43 research outputs found
Checklist dos aspectos estéticos a serem considerados no diagnóstico e tratamento do sorriso gengival
Assessment of the chin in patients undergoing rhinoplasty: What proportion may benefit from chin augmentation?
The biomechanics of rapid maxillary sutural expansion
Micro-displacements (fringe patterns) in the bones of the craniofacial complex as seen through laser holography during midpalatal sutural expansion with the Hyrax appliance are used to define the centers of rotation of the maxillary halves in both the frontal and occlusal views. Biomechanical analyses of the maxillary expansion force system are concomitant with the holographic findings and strongly suggest that the stainless steel wires joining the teeth to any expansion device be of the largest diameter possible. In addition, in the case of the Hyrax expansion device, it is recommended that the manufacturer increase the diameter of the activating screw as well as those of the 2 adjacent wire guides. And, importantly, the use of acrylic as a structural member to join the teeth to a sutural expansion device should be avoided if tipping of the maxillary halves is to be minimized, as the acrylic lacks sufficient rigidity.118325726
Habilidade de ortodontistas e leigos na percepção de assimetrias da mandÃbula Orthodontists' and laypersons' perception of mandibular asymmetries
OBJETIVO: analisar a habilidade de ortodontistas e leigos para perceber as assimetrias faciais causadas por desvios mandibulares. MÉTODOS: foram obtidas fotografias frontais da face de dois indivÃduos, sendo um do sexo masculino e outro do sexo feminino. As fotografias foram tiradas em Posição Natural de Cabeça (PNC) com desvios mandibulares progressivos - em 2, 4 e 6mm -, partindo-se da posição de Máxima Intercuspidação Habitual (MIH). Para testar a reprodutibilidade do método, utilizaram-se os Coeficientes de Correlação Intraclasse (ICC) e o teste de Kappa ponderado.As diferenças entre os examinadores leigos e ortodontistas foram investigadas através do teste de Mann-Whitney, enquanto a análise de Friedman foi utilizada para investigar as diferenças nos escores para os progressivos avanços mandibulares. Todas as estatÃsticas foram executadas com nÃvel de confiabilidade de 95%. RESULTADOS: os ortodontistas foram hábeis em perceber os desvios somente a partir de 4mm, quando comparados à posição de MIH (p≤0,05), enquanto os leigos tiveram o mesmo padrão para o indivÃduo do sexo feminino. Porém, ao examinar o sujeito do sexo masculino, os leigos não observaram nenhuma alteração executada a partir de MIH (p>0,05). De modo geral, apesar de as medianas atribuÃdas pelos ortodontistas terem sido menores que as dos leigos, essa diferença foi significativa apenas para o desvio de 6mm, em ambos os pacientes. CONCLUSÕES: ortodontistas e leigos avaliaram a assimetria mandibular de modo diferente, visto que ortodontistas tendem a ser mais crÃticos quando as assimetrias são mais severas. Conclui-se, ainda, que existe variação na avaliação das assimetrias faciais dependendo do paciente examinado, principalmente entre os examinadores leigos.<br>OBJECTIVE: To analyze orthodontists' and laypersons' perceptions of facial asymmetries caused by mandibular changes. METHODS: The faces of two patients, a man and a woman, were photographed in natural head position, and additional photos were produced with progressive mandibular shifts of 2, 4 and 6 mm from maximum intercuspation (MI). Intraclass correlation coefficients (ICC) and weighted kappa coefficients were used to test method reproducibility. The differences in scores for mandibular positions between orthodontists and lay examiners were examined using Friedman analysis. All statistical analyses were performed at 95% confidence interval. RESULTS: Orthodontists only perceived shifts greater than 4 mm from MI position (p<0.05), and laypersons had similar results when analyzing the woman's photos. However, when examining the man's photos, laypersons did not perceive any change in relation to MI (p>0.05). Although median scores assigned by orthodontists were, in general, lower than those of laypersons, this difference was only significant for the 6-mm shift in both patients. CONCLUSIONS: Orthodontists and laypersons evaluated mandibular asymmetries differently. Orthodontists tended to be more critical when asymmetries were more severe. The evaluation of facial asymmetries also varied according to what patient was being examined, particularly among lay examiners