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INTRODUCTION: Corticotomy is widely used in clinical practice to accelerate tooth movement and shorten the duration of orthodontic treatment. It is effective, but an invasive surgery is needed to induce alveolar bone osteopenia that enable rapid tooth movement. In this study, we discovered the potential of 6-shogaol as a more patient-friendly non-invasive alternative to induce transient osteopenia and accelerate tooth movement. MATERIALS AND METHODS: The effects of 6-shogaol on the bone marrow macrophages (BMM) proliferation and osteoclast differentiation, and bone resorption were determined in vitro. Sprague-Dawley rats were distributed into three groups: CON, IPinj or Localinj and euthanized at day 28. Micro-CT, histology, immunohistological, and TUNEL analysis were performed to evaluate the tooth movement acceleration effect of 6-shogaol. RESULTS: In vitro, 6-shogaol promotes osteoclast differentiation and functional demineralization of alveolar bone. RANKL-induced mRNA expression of osteoclastic-specific genes was significantly higher in the presence of 6-shogaol. A dose-dependent increase in the area of TRAP-positive cells was observed with 6-shogaol treatment. F-actin ring formation and increased bone resorption confirmed that osteoclasts treated with 6-shogaol were mature and functional. 6-shogaol stimulated JNK activation and NFATc1 expression during osteoclast differentiation. In vivo, 6-shogaol promotes alveolar bone transient osteopenia and accelerates orthodontic tooth movement. Alveolar bone mass was reduced, more osteoclasts were observed in bone resorption lacunae on the compression side, and the expression of RANKL and sclerostin were higher than the control group. In conclusion, our results suggest that 6-shogoal accelerates tooth movement by inducing osteopenia by a mechanism similar to surgically induced bone injury.
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Reabsorção Óssea , Técnicas de Movimentação Dentária , Animais , Catecóis , Humanos , Fatores de Transcrição NFATC , Osteoclastos , Ratos , Ratos Sprague-DawleyRESUMO
OBJECTIVES: In patients with facial paralysis, facial reanimation surgery may be needed to normalize facial soft tissue function/movements. Critical for this normalization is the dynamics of the nasolabial folds (NLFs). The objective of this prospective, observational study was to determine the 3D morphologic dynamics of the NLFs in patients with unilateral facial palsy and normal subjects. SETTINGS AND SAMPLE POPULATION: 3D facial soft tissue movement data collected from adults with unilateral, facial paralysis (Bell's Palsy, n = 36); and (2) an age- and sex-frequency matched control group (n = 68). MATERIALS AND METHODS: Movement data were collected during repeated animations from participants using a video-based motion capture system. Movement in terms of displacement and asymmetry of the NLFs, nasal and circumoral regions were analyzed in the lateral, vertical and depth planes; as well as movement of the commissure and NLFs relative to the lower lip midline. Two-sample t tests were used to test for significant group differences. RESULTS: Patients NLFs had less mean displacement, greater mean asymmetry and uncoordinated movements compared with the controls. For both groups during smiling, the NLF and commissure landmarks had approximately similar magnitudes of displacement (control range = 11-14mm; patient range = 7-10mm). CONCLUSION: NLF dynamics during smiling were as significant as oral commissure excursion. Thus, an immobile NLF is an unnatural feature of facial animations. Surgical treatments that address impaired NFL movements must be considered to create a more natural surgical outcome especially during smiling.
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Paralisia Facial , Adulto , Paralisia Facial/cirurgia , Humanos , Lábio/cirurgia , Sulco Nasogeniano/cirurgia , Estudos Prospectivos , SorrisoRESUMO
INTRODUCTION: The objective of this research was to evaluate and compare linear and surface accuracy of dental models fabricated using 3 different vat photopolymerization printing units: digital light synthesis (M2 Printer; Carbon, Redwood City, Calif), digital light processing (Juell 3D Flash OC; Park Dental Research, New York, NY), and stereolithography apparatus (Form 2; Formlabs Inc, Somerville, Mass), and a material jetting printing unit: PolyJet (Objet Eden 260VS; Stratasys, Eden Prairie, Minn). METHODS: Maxillary and mandibular dental arches of 20 patients with the American Board of Orthodontics Discrepancy Index scores ranging between 10 and 30 were scanned using an intraoral scanner. Stereolithographic files of each patient were printed via the 3-dimensional (3D) printers and were digitized again using a 3D desktop scanner to enable comparisons with the original scan data. One-sample t test and linear regression analyses were performed. To further graphically examine the accuracy between the different methods, Bland-Altman plots were computed. The level of significance was set at P <0.05. RESULTS: Bland-Altman analysis showed no fixed bias of one approach vs the other, and random errors were detected in all linear accuracy comparisons. When a 0.25 mm tolerance level was deemed acceptable for any positive or negative surface changes, only the models manufactured from digital light processing and PolyJet units showed more than 97% match with the original scans. CONCLUSION: The surface area of 3D printed models did not yield an utterly identical match to the original scan data and was affected by the type of printer. The clinical relevance of the differences observed on the 3D printed dental model surfaces requires application-specific judgments.
