phenylephrine-hydrochloride and Prognathism

The Gorlin-Goltz syndrome is characterized by four primary symptoms: multiple nevoid basal cell epitheliomas that usually undergo malignant transformation; jaw keratocysts that show constant growth; skeletal anomalies; and intracranial calcifications. A myriad of additional findings may also be noted. Among the most frequent are: palmar and plantar pits, a characteristic flattened facies and broad nasal root, frontal and parietal bossing, mandibular prognathia, hypertelorism, strabismus, dystrophia of the canthi, and clefts of the lip, alveolus, and/or palate. In this study, we review the literature and our 25 cases of Gorlin-Goltz syndrome patients, questioning their incidence of cleft formations (8.5%) as compared to the general population (0.1%). It is our contention that all patients who present with an orofacial cleft warrant deeper investigation as to the presence of additional signs indicative of Gorlin-Goltz syndrome. The nevi turn malignant with time, and thus, early diagnosis, follow-up, and treatment are imperative.

Topics: Adult; Alveolar Process; Basal Cell Nevus Syndrome; Brain Diseases; Calcinosis; Cell Transformation, Neoplastic; Cleft Lip; Cleft Palate; Diagnosis, Differential; Eyelid Diseases; Face; Facies; Female; Follow-Up Studies; Foot Deformities; Frontal Bone; Hand Deformities; Humans; Hypertelorism; Incidence; Jaw Cysts; Male; Mouth Abnormalities; Nose; Parietal Bone; Prognathism; Strabismus

The aims of the present retrospective cephalometry study were (1) to describe the interrelationships of the soft-tissue and dentoskeletal profiles after total mandibular setback osteotomies and (2) to detect whether there were any cephalometric variables that could contribute to an accurate prediction of the surgical effect on the soft-tissue profile. The presurgical and postsurgical lateral cephalograms of 50 consecutively treated patients (37 females and 13 males) were used; these patients had received combined orthodontic-surgical management of mandibular prognathism by means of a bilateral vertical ramus osteotomy with an extraoral approach. At the time of surgery, their ages ranged from 17 to 41 years. Lateral cephalograms with the teeth in habitual occlusion taken before and approximately 1 year after surgery were available for all patients. A computerized cephalometric appraisal, named profile analysis, was developed and used, including variables corresponding to sagittal and vertical relationships of skeletal and soft-tissue profiles, incisal relationships, soft-tissue thickness, and lip morphology. The statistical elaboration of the data was made by means of paired t test, Pearson's product-moment coefficient correlation, and multiple regression analyses. The assessment of the results disclosed that considerable facial changes and improvement took place after the surgical procedure. The skeletal and soft-tissue facial profiles were straightened and the posture of the lips was improved. The normal incisal relationship achieved became influential on the soft tissues overlying both incisors and led to a better lip competence and posture. Posterior movement at points B and Po was accompanied by reductions ranging from 91% to 103% of the corresponding soft tissues. The presence of both significant correlation coefficients (p less than 0.05) and high r square values (greater than 0.70) in the multiple regression analysis for the osseous tissue variables N-B and N-Po, alone or together with the overjet and S-N-B angle, respectively, reflected their high prediction value with regard to the sagittal relationship of the lower lip, its thickness, and the soft-tissue thickness at the chin area. The findings of Pearson's product-moment coefficient correlation also indicated that the operative changes of the thickness of the upper lip, the lower lip, and the soft tissue at the chin region are influenced by the initial preoperative thickness of the area.

Topics: Adult; Cephalometry; Chin; Face; Facial Bones; Female; Humans; Image Processing, Computer-Assisted; Incisor; Lip; Male; Mandible; Nose; Osteotomy; Probability; Prognathism; Tooth; Vertical Dimension

In orthognathic surgery aesthetic issues and facial symmetry are vital parameters in surgical planning. Aim of this investigation was to document and analyze the results of orthognathic surgery on the base of a three-dimensional photogrammetric assessment, to assess the soft tissue response related to the skeletal shift and the alterations in facial symmetry after orthognathic surgery.. In this prospective clinical trial from January 2010 to June 2011, 104 patients were examined who underwent orthognathic surgery due to mono- or bimaxillary dysgnathia. The standardized measurements, based on optical 3D face scans, took place one day before orthognathic surgery (T1) and one day before removal of osteosynthesis material (T2).. Soft tissue changes after procedures involving the mandible showed significant positive correlations and strong soft tissue response (p < 0.05). The midfacial soft tissue response after maxillary advancement was only of minor extent (p > 0.05). The facial surfaces became more symmetric and harmonic with the exception of surgical maxillary expansion, but improvement of facial symmetry revealed no statistical significance.. Soft tissue response after orthognathic surgery and symmetry are only partially predictable, especially in the maxillary and midfacial region. Computer programs predicting soft tissue changes are not currently safely reliable and should not be used or with caution to demonstrate a patient potential outcome of surgery.

