Smile Reproducibility and Its Relationship to Self-Perceived Smile Attractiveness.

The reproducibility of facial expressions has been previously explored, however, there is no detailed information regarding the reproducibility of lip morphology forming a social smile. In this study, we recruited 93 young adults, aged 21-35 years old, who agreed to participate in two consecutive study visits four weeks apart. On each visit, they were asked to perform a social smile, which was captured on a 3D facial image acquired using the 3dMD camera system. Assessments of self-perceived smile attractiveness were also performed using a VAS scale. Lip morphology, including smile shape, was described using 62 landmarks and semi-landmarks. A Procrustes superimposition of each set of smiling configurations (first and second visit) was performed and the Euclidean distance between each landmark set was calculated. A linear regression model was used to test the association between smile consistency and self-perceived smile attractiveness. The results show that the average landmark distance between sessions did not exceed 1.5 mm, indicating high repeatability, and that females presented approximately 15% higher smile consistecy than males (p < 0.05). There was no statistically significant association between smile consistency and self-perceived smile attractiveness (η2 = 0.015; p = 0.252), when controlling for the effect of sex and age

Three-Dimensional Morphological Changes of the True Cleft under Passive Presurgical Orthopaedics in Unilateral Cleft Lip and Palate: A Retrospective Cohort Study

The aim of this cohort study was to quantify the morphological changes in the palatal cleft and true cleft areas with passive plate therapy using a new analysis method based on three-dimensional standardized reproducible landmarks. Forty-five casts of 15 consecutive patients with complete unilateral cleft lip and palate were laser scanned and investigated retrospectively. The landmarks and the coordinate system were defined, and the interrater and intrarater measurement errors were within 1.0 mm. The morphological changes of the cleft palate area after a period of 8 months of passive plate therapy without prior lip surgery are presented graphically. The median decrease in cleft width was 38.0% for the palatal cleft, whereas it was 44.5% for the true cleft. The width of the true and palatal cleft decreased significantly over a period of 8 months. The true cleft area decreased by 34.7% from a median of 185.4 mm2 (interquartile range, IQR = 151.5âEuro"220.1) to 121.1 mm2 (IQR = 100.2âEuro"144.6). The palatal cleft area decreased by 31.5% from a median of 334 mm2 (IQR = 294.9âEuro"349.8) to 228.8 mm2. The most important clinical considerations are the reproducibility and reliability of the anatomical points, as well as the associated morphological changes. We propose using the vomer edge to establish a validated measuring method for the width, area, and height of the true cleft

3D evaluation of mandibular skeletal changes in juvenile arthritis patients treated with a distraction splint: A retrospective follow-up

Objective:  To evaluate three-dimensional (3D) condylar and mandibular growth in patients with juvenile idiopathic arthritis (JIA) with unilateral temporomandibular joint involvement treated with a distraction splint. Materials and Methods:  Cone-beam computed tomography (CBCT) scans were taken for 16 patients with JIA with unilateral TMJ involvement before treatment (T0) and 2 years after treatment (T1). All patients received orthopedic treatment with a distraction splint. Eleven patients without JIA who were undergoing orthodontic treatment without a functional appliance or Class II mechanics and who had taken CBCT scans before and after treatment, served as controls. Reconstructed 3D models of the mandibles at T0 and T1 were superimposed on stable structures. Intra- and intergroup growth differences in condylar and mandibular ramus modifications and growth vector direction of the mandibular ramus were evaluated. Results:  In all patients with JIA there were asymmetric condylar volume, distal and vertical condylar displacement, and ramus length differences that were smaller on the affected side. Condylar displacement was more distal and less vertical in the JIA group than in the control group. A larger distal growth of the condylar head and a more medial rotation of the ramus on the affected side were found in the JIA group. Conclusion:  The orthopedic functional treatment for patients with JIA allows for condylar adaptation and modeling, thereby hindering, although with a widely variable response, a further worsening of the asymmetry. Unilateral affection has a possible influence on the growth of the nonaffected sideS

Quantification of temporomandibular joint space in patients with juvenile idiopathic arthritis assessed by cone beam computerized tomography

Objective To describe a method to calculate the total intra-articular volume (inter-osseous space) of the temporomandibular joint (TMJ) determined by cone-beam computed tomography (CBCT). This could be used as a marker of tissue proliferation and different degrees of soft tissue hyperplasia in juvenile idiopathic arthritis (JIA) patients. Materials and Methods Axial single-slice CBCT images of cross-sections of the TMJs of 11 JIA patients and 11 controls were employed. From the top of the glenoid fossa, in the caudal direction, an average of 26 slices were defined in each joint (N = 44). The interosseous space was manually delimited from each slice by using dedicated software that includes a graphic interface. TMJ volumes were calculated by adding the areas measured in each slice. Two volumes were defined: Ve−i and Vi, where Ve−i is the inter-osseous space, volume defined by the borders of the fossa and Vi is the internal volume defined by the condyle. An intra-articular volume filling index (IF) was defined as Ve−i/Vi, which represents the filling of the space. Results The measured space of the intra-articular volume, corresponding to the intra-articular soft tissue and synovial fluid, was more than twice as large in the JIA group as in the control group. Conclusion The presented method, based on CBCT, is feasible for assessing inter-osseus joint volume of the TMJ and delimits a threshold of intra-articular changes related to intra-articular soft tissue proliferation, based on differences in volumes. Intra-articular soft tissue is found to be enlarged in JIA patientsS

Standardizing Terminology and Assessment for Orofacial Conditions in Juvenile Idiopathic Arthritis : International, Multidisciplinary Consensus-based Recommendations