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Modelos Dentários , Impressão Tridimensional , Desenho Assistido por Computador , Humanos , Mandíbula , Maxila , EstereolitografiaRESUMO
OBJECTIVE: (a) To quantify longitudinal 3D changes in facial soft tissue movements in adults with unilateral facial paralysis, and (b) to compare the patients' movements with an age- and sex-frequency matched control group. SETTINGS AND SAMPLE POPULATION: Prospective 3D facial movement data of 36 patients and 68 control participants. Patients' data were collected within 6 weeks of onset of symptoms (baseline) and then at 3 and 12 weeks after baseline. MATERIALS AND METHODS: The 3D facial movement data were collected during different facial animations. Mean group measurements of displacement, velocity and asymmetry were computed. Two sample t tests were used to test for significant group differences, and linear mixed models were fit to test for significant changes over time in the patient group. Also, 3D dynamic modelling and vector plots were computed to isolate the patients' abnormal movements and/or paralysis. RESULTS: The patients' mean baseline movements were significantly less for both the paralysed and contralateral sides of the face with much greater movement asymmetry than the controls. Patients' mean measures improved significantly from baseline to 12 weeks. The measures were closer to, but fell short of, the control values. CONCLUSION: In unilateral facial paralysis, the contralateral facial side was affected by the paralysis and may be tethered or limited in its movement by the paralysed side. The comprehensive measurement set and 3D facial mapping effectively tracked patient recovery and isolated paralysed facial regions. The 3D measures can be used for diagnosis and outcome assessment of different treatments.
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Paralisia Facial , Adulto , Face , Músculos Faciais , Humanos , Estudos Prospectivos , Amplitude de Movimento ArticularRESUMO
OBJECTIVE: To identify child-, surgeon-, and hospital-specific factors at the time of primary cleft lip repair that are associated with the use of secondary cleft lip surgery. DESIGN: Retrospective cohort study. SETTING: Forty-nine pediatric hospitals. PARTICIPANTS: Children who underwent cleft lip repair between 1999 and 2015. MAIN OUTCOME MEASURE: Time from primary cleft lip repair to secondary lip surgery. RESULTS: By 5 years after primary lip repair, 24.0% of children had undergone a secondary lip surgery. In multivariable analysis, primary lip repair before 3 months had a 1.22-fold increased hazard of secondary surgery (95% confidence interval [CI]: 1.02-1.46) compared to repair at 7 to 12 months of age, and children with multiple congenital anomalies had a 0.77-fold decreased hazard of secondary surgery (95% CI: 0.68-0.87). After adjusting for cleft type, age at repair, presence of multiple congenital anomalies, and procedure volume, there remained substantial variation in secondary surgery use among surgeons and hospitals (P < .01). For children with unilateral cleft lip repaired at 3 to 6 months of age, the predicted proportion of children undergoing secondary surgery within 5 years of primary repair ranged from 4.9% to 21.8% across surgeons and from 4.5% to 24.7% across hospitals. CONCLUSIONS: There are substantial differences among surgeons and hospitals in the rates of secondary lip surgery. Further work is needed to identify causes for this variation among providers.
