The influence of extraction and nonextraction orthodontic treatment on brachyfacial and dolichofacial growth patterns.

The effects of extraction and nonextraction orthodontic treatment mechanics on patients with dolichofacial and brachyfacial growth patterns between one and two standard deviations were studied. Groups underwent treatment of either nonextraction or extraction of four premolars with the appropriate mechanics for the facial type. Changes in the facial axis and correlation between maxillary molar movement and facial axis change were measured. A positive correlation was found between the amount of anteroposterior movement of the upper molar and change in the facial axis in brachyfacial and dolichofacial patients undergoing nonextraction treatment. A weak correlation was found in the extraction treatment groups. No statistically significant difference was found in the facial axis change among any of the groups studied, regardless of facial type or plan of treatment. There were indications of a more severe opening of the facial axis (Ba-Na plane to constructed gnathion) with greater degrees of maxillary molar distal movement in both facial patterns studied.     

拔牙矫治对面部侧貌影响的软组织头影测量研究

目的：探讨拔牙矫治对面部侧貌软组织平衡的影响。方法：选择15例以直丝弓矫治的拔牙矫治病例，对矫治前后患者的软组织侧貌的X线头颅侧位定位片进行测量分析。结果：①拔牙矫治后，面角，鼻唇角，Z角增大；②上唇长度，上唇厚度，下唇厚度增加，上唇突度减小，统计结果均有显著性差异；③正畸治疗后，软组织侧面突度通过拔牙矫治变小，面型由突面型成为较平直的面型；④患者面部侧貌治疗后软组织头影测量指标均值均在正常范围内。结论：拔牙矫治可改善面部的软组织平衡。     

正畸治疗后软组织面形的预测方法

正畸治疗后患者的软组织面形是医生和患者共同关注的焦点,而正畸治疗后,期望达到怎样的面形和究竟能达到怎样的面形是医生和患者之间难以沟通的问题.本文就正畸治疗前后患者的软组织面形的分析和预测方法作一综述.     

Patients’ narratives of orthognathic treatment for facial asymmetry: a qualitative study

To explore patients’ experiences of orthognathic treatment for facial asymmetry and their adaptation to facial changes after surgery, we did a qualitative, cross-sectional study of patients after treatment for non-cleft asymmetry at two UK sites. A total of 15 patients aged 19-40 years were approached after being identified using patient databases and clinical notes. Individual and photo-elicitation interviews were conducted covering experiences prior to treatment, during treatment, and after surgery. Interviews were transcribed and thematic narrative analysis undertaken. Participants were largely positive about their orthognathic treatment. The following themes were identified: preoperative (becoming aware, negative impacts of asymmetry, committing to treatment, establishing expectations), pre-surgery orthodontics and inpatient experiences (challenges and coping strategies, preparedness, support, and shared experiences); and postoperative (surgery as ‘worth it’, positive impacts of treatment, adapting to facial change). Undergoing orthognathic surgery was portrayed as a journey involving recognisable narratives (treatment unfinished, threat of liminality, treatment as resolution, and treatment as transformation). Patients’ experiences of facial asymmetry are associated with feeling ‘abnormal’, and negative impacts, and orthognathic treatment for facial asymmetry is worthwhile. Having the feeling that something is ‘wrong’ legitimised by clinicians allows patients access to a recognisable treatment narrative (resolution). Orthognathic treatment is also described as transformation from ‘normal abnormality’ to being ‘normal’. Nevertheless, the associated challenges can be frustrating, particularly if resolution is hard to envisage. Further psychological input could help patients cope with these challenges and the complex process of adapting to facial change.     

Peripheral facial nerve paralysis of dental origin.

The aetiology, diagnosis and treatment of peripheral facial nerve palsy are discussed. Four cases of facial nerve palsy following dental procedures are reported. Following a revision of the world literature during the last 23 years, the 25 cases of facial nerve palsy documented are analysed and divided into four groups on the basis of aetiology, speed of onset and recovery and modes of treatment suggested.     