Objective. To propose multidisciplinary, consensus-based, standardization of operational terminology and method of assessment for temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA). Methods. Using a sequential expert group–defined terminology and methods-of-assessment approach by (1) establishment of task force, (2) item generation, (3) working group consensus, (4) external expert content validity testing, and (5) multidisciplinary group of experts final Delphi survey consensus. Results. Seven standardized operational terms were defined: TMJ arthritis, TMJ involvement, TMJ arthritis management, dentofacial deformity, TMJ deformity, TMJ symptoms, and TMJ dysfunction. Conclusion. Definition of 7 operational standardized terms provides an optimal platform for communication across healthcare providers involved in JIA-TMJ arthritis management.publishersversionPeer reviewe

Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus-Based Recommendations

Involvement of the temporomandibular joint (TMJ) is common in juvenile idiopathic arthritis (JIA). TMJ arthritis can lead to orofacial symptoms, orofacial dysfunction, and dentofacial deformity with negative impact on quality of life. Management involves interdisciplinary collaboration. No current recommendations exist to guide clinical management. We undertook this study to develop consensus-based interdisciplinary recommendations for management of orofacial manifestations of JIA, and to create a future research agenda related to management of TMJ arthritis in children with JIA. Recommendations were developed using online surveying of relevant stakeholders, systematic literature review, evidence-informed generation of recommendations during 2 consensus meetings, and Delphi study iterations involving external experts. The process included disciplines involved in the care of orofacial manifestations of JIA: pediatric rheumatology, radiology, orthodontics, oral and maxillofacial surgery, orofacial pain specialists, and pediatric dentistry. Recommendations were accepted if agreement was >80% during a final Delphi study. Three overarching management principles and 12 recommendations for interdisciplinary management of orofacial manifestations of JIA were outlined. The 12 recommendations pertained to diagnosis (n = 4), treatment of TMJ arthritis (active TMJ inflammation) (n = 2), treatment of TMJ dysfunction and symptoms (n = 3), treatment of arthritis-related dentofacial deformity (n = 2), and other aspects related to JIA (n = 1). Additionally, a future interdisciplinary research agenda was developed. These are the first interdisciplinary recommendations to guide clinical management of TMJ JIA. The 3 overarching principles and 12 recommendations fill an important gap in current clinical practice. They emphasize the importance of an interdisciplinary approach to diagnosis and management of orofacial manifestations of JIA

Modificazioni dell'osso alveolare in seguito a trattamento ortodontico: studio istomorfometrico, istochimico ed immunocitochimico in modello sperimentale animale

Dottorato di ricerca in ortognatodonzia preventiva. 8. ciclo. Coordinatore I. TollaroConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - P.za Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal

Smile dimensions affect self-perceived smile attractiveness.

Facial expressions play a leading role in human interactions because they provide signaling information of emotion and create social perceptions of an individuals' physical and personality traits. Smiling increases socially perceived attractiveness and is considered a signal of trustworthiness and intelligence. Despite the ample information regarding the social importance of an attractive smile, little is known about the association between smile characteristics and self-assessed smile attractiveness. Here we investigate the effect of smile dimensions on ratings of self-perceived smile attractiveness, in a group of 613 young adults using 3D facial imaging. We show a significant effect of proportional smile width (ratio of smile width to facial width) on self-perceived smile attractiveness. In fact, for every 10% increase in proportional smile width, self-perceived attractiveness ratings increased by 10.26%. In the present sample, this association was primarily evident in females. Our results indicate that objective characteristics of the smile influence self-perception of smile attractiveness. The increased strength of the effect in females provides support to the notion that females are overall more aware of their smile and the impact it has on their public image

Load Transfer during Magnetic Mucoperiosteal Distraction in Newborns with Complete Unilateral and Bilateral Orofacial Clefts: A Three-Dimensional Finite Element Analysis

The primary correction of congenital complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) is challenging due to inherent lack of palatal tissue and small extent of the palatal shelves at birth. The tissue deficiency affects the nasal mucosa, maxillary bone and palatal mucosa. This condition has driven the evolution of several surgical and non-surgical techniques for mitigating the inherent problem of anatomical deficits. These techniques share the common principle of altering the neighboring tissues around the defect area in order to form a functional seal between the oral and nasal cavity. However, there is currently no option for rectifying the tissue deficiency itself. Investigations have repeatedly shown that despite the structural tissue deficiency of the cleft, craniofacial growth proceeds normal if the clefts remain untreated, but the cleft remains wide. Conversely, craniofacial growth is reduced after surgical repair and the related alteration of the tissues. Therefore, numerous attempts have been made to change the surgical technique and timing so as to reduce the effects of surgical repairs on craniofacial growth, but they have been only minimally effective so far. We have determined whether the intrinsic structural soft and hard tissue deficiency can be ameliorated before surgical repair using the principles of periosteal distraction by means of magnetic traction. Two three-dimensional maxillary finite element models, with cleft patterns of UCLP and BCLP, respectively, were created from computed tomography slice data using dedicated image analysis software. A virtual dental magnet was positioned on either side of the cleft at the mucoperiosteal borders, and an incremental magnetic attraction force of up to 5 N was applied to simulate periosteal distraction. The stresses and strains in the periosteal tissue induced by the magnet were calculated using finite element analysis. For a 1 N attraction force the maximum strains did not exceed 1500 µstrain suggesting that adaptive remodeling will not take place for attraction forces lower than 1 N. At 5 N the regions subject to remodeling differed between the UCLP and BCLP models. Stresses and strains at the periosteum of the palatal shelf ridges in the absence of compressive forces at the alveolar borders were greater in the UCLP model than the BCLP model. The findings suggest that in newborns with UCLP and BCLP, periosteal distraction by means of a magnetic 5 N attraction force can promote the generation of soft and hard tissues along the cleft edges and rectify the tissue deficiency associated with the malformation