True vertical validation in facial orthognathic surgery planning.

OBJECTIVES: To validate the effectiveness of the original standards of True Vertical (TV) Subnasal Line in orthognatic surgery planning. The present study evaluates the changes occurring in patients with skeletal Class II alterations programmed for orthognathic surgery with a view to improving their facial profile. STUDY DESIGN: [corrected] We showed a series of black profiles (composed by a first control group of subjects with normal occlusion, and another two additional groups comprised patients before -Group 2- and after orthognatic surgical correction of Class II malocclusion -Group 3-) for three groups of observers (orthodontists, surgeons and laypeople). The facial images became black silhouettes in order to determine a series of parameters (including aesthetic assessment) by means of the observers. Their observation were assessed using a 5-point Likert scale. RESULTS: The sample was composed of 52 profile's subjects who were tested for a total of 72 observers. Aesthetic assessment yielded mean scores of 2.57, 1.67 and 2.46 for groups 1, 2 and 3, respectively. There was a statistically significant difference (p<0.001) between group 1 versus group 2. There were no significant differences in terms of observer assessment of aesthetics, with the exception of a wider perception range among the orthodontists. Regarding the studied profile measures, significant differences were recorded for point B' and Pg' (p<0.02) between groups 2 and 3 (i.e., pre- versus post-surgery). CONCLUSIONS: The results of our study suggest the subnasale vertical and sagittal measures of the lower third of the face are decisive in facial aesthetics, and therefore also for the planning of orthognathic surgery. Consequently, these aesthetic parameters can be used as an objective tool for the planning of orthodontic treatment. Key words:Facial profile, Class II, orthognathic surgery, cephalometric analysis, facial soft tissue, subnasale vertical.

Arcos segmentados. Mecánica de cierre en las mordidas abiertas. Aportaciones clínicas / Segmented arches. Closure mechanism in open bite. Clinical contributions

La mordida abierta es una entidad muy frecuente asociada a una etiología multifactorial. De ahí que en el tratamiento haya que considerar todo el recorrido en su aparición, intentando llegar hasta los procesos etiológicos que permitan la corrección de la misma. En este trabajo, presentamos una mecánica sencilla que nos permite, mediante modificaciones en el plano oclusal (segmentación de los arcos), conseguir el cierre de la misma; este método resulta de extrema sencillez y fácilmente tolerable por el paciente. No sólo aporta un sistema eficaz en el cierre, sino una ayuda en la mecánica habitual para corregir situaciones de falta de oclusión parcial, uni o bilateral de las arcadas dentarias (AU)

Open bite is a highly common entity that is associated with a multifactorial etiology. Hence, all the steps involved in its development should be considered in its treatment, attempting to identify the etiological processes that allow this entity to be corrected. in this article, we present a simple mechanism that allows closure to be achieved through changes in the occlusal plane (arch segmentation). This method is extremely simple, and is easily tolerated by the patient. Moreover, this mechanism not only provides an effective system for closure, but also helps to correct situations of uni- or bilateral malocclusion of the dental arches (AU)

Rol de las maloclusiones en la génesis de disfunción craneomandibular (revisión bibliográfica) / The role of malocclusions in the etiology of craniomandibular dysfunction (a review of the literature)

Este trabajo consiste en una revisión bibliográfica sobre el papel que juegan las maloclusiones como etiología de disfunción craneomandibular. Se analizan maloclusiones de tipo transversal, sagital, vertical e interferencias oclusales (oclusión no funcional) y cómo éstas producen alteraciones en diferentes estructuras del sistema estomatognático, que podrían traducirse, al no ser tratadas, en disfunción craneomandibular. Se clasificaron las publicaciones revisadas de acuerdo a los siguientes criterios: si las maloclusiones corresponden a factores etiológicos de disfunción y el tipo de estudio de cada artículo)punto de vista del autor, estudio de corte transversal o estudio longitudinal). Se concluye que existe controversia entre los artículos publicados en relación al rol de las maloclusiones en la génesis de disfunción craneomandibular. La mayoría de ellos muestra asociaciones entre factores oclusales y problemas disfuncionales, pero no se puede establecer una relación causa-efecto entre ellos