Facial fractures occurring in a medium-sized metropolitan area: recent trends

A retrospective 3-year survey of 311 patients sustaining 564 facial fractures in a medium-sized metropolitan area is presented. Etiology, distribution and treatment of these facial fractures are reported and compared with earlier studies, where changing patterns of etiology and treatment were noted. Contemporary knowledge of facial injuries is important if diagnosis and treatment are to be accurate and treatment optimal.     

Innovative Approach for Interim Facial Prosthesis Using Digital Technology

Despite the important role of facial prosthetic treatment in the rehabilitation of head and neck cancer patients, delay in its implementation can be unavoidable, preventing patients from receiving a prompt facial prosthesis and resuming a normal social life. Here, we introduce an innovative method for the fabrication of an interim facial prosthesis. Using a 3D modeling system, we simplified the fabrication method and used a titanium reconstruction plate for facial prosthesis retention. The patient received the facial prosthesis immediately after surgery and resumed a normal social life earlier than is typically observed with conventional facial prosthetic treatment.     

McLaughlin’s legacy in the current treatment of facial palsy

Charles Redmond McLaughlin was a pioneer in both facial palsy surgery and in facial plastic surgery (East Grinstead, 1946-1969). Thanks to his work, the personalised treatment of facial palsy was begun.     

Assessment of orthodontic treatment need: a comparison of study models and facial photographs

Abstract – Objectives: The current study aims to examine how orthodontic treatment need is prioritized depending upon whether dental study models or facial photographs are used as the means of assessment. Methods: A group of three orthodontists and three postgraduate orthodontic students assessed: (i) dental attractiveness; and (ii) need for orthodontic treatment in 40 subjects (19 males, 21 females). The 40 subjects displayed a range of malocclusions. Separate assessments were made from study models and facial photographs. Results: There was a bias towards higher scores for dental attractiveness from facial photographs compared with assessment of study casts, for all examiners. This was statistically significant for five of the six examiners (P = 0.001–0.101). The need for orthodontic treatment was rated as 20% higher from study models compared with facial photographs (P < 0.001); overall the level of need for orthodontic treatment was rated as 18.9% higher from study models compared with facial photographs (P < 0.001). Reproducibility analyses showed that there was a considerable variation in the intra‐ and inter‐examiner agreement. Conclusions: This study shows that a group of three orthodontists and three postgraduate students in orthodontics: (i) rated orthodontic treatment need higher from study models compared with facial photographs and; (ii) rated dental attractiveness higher from facial photographs compared with study models. It is suggested that the variable intra‐examiner agreement may result from the assessment of orthodontic treatment need and dental attractiveness in the absence of any specific assessment criteria. The poor reproducibility of assessment of orthodontic treatment need and dental attractiveness in the absence of strict criteria may suggest the need to use an appropriate index.     

不同年龄组偏颌患者正畸治疗前后面部对称性变化的研究

目的对偏颌患者正畸治疗前后的X线头颅正位片和正面面像进行测量,分析偏颌患者颜面软组织及硬组织的对称性的变化。方法选择年龄12～16岁(青少年组20例)和23～28岁(成年组20例)的2组偏颌患者作为研究对象,男女各半,计算治疗前后面部软硬组织的非对称率。数据采用SPSS 13.0软件包进行统计分析,采用配对t检验对治疗前后的测量项目进行分析。结果青少年组正畸治疗前,Mas、Max的非对称率低,Go、Ag的非对称率高于5%,Me偏斜大于3.0 mm。治疗后,Go、Ag的非对称率明显降低,正面面像测量结果与硬组织测量结果一致。成年组治疗前,Mas、Max、Go、Ag的非对称率异常,Me偏斜大于3.0 mm。治疗后,Go、Ag的非对称率稍有降低。面像测量数据显示,软组织对称性与硬组织一致,面部非对称率少小于硬组织。结论偏颌患者面部的对称性从面中1/3到面下1/3依次降低,软硬组织的对称性一致,成年组的软组织对称性稍好于硬组织。青少年组经过正畸治疗,面部对称性改善较大,成年偏颌患者改善有限,提示偏颌畸形需尽早矫治。     