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Fenda Labial , Fissura Palatina , Cirurgiões , Criança , Pré-Escolar , Hospitais Pediátricos , Humanos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVES: To investigate the association between upper lip thickness and the amount of upper lip repositioning upon retraction of maxillary incisors. SETTING AND SAMPLE POPULATION: Pre- and post-treatment lateral cephalograms of 101 patients were reviewed. All subjects were treated with fixed orthodontic appliances including extraction of two maxillary premolars. Only subjects without change in lip thickness between pre- and post-treatment cephalograms were included. MATERIAL AND METHODS: Digital software measurements for lip thickness, pre- and post-treatment upper lip position were performed. Appropriate regression models were developed to explore the correlation between maxillary incisor retraction and lip retraction when controlling for lip thickness and other confounding factors. The level of statistical significance was set at 0.05 for all analyses. RESULTS: A significant correlation was found between change in maxillary incisor position following premolars extraction and change in upper lip position (r = 0.95, P < 0.001). The average ratio between maxillary incisor retraction and upper lip repositioning was 1.43:1. Upper lip thickness was not significantly associated with this ratio (r = 0.003, P > 0.05). CONCLUSION: Although there is a highly significant correlation between maxillary incisor retraction and upper lip repositioning, lip thickness is not significantly associated with the amount of repositioning.
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Incisivo/anatomia & histologia , Lábio/anatomia & histologia , Adolescente , Adulto , Cefalometria , Criança , Feminino , Humanos , Masculino , Aparelhos Ortodônticos Fixos , Técnicas de Movimentação Dentária , Adulto JovemRESUMO
OBJECTIVE : To determine whether secondary lip revision surgery impacts sensitivity of the upper lip. DESIGN : A three-group, parallel, prospective, nonrandomized clinical trial. SETTING : University of North Carolina School of Dentistry. PATIENTS, PARTICIPANTS : Three groups: (1) patients with repaired cleft lip/palate who were scheduled for lip revision (revision; N = 20); (2) patients with repaired cleft lip/palate who did not receive a lip revision (non-revision; N = 13); and (3) non-cleft control subjects (non-cleft; N = 22). Interventions : Lip revision surgery. MAIN OUTCOME MEASURES : Measures of (1) two-point perception threshold (two-point), (2) warmth detection threshold (warm), and (3) cool detection threshold (cool) were obtained from two sites on the upper lip vermilion. The revision participants were tested approximately 1 week before surgery and then approximately 3 and 12 months after surgery. The non-revision and non-cleft participants were tested at similar times. RESULTS : There were no significant differences among the three groups at baseline for two-point, warm, or cool. The main effects of group, age, sex, and time were not statistically significant for the two-point or warm (p > .05). The mean differences between the 3- and 12-month follow-up visits and baseline for two-point and warm were small for all three groups. For cool, group was statistically significant (p = .04), the difference in the non-revision group between follow-up and baseline was 31% to 34% higher than in the non-cleft group (p = .01). CONCLUSIONS : Although at postsurgery revision participants exhibited threshold values comparable to presurgical values, the sensory differences observed among subgroups of participants with cleft lip are complex.
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Fenda Labial , Lábio , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Lábio/cirurgia , Estudos ProspectivosRESUMO
Objective : To determine whether a systematic evaluation of facial soft tissues of patients with cleft lip and palate, using facial video images and objective three-dimensional measurements of movement, change surgeons' treatment plans for lip revision surgery. Design : Prospective longitudinal study. Setting : The University of North Carolina School of Dentistry. Patients, Participants : A group of patients with repaired cleft lip and palate (n = 21), a noncleft control group (n = 37), and surgeons experienced in cleft care. Interventions : Lip revision. Main Outcome Measures : (1) facial photographic images; (2) facial video images during animations; (3) objective three-dimensional measurements of upper lip movement based on z scores; and (4) objective dynamic and visual three-dimensional measurement of facial soft tissue movement. Results : With the use of the video images plus objective three-dimensional measures, the operating surgeon changed the problem list of the surgical treatment plan for 86% of the patients (95% confidence interval, 0.64 to 0.97) and the surgical goals for 71% of the patients (95% confidence interval, 0.48 to 0.89). The surgeon group varied in the percentage of patients for whom the problem list was modified, ranging from 24% (95% confidence interval, 8% to 47%) to 48% (95% confidence interval, 26% to 70%) of patients, and the percentage for whom the surgical goals were modified, ranging from 14% (94% confidence interval, 3% to 36%) to 48% (95% confidence interval, 26% to 70%) of patients. Conclusions : For all surgeons, the additional assessment components of the systematic valuation resulted in a change in clinical decision making for some patients.
