. Midvault reconstruction, dorsal augmentation, and camouflage are additional key elements for the success of the operation. Complications such as undercorrection and dorsal irregularities are not uncommon, requiring surgeons to take utmost care to address them.


Asunto(s)
Implantes Dentales , Rinoplastia , Grupo de Ascendencia Continental Asiática , Estética Dental , Humanos , Tabique Nasal/cirugía , Nariz/cirugía
17.
Facial Plast Surg ; 36(5): 563-574, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33368080

RESUMEN

Differences between Oriental and Caucasian eyelids have been explained in great detail in several reports in the past. The purpose of this article is to discuss the functional aspects of Asian double fold upper blepharoplasty and to present techniques that help to improve both the functional and cosmetic outcomes and satisfaction after surgery. The eyes of Asians are relatively small with thick skin in the eyelids and periorbital area. They typically lack the upper eyelid crease (creating the so-called double eyelid) due to burden factors like thick skin, hypertrophied orbicularis oculi muscle (OOM), submuscular fibroadipose tissue, thick orbital septum, abundant preaponeurotic fat, and lower positioned transverse ligament. Asian eyes may also have a superior visual field defect due to skin overriding the upper lid margin (skin-OOM-fat complex slide down). These burden factors result in the eyelashes appearing short and becoming misdirected and pressed toward the globe, causing functional discomfort. As a compensatory mechanism, Asian people tend to engage the frontalis muscle to lift the eyebrow to help them open their eyes. Along with aesthetic enhancement, double-eyelid surgery in Asian burden lids can improve the functional deficiencies helping the patients to open the eyes more easily. In addition, treatment of the Mongolian fold (medial epicanthal fold), caused by medial hypertrophy of preseptal OOM, augments the surgical results. In this report, we present the appropriate preoperative assessment, surgical technique, and postoperative care that should be employed to achieve consistently good functional and aesthetic outcomes in these patients.


Asunto(s)
Blefaroplastia , Grupo de Ascendencia Continental Asiática , Estética Dental , Párpados/cirugía , Músculos Faciales/cirugía , Humanos
18.
Facial Plast Surg ; 36(5): 602-612, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33368083

RESUMEN

A prominent mandible that gives a squared face in Asians is considered unattractive as it imparts a coarse and masculine image. Mandibular contouring surgery allows slender oval faces. The purpose of conventional mandible reduction is to make the lower face appear slim in frontal view and to have a smooth contour in lateral view. As shaping the lateral contour of the mandible alone may result in minimal improvement in the frontal view, surgical techniques to reduce the width of the lower face through narrowing genioplasty (i.e., the "V-line" surgery) and sagittal resection of the lateral cortex should be combined. Examination of the shape and symmetry, the relationship between the maxilla and the mandible, understanding overlying soft tissue contribution, and understanding the overall balance of the face are mandatory. An important factor influencing ideal facial shape is patient's personal preference, which is often influenced by his/her ethnic and cultural background. Especially when consulting patients of different nationalities or ethnic backgrounds, careful attention should be paid to the patient's aesthetic sensibility regarding the ideal or desirable facial shape. Narrowing the chin and modification of chin shape can be accomplished by narrowing genioplasty with central strip resection. This midsymphyseal sectioning procedure yields safe and very satisfactory results. This procedure not only augments the narrowing effect by leaving soft tissues attached to the bone but also enables modification of chin shape by altering the shape of resection. The surgeon should customize the surgery based on a comprehensive assessment of the patient's preoperative chin and mandible morphology complemented by an assessment of their aesthetic goals.


Asunto(s)
Estética Dental , Mandíbula , Grupo de Ascendencia Continental Asiática , Mentón/cirugía , Femenino , Mentoplastia , Humanos , Masculino , Mandíbula/cirugía
19.
Facial Plast Surg ; 36(5): 613-622, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33368084

RESUMEN

Zygoma reduction is indicated in patients where the primary aim of surgery is reduction in the width of cheekbones to achieve smoother and more feminine facial aesthetic lines. Surgeons should evaluate the width of midface (bizygomatic width) and the protrusion of zygoma (volume and position of the zygomatic body) when evaluating patients where such a procedure is indicated. Intraoral high-L osteotomy is the most useful method to successfully treat a wide spectrum of zygomatic protrusions and is widely accepted as the treatment of choice for aesthetic purposes. The amount of ostectomy is determined by evaluating the volume of zygomatic body. The zygomatic body and arch are usually moved posteromedially during surgery; the point of maximal malar projection is evaluated and transposed to a new ideal position. Zygoma reduction can be performed solely or in combination with other facial bone contouring procedures such as mandible reduction, genioplasty, or forehead augmentation. Soft tissue sagging, nonunion, malunion, and paresthesia are the most common complications of this procedure. Undercorrection and asymmetry are the most common aesthetically unfavorable sequelae and should be carefully prevented by proper preoperative planning and meticulous execution of surgical technique.


Asunto(s)
Procedimientos Quirúrgicos Reconstructivos , Cigoma , Estética Dental , Humanos , Mandíbula/cirugía , Osteotomía , Cigoma/diagnóstico por imagen , Cigoma/cirugía
20.
Facial Plast Surg ; 36(6): 711-714, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33368126

RESUMEN

Orbitocranial reconstruction objectives include creation of a solid barrier between intracranial contents and the environment allowing restoration of physiologic homeostasis and restoration of aesthetic craniofacial contours. Historically, bone grafts have been used for reconstruction but were fraught with unpredictable resorption and imperfect contouring given the complex anatomy of the orbitofrontal bones. With advances in three-dimensional modeling technology, alloplastic custom implants in orbital and frontal bone reconstruction have allowed for rapid fixation reducing surgical times and improved cosmesis.


Asunto(s)
Implantes Dentales , Procedimientos Quirúrgicos Reconstructivos , Trasplante Óseo , Estética Dental , Hueso Frontal/cirugía , Humanos , Órbita/cirugía
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