Topics: Adult; Anatomic Landmarks; Cephalometry; Chin; Face; Facial Bones; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Lip; Male; Malocclusion; Mandible; Maxilla; Nose; Orthognathic Surgical Procedures; Osteogenesis, Distraction; Osteotomy, Le Fort; Osteotomy, Sagittal Split Ramus; Palatal Expansion Technique; Photogrammetry; Prognathism; Prospective Studies; Retrognathia

We sought to identify the hard tissue points and vectors that have the greatest effect on soft tissue movement after orthognathic surgery in patients with mandibular prognathism.. The present retrospective study involved patients who had undergone mandibular setback surgery with or without maxillary advancement. Multiple linear regression models were adapted to evaluate the association between the 8 hard tissue landmark (predictor variables) changes and 11 soft tissue responses (outcome variables) using the x and y coordinates assessed from superimposed pre- and postoperative 3-dimensional computed tomography images.. A total of 50 patients (42 patients had undergone 2-jaw surgery; 8 patients had undergone 1-jaw surgery; mean age 23 ± 4 years) were included in the present study. Our statistical models demonstrated that the horizontal hard tissue changes had a greater influence on the soft tissue responses than did the vertical changes, and these changes were more notable in the lower facial area (lower lip contour and chin profile) than the midfacial area (nasal profile, upper lip contour, upper lip length, and nasolabial angle). In the horizontal soft tissue response model, the soft tissue A point/A point ratio was 0.86:1 (95% confidence interval [CI] 0.674-1.049); the soft tissue B point/B point ratio was almost 1:1 (95% CI 0.919-1.071); and the soft tissue pogonion/pogonion ratio was 0.88:1 (95% CI 0.805-0.963).. Horizontal or vertical bone tissue changes affected both the horizontal and vertical soft tissue changes in most areas. Our study demonstrated that the soft tissue response is not linear but a more complicated and dynamic reaction.

Topics: Adolescent; Adult; Anatomic Landmarks; Female; Follow-Up Studies; Humans; Linear Models; Lip; Male; Nose; Orthognathic Surgical Procedures; Osteotomy, Le Fort; Prognathism; Retrospective Studies; Tomography, X-Ray Computed; Treatment Outcome; Young Adult

To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group.. Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student's t-test.. Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05).. Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.

Topics: Acromegaly; Adult; Cephalometry; Chin; Face; Facial Bones; Female; Humans; Lip; Male; Mandible; Maxilla; Middle Aged; Nasal Bone; Nose; Orbit; Prognathism; Skull Base; Vertical Dimension

Several reports have demonstrated a relationship between second to fourth digit ratio (2D:4D) and facial shape, suggesting that prenatal sex hormones play a role in the development of the craniofacial complex. Using 3D surface imaging and geometric morphometrics, we test the hypothesis that decreased digit ratio (indicative of increased prenatal androgen exposure) is associated with a more masculine facial phenotype.. 3D facial surface images and digit measures were collected on a sample of 151 adult males. Facial landmarks collected from the images were aligned by Procrustes superimposition and the resulting shape coordinates regressed on 2D:4D. Variations in facial shape related to 2D:4D were visualized with deformable surface warps.. A significant statistical relationship was observed between facial shape variation and 2D:4D (p = 0.0084). Lower 2D:4D ratio in adult males was associated with increased facial width relative to height, increased mandibular prognathism, greater nasal projection, and increased upper and lower lip projection.. A statistical relationship between 2D:4D and facial shape in adult males was observed. Faces tended to look more masculine as 2D:4D decreased, suggesting a biologically plausible link between prenatal androgen exposure and the development of male facial characteristics.