Facial aesthetics: 2. Clinical assessment

The clinical ability to alter dentofacial form requires an understanding of facial aesthetics. This is vital for any clinician involved in treatment that will alter a patient's dentofacial appearance, whether through orthodontics, facial growth modification, corrective jaw surgery or aesthetic dentistry. Part 1 of this article covered the historical and theoretical aspects of facial aesthetics and their importance in contemporary dentofacial treatment. Part 2 covers important aspects of the interview and clinical assessment of patients requiring alterations in their dentofacial appearance, including guidelines used in the assessment of facial proportions and symmetry. CLINICAL RELEVANCE: These articles cover the theoretical and clinical aspects of facial aesthetics required by clinicians involved in the treatment of dentofacial deformity.     

氨基胍干预对创伤性面瘫大鼠外周面神经及周围组织一氧化氮合酶表达的影响

目的　研究诱导型一氧化氮合酶抑制剂氨基胍对创伤性面瘫大鼠外周面神经及周围组织一氧化氮合酶表达的影响。方法　通过大鼠面瘫前后腹膜内小剂量给予氨基胍,在伤后各个时间点切取损伤面神经和软组织, 采用兔抗大鼠一氧化氮合酶(NOS)抗血清免疫组织化学ABC法对面神经和肌肉软组织内NOS表达的变化进行研究。结果　氨基胍组面神经和肌肉软组织伤后诱导型一氧化氮合酶免疫反应性明显降低。结论　氨基胍慢性干预明显抑制面神经和肌肉软组织内诱导型一氧化氮合酶的表达,为面神经再生与组织创伤修复创造了有利条件。     

Expectations of treatment and satisfaction with facial appearance in Nigerian orthodontic patients.

The aim of this study was to investigate correlation between satisfaction with facial appearance and expectations of orthodontic treatment. The effects of sex and age on these variables were also explored. A sample of 201 patients who presented for orthodontic treatment at two referral centers in Nigeria: the Orthodontic Unit, University College Hospital, Ibadan and Department of Child Dental Health, Lagos University Teaching Hospital, Lagos, completed a questionnaire on satisfaction with facial appearance and expectations of orthodontic treatment. They consisted of 89 (44.3%) males and 112 (55.7%) females with age range of 8 to 40 years (mean age, 13.60 +/- 8.03 SD). Correlation between patients' expectations, satisfaction with facial appearance, age and sex were examined. A multiple regression analysis was used to estimate the effect of the initial facial satisfaction on expectations of orthodontic treatment. No significant correlation was found between satisfaction with facial appearance and patients' expectations. The correlation was invariant over gender, but age was found a significant predictor of expectations of orthodontic treatment for patients up to 16 years of age (r = .210; p < 0.05). It was concluded that satisfaction with facial appearance is not a significant predictor of Nigerian orthodontic patients' expectations of treatment. However, age was found a significant predictor of orthodontic patients' expectations of treat-ment for the child orthodontic population sub-sample.     

Facial aesthetics: 1. Concepts and canons

The clinical ability to alter dentofacial form requires an understanding of facial aesthetics. This is vital for any clinician involved in treatment that will alter a patient's dentofacial appearance, whether through orthodontics, facial growth modification, corrective jaw surgery or aesthetic dentistry. Part 1 of this article aims to cover the historical and theoretical aspects of facial aesthetics and their importance in contemporary dentofacial treatment. Part 2 will cover important aspects of the interview and clinical assessment of patients requiring alterations in their dentofacial appearance, including guidelines used in the assessment of facial proportions and symmetry. Clinical Relevance: These articles cover the theoretical and clinical aspects of facial aesthetics required by clinicians involved in the treatment of dentofacial deformity.     

