Coverage error of commercial skin pigments as compared to human facial skin tones

Objectives

It is unknown if present-day pigments used for intrinsic colouration of maxillofacial prostheses are representative of human facial skin tones. This study's purpose was to measure L*a*b* values of pigmented elastomers coloured by eleven skin tone pigments and determine coverage error (CE) when the pigments were compared to human facial lip and nose colour data.

Methods

11 skin tone pigments were combined at 0.1%, 1% and 10% by weight with A-2186 elastomer (n = 3). L*a*b* values were measured with a spectrophotometer and group means were used to calculate ΔE* colour differences with each L*a*b* value obtained for human nose and lip. Pigmented elastomer CEs were calculated for nose and lip. Results were compared to CEs for proposed shade guide colours obtained from clustering analyses of facial skin colours.

Results

L* values of pigmented elastomers generally were higher than those measured for nose and lip, whereas a* values were lower. CEs for pigmented elastomers were higher than those obtained from the proposed shade guide obtained from clustered skin measurements.

Conclusions

Overall, the current commercial elastomers appeared to be too white and not red enough to adequately match the skin tones of the subject population. Adjustments must be made to the existing pigmenting system in order to adequately match the skin colours of the study population.

Clinical significance

The creation of a shade guide and a collection of intrinsic pigments representing the realm of human facial skin colours would greatly decrease the time a patient must sit while the clinician is obtaining an acceptable colour match for the silicone to be used for processing the final prosthesis, thereby increasing both patient satisfaction and clinician productivity.     

牙龈生物型对上前牙全瓷冠美学修复效果的影响

将48例患者共56颗患牙分为厚龈型组、薄龈型组各28颗,经氧化锆全瓷冠修复上前牙于修复前及修复后1、2年,评价其牙龈指数、牙龈边缘退缩值及牙龈边缘颜色满意度.厚龈型组修复后1、2年牙龈指数升高(P＜0.05),余项指数与修复前比较差异无统计学意义(P＞0.05);薄龈型组修复后1年各项指数与修复前比较差异无统计学意义(P＞0.05),修复后2年牙龈边缘退缩指数升高P＜0.05).     

即刻种植翻瓣与不翻瓣术临床疗效分析

目的:评估即刻种植中翻瓣或不翻瓣手术唇侧骨板骨吸收量、种植体留存率、软组织得分,为临床选择不同的术式提供参考。方法:选取上颌前牙即刻种植的42例患者作为研究对象,分为翻瓣组（22例、24颗种植体）和不翻瓣组（20例、22颗种植体）。应用Mimics软件,通过拟合,比较患者术后当天和术后6个月局部骨量。采用SPSS 20.0软件包分析种植术后6个月时的骨吸收量平均值和方差,统计种植体留存率。于永久修复后2年,对2组患者的粉色美学指数（pink esthetic score, PES）及牙龈乳头指数（papilla index score, PIS）进行评分。结果:翻瓣组与不翻瓣组种植体平台（种植体颈部平台）、中部（种植体长度1/2）、根尖点（种植体最底端）种植术后6个月的骨吸收量分别为（0.591±0.604）、（1.145±0.923）、（0.951±1.092）mm和（0.384±0.321）、（0.469±0.321）、（0.209±0.288）mm。种植体中部及根尖点骨吸收量具有显著差异,种植体颈部骨吸收量无显著差异。2组种植体在观察期内无一脱落,种植体存留率为100%。翻瓣组（19例）及不翻瓣组（18例）单颗种植冠的PES及PIS得分分别为（7.34±1.132）、（8.04±0.631）和（2.04±0.591）、（2.41±0.254）,差异无统计学意义。结论:即刻种植时翻瓣与不翻瓣相比,种植体边缘骨水平均相对稳定,不翻瓣组骨吸收低于翻瓣组。永久修复后2年,两者的PES、PIS无显著差异。     

Ten-year experience in face and neck unit reconstruction using tissue expanders

Background

Tissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue to reconstruct a defect without creation of significant donor site morbidity, especially in the face and upper neck area.

Methods

A total of 78 patients underwent facial reconstruction by insertion of a tissue expander (TE) in the cheek or the neck due to burn scar, traumatic scar, leschmaniasis or large pigmented nevi.

Results

All reconstructions were completed satisfactorily; complications were: complete extrusion (2.6%), incomplete extrusion (3.8%), partial necrosis (14.1%), haematoma (6.4%), wide scar (33.3%), hypertrophic scar (17.9%), lower lid ectropion (1.3%), post-expansion atrophy (2.6%), permanent decrement in sensation (1.3%), sagging (14.1%) and infection (2.6%).

Conclusions

The lateral facial areas and neck contain essentially the same type of skin; hence, tissue expansion allows optimal aesthetic reconstruction by the use of a similar adjacent tissue and expanding either the lower face or the neck interchangeably without creation of major donor site morbidity; even when we use free flaps for coverage, although we achieved good contour and sufficient bulk, but due to poor colour match, reconstruction with expanded skin of the upper neck is needed for better result.     