Topics: Adolescent; Adult; Anatomic Landmarks; Androgens; Anthropometry; Cephalometry; Chin; Face; Fingers; Humans; Imaging, Three-Dimensional; Lip; Male; Mandible; Maxillofacial Development; Nose; Prognathism; Young Adult

Orthognathic surgery alters the position of maxilla and mandible, and consequently changes the nasal shape. The nasal change remains a concern to Asian patients. The aim of this study was to measure the nasal changes using a novel three-dimensional photographic imaging method.. A total of 38 patients with Class III malocclusion and prognathism were enrolled. All patients underwent two-jaw surgery with the standard technique. A nasal alar cinching suture was included at the end of procedure. Facial landmarks and nasal morphology were defined and measured from pre- and postoperative three-dimensional photographic images. Intra-rater errors on landmark identification were controlled. Patient's reports of perceptual nasal changes were recorded.. The average width of the alar base and subalare remained similar after surgery. Alar width was increased by 0.74 mm. Nasal height and length remained the same. Nasolabial angle increased significantly. The area of nostril show revealed a significant increase and was correlated with a decrease of columella inclination. Nasal tip projection decreased significantly, by 1.99 mm. Preoperative nasal morphology was different between patients with and without cleft lip/palate, but most nasal changes were concordant. In the self-perception, 37% of patients reported improved nasal appearance, 58% reported no change, and 5% were not satisfied with the nasal changes.. After the surgery, characteristic nasal changes occurred with an increase of nasolabial angle and nostril show, but a preserved nasal width. The majority of patients did not perceive adverse nasal changes.

Topics: Adolescent; Adult; Body Image; Cleft Palate; Female; Humans; Imaging, Three-Dimensional; Male; Malocclusion, Angle Class III; Mandible; Maxilla; Nose; Orthognathic Surgical Procedures; Photogrammetry; Postoperative Complications; Prognathism; Retrospective Studies; Taiwan; Young Adult

In some skeletal Class III adult patients with nasomaxillary hypoplasia, the LeFort I osteotomy provides insufficient correction. This case report describes a 20-year-old woman with a combination of nasomaxillary hypoplasia and a protrusive mandible with a congenitally missing mandibular second premolar.. We performed a LeFort II osteotomy for maxillary advancement. Autotransplantation of a tooth was also performed; the donor tooth was used to replace the missing permanent tooth. To increase the chance of success, we applied light continuous force with an improved superelastic nickel-titanium alloy wire technique before extraction and after transplantation.. The patient's profile and malocclusion were corrected, and the autotransplanted tooth functioned well. The postero-occlusal relationships were improved, and ideal overbite and overjet relationships were achieved.. The methods used in this case represent a remarkable treatment.

Topics: Anodontia; Autografts; Bicuspid; Dental Alloys; Female; Humans; Malocclusion, Angle Class III; Maxilla; Nickel; Nose; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Wires; Osteotomy, Le Fort; Patient Care Planning; Prognathism; Titanium; Treatment Outcome; Young Adult

To objectively classify the nose-lip-chin profiles of adult women and identify any associations between the nose-lip-chin profile patterns and dentoskeletal patterns.. Lateral facial photographs and lateral cephalograms were obtained for 229 Japanese women who were being assessed for orthodontic treatment.. A feature vector that was effective in distinguishing differences in nose-lip-chin profiles was extracted for each photograph. To categorize the records into an optimum number of subclasses according to nose-lip-chin profile configurations, a vector quantization method was applied to the feature vectors of all samples. Dentoskeletal patterns that corresponded to the nose-lip-chin profile subclasses were compared.. Eight profile patterns were identified, and the differences among patterns were notably maximized by the nasolabial angle, configuration and vertical length of the subnasal region, vertical thickness of the lip vermilion borders, sagittal position of the upper- and lower-lip vermilion borders and their relation to each other, labiomental angle, depth of the labiomental sulcus, degree of prominence of the chin, and degree of protrusion of the mandible. The dentoskeletal patterns showed significant differences between the classified profile patterns (p < 0.01).. A method to objectively classify the nose-lip-chin profiles of adult women was established, and the nose-lip-chin profile patterns were found to be associated with the dentoskeletal patterns.

Topics: Adolescent; Adult; Anatomic Landmarks; Cephalometry; Chin; Female; Frontal Bone; Humans; Lip; Malocclusion; Mandible; Maxilla; Middle Aged; Nasal Bone; Neck; Nose; Photography; Prognathism; Retrognathia; Vertical Dimension; Young Adult

Tricho-rhino-phalangeal Syndrome (TRPS) is a rare inherited dysplasia affecting hair, nasal structure and fingers. A literature review indicated that since first described, three types of manifestations have been identified. A Table summarising the oral manifestations demonstrates the variety of presentations. A South African male child presented with the syndrome and was found to show premature eruption of permanent teeth, a finding that has not been previously reported. His oro-facial manifestations also included malaligned and unerupted crowded teeth, bulbosity of the nasal tip and an elongated philtrum and evidence of mild intellectual impairment. A protocol has been developed to guide the future management of these cases.

