The enigma of the mental foramen as it relates to plastic surgery.

The mental foramen position changes because of individual characteristics, and the knowledge of its location is paramount in a number of surgical procedures. This study's goal was to assess its position in relation to dentition and its symmetry in a Brazilian population. One hundred ninety-one dried jaws were divided in 3 groups according to the presence or absence of dentition and bone resorption in the foramen region. Standardized measurements of the distance between the foramen and anatomical references were made to establish its position and symmetry. The majority of the specimens studied belonged to white (74%) male (72%) individuals. The foramen most frequent position, using the teeth as reference, was between the premolars for both sexes (males, 41%; females, 60.3%). Most of the mandibles (56%) did not present symmetry between the right and left sides. Accessory foramina were found in 13.6% of jaws. The most frequent position of the mental foramen was between the premolars (position III of Tebo and Telford [Anat Rec 1950;107:61-66]), and they were predominantly asymmetric. The group with no teeth in the mental foramen area showed a reduction of the distance between the alveolar margin of the jaw and the mental foramen.

Tratamento cosmético com OnabotulinumtoxinA (Botox®): relação entre avaliação clínica inicial, dosagem e custos / Cosmetic treatment with OnabotulinumtoxinA (Botox®): relationship between initial clinical assessment, dosage and costs

Objetivo: O objetivo deste trabalho é demonstrar como a correta avaliação clínica pode influenciar na dosagem utilizada no tratamento cosmético de onabotulinumtoxinA (Botox®, Allergan, Inc, Dublin, UK) e sua consequente relação com custo e valor do tratamento a longo prazo. Método: Foram selecionados quatro pacientes para tratamento cosmético com Toxina Botulínica tipo A. Foi realizado registro fotográfico pré-procedimento, com 15 dias pós-procedimento; 3, 4, 7 e 10 meses pós-procedimento. A avaliação inicial dos pacientes, a técnica, objetivo e as dosagens utilizadas foram comentadas pelo médico que efetuou o tratamento. A avaliação e os comentários das fotos pós-procedimentos foram realizados por outro médico especialista. Resultados: Todos os pacientes tiveram as regiões frontal, glabelar e peri-orbital tratadas. As doses totais utilizadas em cada paciente foram: paciente 1: 64U; paciente 2: 69U; paciente 3: 78U e paciente 4: 81U. Conclusões: A correta avaliação clínica é fundamental para o adequado planejamento do tratamento cosmético com Botox®. Resultados duradouros, que geram alta satisfação aos pacientes, estão associados à correta escolha das doses. O custo do tratamento cosmético de Botox® deve ser avaliado de forma global e a longo prazo.

Objective: The aim of this study is to demonstrate how the correct clinical assessment can influence the dosage used in the cosmetic treatment with onabotulinumtoxinA (Botox®, Allergan, Inc., Dublin, UK) and its consequent relationship to cost and value of long-term treatment. Method: Four patients were selected for cosmetic treatment with Botulinum Toxin Type A. Patients` pictures were taken pre procedure, 15 days post procedure, 3, 4, 7 and 10 months post procedure. The patient initial evaluation, technique, objective and dosages used were commented by the doctor who performed the treatment. Evaluation and comments of the pictures post procedure were performed by another medical specialist. Results: All patients had the frontal, glabellar, and periorbital areas treated. Total doses used for each patient were as follows: patient 1: 64U; patient 2: 69U; patient 3: 78U and patient 4: 81U. Conclusions: The correct clinical assessment is essential for proper planning of cosmetic treatment with Botox®. Long lasting results, with high satisfaction rates among patients, are associated with the correct choice of doses. The cost of Botox® cosmetic treatment should be evaluated comprehensively and in a long term manner.