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Fissura Palatina , Lábio , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Lábio/cirurgia , Estudos Longitudinais , Estudos Prospectivos , CirurgiõesRESUMO
Objectives : (1) To collect three-dimensional, dynamic facial images from two groups of infants: one group born with cleft lip and palate slated to have a primary lip repair and a second, age-matched, noncleft control group. (2) To develop analyses to determine differences in facial movement between infants with cleft lip with or without palate (CL±P) and noncleft control infants and to determine changes in facial movement before and after primary lip repair. Design : Longitudinal, prospective case-control study. Setting : Facial Animation Laboratory at the University of North Carolina School of Dentistry. Participants : Two groups of infants: one group with unrepaired CL±P slated to have primary lip repair (n = 15) and a second group of age-matched, noncleft controls (n = 15). Interventions : Movement testing before and 4 months after primary lip repair in infants with CL±P and at similar time points in noncleft infants. Main Outcome Measures : Seven measures of facial movement. Results : The range of facial movements increased by 17% for all infants during the 4-month period. Compared with the noncleft group (1) infants with unilateral CL±P had 50% less nasolabial movement, and this difference did not change due to the lip repair; and (2) infants with unilateral or bilateral CL±P had 58% and 118% greater lateral upper lip movement, respectively, and 3.67 and 3.56 times greater asymmetry of movement, respectively, before lip repair. The procedure almost entirely removed the hypermobility and decreased the asymmetry. Conclusions : Primary surgical lip repair decreased hypermobility and improved asymmetry of upper lip movement.
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Fissura Palatina , Lábio , Estudos de Casos e Controles , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Estudos ProspectivosRESUMO
Objective: To qualitatively assess surgeons decision making for lip surgery in patients with cleft lip/palate (CL/P). Design: Prospective, non-randomized, clinical trial. Setting: Clinical data institutional laboratory setting. Patients Participants: The study included both patient and surgeon participants recruited from four craniofacial centers. The patient participants were babies with a CL/P requiring primary lip repair surgery (n=16) and adolescents with repaired CL/P who may require secondary lip revision surgery (n=32). The surgeon participants (n=8) were experienced in cleft care. Facial imaging data that included 2D images, 3D images, videos, and objective 3D visual modelling of facial movements were collected from each patient, and compiled as a collage termed the Standardized Assessment for Facial Surgery (SAFS) for systematic viewing by the surgeons. Interventions: The SAFS served as the intervention. Each surgeon viewed the SAFS for six distinct patients (two babies and four adolescents) and provided a list of surgical problems and goals. Then an in-depth-interview (IDI) was conducted with each surgeon to explore their decision-making processes. IDIs were conducted either in person or virtually, recorded, and then transcribed for qualitative statistical analyses using the Grounded Theory Method. Results: Rich narratives/themes emerged that included timing of the surgery; risks/limitations and benefits of surgery; patient/family goals; planning for muscle repair and scarring; multiplicity of surgeries and their impact; and availability of resources. For diagnoses/treatments, surgeons agreed, and level of surgical experience was not a factor. Conclusions: The themes provided important information to populate a checklist of considerations to serve as a guide for clinicians.
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Objective: To qualitatively assess surgeons' decision making for lip surgery in patients with cleft lip/palate (CL/P). Design: Prospective, non-randomized, clinical trial. Setting: Clinical data institutional laboratory setting. Patients Participants: The study included both patient and surgeon participants recruited from four craniofacial centers. The patient participants were babies with a CL/P requiring primary lip repair surgery (n=16) and adolescents with repaired CL/P who may require secondary lip revision surgery (n=32). The surgeon participants (n=8) were experienced in cleft care. Facial imaging data that included 2D images, 3D images, videos, and objective 3D visual modelling of facial movements were collected from each patient, and compiled as a collage termed the 'Standardized Assessment for Facial Surgery (SAFS)' for systematic viewing by the surgeons. Interventions: The SAFS served as the intervention. Each surgeon viewed the SAFS for six distinct patients (two babies and four adolescents) and provided a list of surgical problems and goals. Then an in-depth-interview (IDI) was conducted with each surgeon to explore their decision-making processes. IDIs were conducted either 'in person' or virtually, recorded, and then transcribed for qualitative statistical analyses using the Grounded Theory Method. Results: Rich narratives/themes emerged that included timing of the surgery; risks/limitations and benefits of surgery; patient/family goals; planning for muscle repair and scarring; multiplicity of surgeries and their impact; and availability of resources. In general, there was surgeon agreement for the diagnoses/treatments. Conclusions: The themes provided important information to populate a checklist of considerations to serve as a guide for clinicians.