Topics: Abnormalities, Multiple; Child, Preschool; Fingers; Follow-Up Studies; Gingivitis, Necrotizing Ulcerative; Hair; Halitosis; Humans; Male; Mouth Diseases; Nose; Prognathism; Syndrome; Tooth Diseases; Tooth Eruption

This article is based on a pre- and postoperative retrospective analysis of a sample of patients affected by progenic syndrome who underwent maxillary bone repositioning by maxillomandibular osteotomies. Pre- and postoperative clinical, photographic, and cephalometric analysis are carried out to assess modifications of the nasal shape due to maxillary osteotomies.. The sample group studied was made up of 25 patients (13 women, 12 men) who underwent orthodontic-surgical treatment for correction of maxillomandibular deformities. The sample group was divided into two groups: the first (group A) was made up of patients who underwent maxillomandibular repositioning with advancement and lowering of the maxilla, and the second (group B) comprised patients who, as a consequence of surgical repositioning, had a maxilla that was advanced and raised. Surgical treatment was based on Le Fort I and quadrangular Le Fort osteotomies.. Evaluation of angular and linear measurements, derived from both photographic and cephalometric material, allowed the authors to compare the two groups of patients and the modifications of the nasal region. These results are then compared with those available from current scientific literature so as to define the predictability of nasal shape modification. In conclusion, it is inadvisable to perform rhinoplasty at the time of orthognathic surgery to correct pre-existing defects, such as a dorsal hump, a nasal base that is too wide or too narrow, a nasal pyramid deviation, or other esthetic defects resulting from orthognathic surgery.

Topics: Cephalometry; Esthetics; Female; Follow-Up Studies; Humans; Lip; Male; Mandibular Osteotomy; Maxillary Osteotomy; Nasal Bone; Nose; Orthognathic Surgical Procedures; Osteotomy, Le Fort; Photography; Prognathism; Retrospective Studies; Sella Turcica; Treatment Outcome

The aim of this article is to compare the soft-tissue changes in the midfacial areas of patients who had undergone mandibular setback sagittal split ramus osteotomy (SSRO) with that of mandibular setback SSRO with paranasal augmentation. The subjects included 15 patients (group I), SSRO with paranasal augmentation and 20 patients (group II), SSRO alone. To evaluate the difference of the midfacial soft-tissue changes between groups, cone-beam computed tomography superimposition was utilized and the soft-tissue changes were measured both preoperatively and postoperatively by a 10 × 27 grid. In group I, the soft tissues were changed at the areas bounded superiorly by the infraorbital foramen, zygomatic eminence, posteriorly by the masseteric muscle and medially by the lateral aspect of the nose and following the nasolabial fold. In group II, the midfacial soft-tissue measurements were unchanged. This study may help clinicians to predict improvement in the midfacial region from mandibular setback SSRO with or without a paranasal augmentation procedure in class III deformities.

Topics: Adolescent; Adult; Biocompatible Materials; Cephalometry; Cone-Beam Computed Tomography; Face; Facial Bones; Female; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Lip; Male; Mandible; Masseter Muscle; Nose; Orbit; Osteotomy; Osteotomy, Sagittal Split Ramus; Plastic Surgery Procedures; Polyethylenes; Prognathism; Prostheses and Implants; Retrospective Studies; Young Adult; Zygoma

To evaluate correlations between presurgical and postsurgical changes in quality of life (QoL) and cephalometric hard and soft tissue changes in patients undergoing orthognathic surgery.. The study sample consisted of 30 patients (mean age 24.3 ± 4.5 years) with Class III malocclusion undergoing orthognathic surgery for mandibular setback with a median follow-up of 8.3 ± 1.2 months. Presurgical and postsurgical cephalograms were traced and Oral Health Impact Profile (OHIP) questionnaires were completed. Each questionnaire consisted of 14 items designed to evaluate functional, physical, psychological, and social impacts.. Significant correlations between significant presurgical-to-postsurgical changes in individual items and OHIP parameters were found between labiomental angle (LA) and question 5 ("feeling self-conscious"; correlation coefficient [r]  =  0.530), between LA and question 6 ("feeling tense"; r  =  0.598), between nasion-pogonion and question 5 (r  =  0.523), and between facial convexity and question 5 (r  =  -0.540). Hence, reduction of both LA and nasion-pogonion led to a significant decrease in the impact scores of items covering psychological discomfort, while reduced facial convexity led to increased impact scores.. Although the associations were moderate, changes in QoL following cephalometric modifications should be considered as a major concern when planning orthognathic surgery. Postsurgical changes to a more convex profile after mandibular setback should be emphasized before surgery to help patients become accustomed to their new appearance more easily without negatively affecting QoL.