Novel Port Placement and 5-mm Instrumentation for Robotic-Assisted Hysterectomy

Background and Objectives:

The value of robotic surgery for gynecologic procedures has been critically evaluated over the past few years. Its drawbacks have been noted as larger port size, location of port placement, limited instrumentation, and cost. In this study, we describe a novel technique for robotic-assisted laparoscopic hysterectomy (RALH) with 3 important improvements: (1) more aesthetic triangular laparoscopic port configuration, (2) use of 5-mm robotic cannulas and instruments, and (3) improved access around the robotic arms for the bedside assistant with the use of pediatric-length laparoscopic instruments.

Methods:

We reviewed a series of 44 women who underwent a novel RALH technique and concomitant procedures for benign hysterectomy between January 2008 and September 2011.

Results:

The novel RALH technique and concomitant procedures were completed in all of the cases without conversion to larger ports, laparotomy, or video-assisted laparoscopy. Mean age was 49.9 years (SD 8.8, range 33–70), mean body mass index was 26.1 (SD 5.1, range 18.9–40.3), mean uterine weight was 168.2 g (SD 212.7, range 60–1405), mean estimated blood loss was 69.7 mL (SD 146.9, range 20–1000), and median length of stay was <1 day (SD 0.6, range 0–2.5). There were no major and 3 minor peri- and postoperative complications, including 2 urinary tract infections and 1 case of intravenous site thrombophlebitis. Mean follow-up time was 40.0 months (SD 13.6, range 15–59).

Conclusion:

Use of the triangular gynecology laparoscopic port placement and 5-mm robotic instruments for RALH is safe and feasible and does not impede the surgeon''s ability to perform the procedures or affect patient outcomes.     

Facial feminisation surgery in NHS Scotland

Facial feminisation surgery (FFS) is integral to the management of transgender adult females. Literature detailing the conduct and outcomes of FFS is lacking. The aim of this project was to review surgical practices in NHS Scotland. We identified Gender Identity Clinics throughout Scotland. These clinics were then contacted to discuss which services were available regarding FFS and to whom they refer patients. Retrospective review of electronic case notes between June 2014 and June 2019 was carried out and data was recorded on patient demographics, procedures employed, surgical complications, and postoperative outcome. FFS was carried out in two centres. Sixty patients received FFS during the study period, in 160 separate surgical procedures. Patients were all transitioning from natal biological male to female gender, with an average age of 36 years. The most common procedure was rhinoplasty (n = 36). Surgical complications occurred in eight procedures, and negative outcomes were recorded in 12/88 operating sessions. Increasing demand for surgery was noted throughout the study period. These results suggest that a wide variety of procedures are used, and that FFS is well accepted with relatively few surgical complications and negative outcomes. In depth understanding of patient's perceptions and views of their experiences, alongside objective measures, are essential to determine the impacts of FFS.     

3种即刻义齿修复单颗上前牙的红色美学指数比较

目的 评价拔牙后立即应用3种即刻义齿对缺牙区牙龈塑形的临床效果。方法 选择2014年8月至2015年4月在安徽省口腔医院就诊的单颗上前牙缺损或缺失且欲拔除患牙的患者15例,随机分为即刻固定桥组、即刻隐形义齿组、正畸压模式即刻义齿组,每组5例,拔牙后30 min立即戴入即刻义齿。拔牙前、拔牙后3个月复诊时,记录缺牙处的部分红色美学指数（PES）。结果 15例义齿均使用良好,与拔牙前相比,拔牙3个月后的近中龈乳头、软组织水平、软组织轮廓、软组织颜色和软组织质地的PES改变显著,差异有统计学意义（P<0.05）。3种即刻义齿PES变化进行比较,差异无统计学意义（P>0.05）。结论 3种即刻义齿都能获得良好的上前牙牙龈塑形效果。     

Restitution of maxillary anterior aesthetics with all-ceramic components

This paper discusses the use of four types of ceramics; zirconia, leucite reinforced glass, densely-sintered pure aluminium oxide and a low fusing porcelain, for the restitution of anterior aesthetics. Recent advances in dental ceramic technology have made this scenario a reality, which only a decade ago, was thought elusive. While ceramics offer obvious advantageous properties of enhanced appearance, they also need to satisfy functional and longevity criteria to be considered viable restorative materials. Numerous studies have cited data to fulfil these criteria, including sustained function and survival rates similar to porcelain fused to metal (PFM) restorations. This discussion will focus on current dental ceramic advances, and present a clinical case study using all ceramic constituents to rectify a deteriorating dentition.     

论医学院校《文学鉴赏》课的美育教育

近代著名教育家蔡元培先生曾经提出“凡是学校所有的课程，都没有与美育无关的”。《文学鉴赏》作为一门陶冶情操、修善身心的课程，其美育功能尤为鲜明。作者着眼于该课在医学院校进行美育教育的可能性和必要性及有关的美育内容等方面进行了探讨，以对高校文学美育教育起到抛砖引玉的效果。     

定形次全厚皮片修复烧创伤创面的美学观察

目的：研究烧创伤皮肤缺损的新式皮片移植技术。方法：选择12例复杂的烧创伤皮肤缺损患者，早期作创面康复治疗，创面恢复活力后作定形次全厚皮片移植术。结果：12个定形皮片中10个皮片完全成活。有2个皮片有点状皮片坏死，自然愈合。术后3～23个月随访10例，各修复部位皮片缝合口瘢痕不明显，表面平坦，外观优良。结论：定形次全厚皮片移植是一种获得烧创伤创面美容修复的理想方法。