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OBJECTIVE: To measure and compare the perioral stiffness among three groups of pediatric subjects: a group of patients with a repaired cleft lip (and palate) who had a secondary lip revision surgery (revision), another group of patients with repaired cleft lip (and palate) who did not have secondary surgery (nonrevision), and a group of noncleft "normal" patients (noncleft). DESIGN: A parallel, three-group, nonrandomized clinical trial. PARTICIPANTS: A total of 16 patients with repaired cleft lip/palate who did not have lip revision, 13 patients with repaired cleft lip/palate who had lip revision surgery and were tested at 18 to 24 months postsurgery, and 27 noncleft patients. ANALYSIS: Nonparticipatory perioral stiffness was sampled using a recently developed face-referenced measurement technology known as OroSTIFF. Perioral stiffness, derived as a quotient from resultant force and interangle lip span, was modeled with multilevel regression techniques. Real-time calculation of the perioral stiffness function demonstrated a significant quadratic relation between imposed interangle stretch and resultant force for each of the three groups. RESULTS: This nonlinear stiffness growth function was significantly elevated in the nonrevision patients compared with the noncleft controls and is likely due to the presence of scar tissue in the upper lip; it was significantly lower among patients with cleft lip/palate who completed lip revision surgery. CONCLUSION: This study demonstrates the efficacy of applying an objective measurement to map differences in perioral tissue biomechanics among patients born with orofacial clefts.
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Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Avaliação da Deficiência , Lábio/fisiopatologia , Complicações Pós-Operatórias/fisiopatologia , Adolescente , Fenômenos Biomecânicos , Estudos Transversais , Elasticidade , Feminino , Humanos , Masculino , ReoperaçãoRESUMO
Objective: Residual scarring after cleft lip repair surgery remains a challenge for both surgeons and patients and novel therapeutics are critically needed. The objective of this preclinical experimental study was to evaluate the impact of the methyl-ester of pro-resolving lipid mediator lipoxin A4 (LXA4-ME) on scarring in a novel rabbit model of cleft lip repair. Methods: A defect of the lip was surgically created and repaired in eight six-week old New Zealand white rabbits to simulate human cleft lip scars. Rabbits were randomly assigned to topical application of PBS (control) or 1 ug of LXA4-ME (treatment). 42 days post surgery all animals were euthanized. Photographs of the cleft lip area defect and histologic specimens were evaluated. Multiple scar assessment scales were used to compare scarring. Results: Animals treated with LXA4-ME exhibited lower Visual Scar Assessment scores compared to animals treated with PBS. Treatment with LXA4-ME resulted in a significant reduction of inflammatory cell infiltrate and density of collagen fibers. Control animals showed reduced 2D directional variance (orientation) of collagen fibers compared to animals treated with LXA4-ME demonstrating thicker and more parallel collagen fibers, consistent with scar tissue. Conclusions: These data suggest that LXA4-ME limits scarring after cleft lip repair and improves wound healing outcomes in rabbits favoring the resolution of inflammation. Further studies are needed to explore the mechanisms that underlie the positive therapeutic impact of LXA4-ME on scarring to set the stage for future human clinical trials of LXA4-ME for scar prevention or treatment after cleft lip repair.
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Fenda Labial , Lipoxinas , Animais , Cicatriz/patologia , Cicatriz/prevenção & controle , Fenda Labial/cirurgia , Colágeno , Humanos , Lipoxinas/farmacologia , Lipoxinas/uso terapêutico , Coelhos , CicatrizaçãoRESUMO
The purpose of this article is to describe a dynamic approach for 3-dimensional analyses of facial soft-tissue movements. The method and analysis have numerous applications but, most specifically, are used to assess diagnostic and treatment outcomes of soft-tissue surgery in patients with repaired cleft lip and palate.