点阵激光在面部美容中的疗效观察

目的：评价点阵激光在面部美容中的疗效。方法：从2009年10月-2010年8月,用点阵激光进行面部美容158例,其中皱纹52例,毛孔粗大43例,色斑35例,嫩肤28例。结果：总有效率为94％,痊愈率为58％,显效率为86％。效果最好为嫩肤,其次是毛孔粗大、皱纹、色斑。结论l点阵激光在面部美容中疗效显著。     

原发于腮腺内面神经鞘瘤3例的临床分析

目的 探讨原发于腮腺内的面神经鞘瘤的临床特点、诊断及治疗方法 。方法 3例术前均被误诊,均行手术治疗。其中2例来源于面神经的末梢分支,1例源于面神经的主干,术后病理及免疫组化明确诊断为神经鞘瘤。结果 3例随访,均无复发,1例术后出现面神经麻痹症状加重,2例治愈。结论 神经鞘瘤诊断须依靠病理学分析,影像学检查亦有辅助诊断的价值。应手术完整摘除,努力保存面神经的功能。     

Cephalometric soft tissue facial analysis.

My objective is to present a cephalometric-based facial analysis to correlate with an article that was published previously in the American Journal of Orthodontic and Dentofacial Orthopedics. Eighteen facial or soft tissue traits are discussed in this article. All of them are significant in successful orthodontic outcome, and none of them depend on skeletal landmarks for measurement. Orthodontic analysis most commonly relies on skeletal and dental measurement, placing far less emphasis on facial feature measurement, particularly their relationship to each other. Yet, a thorough examination of the face is critical for understanding the changes in facial appearance that result from orthodontic treatment. A cephalometric approach to facial examination can also benefit the diagnosis and treatment plan. Individual facial traits and their balance with one another should be identified before treatment. Relying solely on skeletal analysis, assuming that the face will balance if the skeletal/dental cephalometric values are normalized, may not yield the desired outcome. Good occlusion does not necessarily mean good facial balance. Orthodontic norms for facial traits can permit their measurement. Further, with a knowledge of standard facial traits and the patient's soft tissue features, an individualized norm can be established for each patient to optimize facial attractiveness. Four questions should be asked regarding each facial trait before treatment: (1) What is the quality and quantity of the trait? (2) How will future growth affect the trait? (3) How will orthodontic tooth movement affect the existing trait (positively or negatively)? (4) How will surgical bone movement to correct the bite affect the trait (positively or negatively)?     

颜面缺损赝复数字化诊疗体系

传统的颜面缺损赝复诊疗过程复杂、效率低,且美观及精度差,无法满足患者的要求。20世纪90年代开始,计算机辅助设计和制作技术的引入开创了颜面缺损赝复诊疗技术发展的新篇章。经过10多年的研究与发展,已逐步形成一套颜面缺损赝复数字化诊疗体系,该体系包括：颜面缺损信息的数字化采集、赝复体的计算机辅助设计和赝复体快速成型加工。随着该体系的进一步完善,必将成为颜面缺损赝复诊疗的发展方向与主流技术。     

Three-dimensional assessment of functional change following Class 3 orthognathic correction - A preliminary report

Orthognathic surgery is a well-documented clinical procedure for patients who complain of functional and aesthetic problems related to dento-facial imbalance. The aims of treatment are to establish facial harmony, normalise function and maximise the stability of the outcome. Conventional diagnostic aids to treatment include plain film radiographs and photographs which provide a static analysis of the facial structures at a particular point in time. Functional assessment of facial movement is rarely performed but could have important implications on the stability of the surgery through post-surgical soft tissue adaptation to the new skeletal relationships. A case report is presented for which novel three-dimensional motion analysis techniques were used to assess facial movement through the surgical correction of a Class 3 malocclusion. It was found that facial movement increased for all circum-oral postures post-surgery. Future research in this field recommends collection of data from a control group to allow comparisons of facial movement between different surgical samples.     

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目的    探讨面中部骨折的特点、治疗方法及并发症的处理。方法    对2005年1月至2009年12月中国医科大学第一附属医院整形外科收治的142例面中部骨折的病例资料进行总结分析。结果    患者伤口全部愈合良好,面部外形恢复满意,部分患者配合1～2周的颌间牵引,咬合关系、张口度恢复正常。结论    三维重建CT在诊断鼻、眶、颧、上颌骨骨折中有重要临床参考意义,正确复位后坚固内固定是常用治疗方法。