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Expressão Facial , Processamento de Imagem Assistida por Computador , Pontos de Referência Anatômicos , Humanos , Imageamento Tridimensional/métodos , Modelos Estatísticos , Movimento , Fatores de TempoRESUMO
OBJECTIVES: To measure and compare three-dimensional lip form in participants with a repaired cleft lip and noncleft control participants. DESIGN: Retrospective study. Three-dimensional facial images of each participant were obtained. PARTICIPANTS: The sample consisted of two groups: a repaired cleft lip group (n â=â 57) and a noncleft "normal" group (n â=â 28). MAIN OUTCOME MEASURES: Thirty-four variables that described the features of each participant's lip form were extracted from the image data. A t test was used for each variable to test for significant differences between the groups, and a mathematical technique was used to categorize the lip forms in both groups. RESULTS: Seventeen variables showed significant between-group differences. The differences were focused on the free edges of the upper and lower lip vermilion borders, upper and lower lip protrusion, and lip symmetry. Lip forms were described by seven categories. Participants with cleft lip were represented in all categories but fell mainly into two categories at one extreme. Noncleft participants were represented in five categories but also exclusively in two categories at the other extreme from participants with a repaired cleft lip. The findings show greater variation in lip form for the participants with a cleft lip. CONCLUSION: Three-dimensional lip form in participants with a repaired cleft lip was found to have greater variation and to be significantly different from that in noncleft participants. This method can be used to assess surgical outcomes of lip form.
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Fenda Labial/patologia , Imageamento Tridimensional , Lábio/patologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Fenda Labial/classificação , Fenda Labial/cirurgia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Estatísticas não Paramétricas , Adulto JovemRESUMO
OBJECTIVES: To investigate the relationship between salivary alkaline phosphatase activity (ALP), protein concentration, and chronological age with cervical vertebral maturation stages (CVMS) as noninvasive biomarkers for skeletal maturity assessment. MATERIALS AND METHODS: This cross-sectional study included 79 subjects (48 females, 31 males; 7 to 23 years old) categorized into five CVMS based on lateral cephalographs evaluated by three examiners. ALP activity and protein concentration in unstimulated whole saliva were compared among five CVMS. The association between age and CVMS was assessed and five multinomial logistic regression models were utilized to predict CVMS based on salivary ALP activity, protein concentration, and chronological age. RESULTS: Salivary ALP reached the peak at early pubertal stage and then declined with a significant difference between CVMS I and CVMS II (P < .001) and between CVMS I and CVMS V (P = .004). A significant positive correlation between age and CVMS was found (rs = 0.763, P < .001). The models' overall correct classification rates for predicting CVMS were 32.9% using protein concentration, 35.4% using ALP activity, and 53.2% using both ALP activity and age. CONCLUSIONS: The combination of salivary ALP activity and chronological age may provide the best CVMS prediction.
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Fosfatase Alcalina , Vértebras Cervicais , Adolescente , Determinação da Idade pelo Esqueleto , Fosfatase Alcalina/metabolismo , Biomarcadores/metabolismo , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Saliva/enzimologia , Adulto JovemRESUMO
BACKGROUND: The objective of this study was to demonstrate simple three-dimensional analyses of facial soft tissue shape and asymmetry. METHODS: There were 2 study samples: one retrospective comprised patients with repaired cleft lip and palate (CL/P) and control subjects; and the other prospective comprised patients with unilateral facial paralysis (FP) and control subjects. The data collected were digitized three-dimensional facial landmarks. Scores for shape and asymmetry of subjects' faces and for different facial regions were generated using Procrustes methods. Pivotal bootstrap methods and analysis of variance were used to test for significant differences in the scores between the patients and controls, and plots of the scores were generated to compare differences among the subjects. RESULTS: (1) Shape scores: The CL/P patients demonstrated significant overall and regional facial differences (P ≤ 0.01). The patients were further from the control mean, especially those with unilateral CL/P. Patients with FP demonstrated significant differences (P ≤ 0.05) for the lower face only. (2) Asymmetry scores: CL/P and FP patients demonstrated significant overall and regional facial differences (CL/P, P ≤ 0.0001; FP, P ≤ 0.01). CL/P and FP patients were more asymmetric and were further from the control mean, and patients with unilateral CL/P were more asymmetric than the bilateral CL/P patients. CONCLUSION: Clinicians can use the analyses to isolate differences and/or changes in the face due to shape or asymmetry, or a combination of both; based on the score plots, the extent of the shape and asymmetry differences can be compared among subjects and the extent of changes due to surgery measured.
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BACKGROUND: The aims of this observational study were 2-fold: (1) To demonstrate a method and measures to quantify impaired facial soft-tissue movements in patients with facial paralysis; and (2) To quantify the differences in magnitude and velocity of facial soft-tissue movements between patients with facial paralysis and control participants. METHODS: The study sample that addressed both aims consisted of 20 adults with acute, unilateral, flaccid facial paralysis who presented at the onset of their paralysis, and a control group of 20 healthy adults. Dynamic 3D facial movement data were collected from each participant during 11 facial animations. To compare the movements between the patients and control participants, dynamic modeling comparisons of mean facial movements were computed as well as plots of movement vectors for each animation, in addition, measures of maximum displacement, movement velocity, and asymmetry were computed. RESULTS: Dynamic 3D modeling of critical facial landmarks provided precise profiles of zone-specific asymmetries and customized reporting that highlighted areas of importance for individual patients. The dynamic 3D movement data confirmed that the nonparalyzed side of patients' faces had abnormal directional movements. As expected, the controls had significantly higher excursive facial movements during all animations except during gentle eye closure, which was greater for the patients and the controls had significantly greater movement velocity than the patients. The patients had significantly greater asymmetry for all the animations, and the hierarchy of the asymmetry was such that maximum smile > lip purse > grimace > cheek puff. CONCLUSION: Dynamic 3D modeling appeared to be an effective tool to provide precise profiles of zone-specific asymmetries and customized reports for patients with facial paralysis.
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A consistent theme in the national dialogue about future directions for the educational arm of dentistry is how best to cultivate a school environment that will be seen as attractive by members of the dental community who desire to serve their profession as teachers and scholars. As a first step toward stimulating broad-based reflection on the working environment within dental schools, the ADEA Commission on Change and Innovation (CCI) conducted a symposium titled "Change, Innovation, and the Quality of Faculty Work-Life" at the 2007 ADEA Annual Session in New Orleans. Aspects of this article are based on the content of this symposium, which explored research on the perceptions and concerns of dental faculty regarding the current academic workplace and provided perspectives of university faculty about university life and career growth. This article reviews the findings from two interview-based qualitative assessments of faculty perceptions of work-life in dental schools and other schools of higher education, presents a preliminary summary of the first national survey of dental school faculty regarding their impressions of the academic work environment, and makes recommendations for enhancing the dental school work environment with an emphasis on those factors that influence career growth. Results from these three studies illustrate faculty perceptions about the promotion and tenure and performance evaluation processes; workload and quality of work-life; and quality of institutional support.
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Docentes de Odontologia , Faculdades de Odontologia , Meio Social , Escolha da Profissão , Feminino , Humanos , Entrevistas como Assunto , Satisfação no Emprego , Masculino , Mentores , Cultura Organizacional , Qualidade de Vida , Desenvolvimento de Pessoal , Inquéritos e Questionários , Ensino , Carga de Trabalho , Local de TrabalhoRESUMO
Results of the annual American Dental Education Association surveys of dental school seniors show approximately 10 percent of graduates enter federal government services while less than 1 percent enter dental academia. To examine this difference, this study sought the perceptions of senior dental students and junior military dental officers regarding their choice of a military career in order to determine how military recruitment strategies influenced their career decisions. Official documents explaining military recruitment efforts were requested from the military services and summarized. In-depth telephone interviews were conducted to gather perception data from the students and dental officers on successful strategies. By employing several strategies, the military was able to inform potential recruits about the benefits of being a dentist in the military. The opportunity to have the military finance a student's dental education was a successful military recruitment tool. Other enticing factors included guaranteed employment upon graduation, prestige associated with serving in the military, access to postgraduate training, minimal practice management responsibilities, and opportunities to continue learning and improve clinical skills without significant financial implications. It was concluded that dental education can use the same strategies to highlight the benefits of an academic career and offer many similar incentives that may encourage students to consider a career path in dental education.