Topics: Anatomic Landmarks; Anxiety; Attitude to Health; Cephalometry; Chin; Face; Facial Bones; Female; Follow-Up Studies; Humans; Lip; Male; Malocclusion, Angle Class III; Mandible; Nose; Orthognathic Surgical Procedures; Osteotomy, Sagittal Split Ramus; Plastic Surgery Procedures; Prognathism; Prospective Studies; Quality of Life; Self Concept; Stress, Psychological; Young Adult

To propose a more accurate method to predict the soft tissue changes after orthognathic surgery.. The subjects included 69 patients who had undergone surgical correction of Class III mandibular prognathism by mandibular setback. Two multivariate methods of forming prediction equations were examined using 134 predictor and 36 soft tissue response variables: the ordinary least-squares (OLS) and the partial least-squares (PLS) methods. After fitting the equation, the bias and a mean absolute prediction error were calculated. To evaluate the predictive performance of the prediction equations, a 10-fold cross-validation method was used.. The multivariate PLS method showed significantly better predictive performance than the conventional OLS method. The bias pattern was more favorable and the absolute prediction accuracy was significantly better with the PLS method than with the OLS method.. The multivariate PLS method was more satisfactory than the conventional OLS method in accurately predicting the soft tissue profile change after Class III mandibular setback surgery.

Topics: Adolescent; Adult; Algorithms; Anatomic Landmarks; Cephalometry; Chin; Face; Female; Follow-Up Studies; Forecasting; Genioplasty; Humans; Image Processing, Computer-Assisted; Least-Squares Analysis; Lip; Male; Malocclusion, Angle Class III; Mandible; Mandibular Osteotomy; Models, Statistical; Nose; Orthognathic Surgical Procedures; Osteotomy, Sagittal Split Ramus; Prognathism; Reproducibility of Results; Sella Turcica; Vertical Dimension; Young Adult

In this article, we report the successful use of miniscrews in a patient with an Angle Class III malocclusion, lateral open bite, midline deviation, and severe crowding. Simultaneously resolving such problems with conventional Class III treatment is difficult. In this case, the treatment procedure was even more challenging because the patient preferred to have lingual brackets on the maxillary teeth. As a result, miniscrews were used to facilitate significant asymmetric tooth movement in the posterior and downward directions; this contributed to the camouflage of the skeletal mandibular protrusion together with complete resolution of the severe crowding and lateral open bite. Analysis of the jaw motion showed that irregularities in chewing movement were also resolved, and a stable occlusion was achieved. Improvements in the facial profile and dental arches remained stable at the 18-month follow-up.

Topics: Adult; Bone Screws; Cephalometry; Chin; Female; Follow-Up Studies; Humans; Incisor; Lip; Malocclusion; Malocclusion, Angle Class III; Mandible; Mandibular Condyle; Mastication; Nose; Open Bite; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Brackets; Patient Care Planning; Prognathism; Range of Motion, Articular; Tooth Movement Techniques; Treatment Outcome

Two-dimensional cephalometric planning software should be helpful for prediction of hard tissue outcome after bilateral sagittal split ramus osteotomy (BSSRO) or bimaxillary osteotomy, but transferring two-dimensional data to three-dimensions (including mock operation and surgery) may result in errors. The objective of this retrospective study was to analyze deviations between predicted results and postoperative outcome using cephalometric analyses, and to evaluate this procedure for daily use. Fifty-four subjects (mean (SD) age 26 (8) years) had a BSSRO (n=21) alone or in combination with Le Fort I osteotomy (n=33). Predictions were made for each case by cephalometric planning software and mock operations done with study models. Postoperative cephalograms were obtained after 14 days and compared with predicted cephalograms for sagittal (SNA, SNB, ANB,) and vertical (ArMeGo, ML-NSL, NL-NSL) measurements. Mean (SD) differences for all measurements varied between 1.3 degrees (1.1 degrees) and 2.2 degrees (1.6 degrees) for BSSRO; and between 1.1 degrees (1.3 degrees) and 2.2 degrees (1.6 degrees) for bimaxillary osteotomy. There were no significant differences between measurements or operations, indicating that the predictions were accurate. A difference of up to 8.5 degrees could be measured in a single case. Cephalometric prediction therefore remains an accurate tool for planning, particularly maxillary rearrangement in the vertical and sagittal dimension for routine operations. If greater shifts in the transversal dimension are necessary, exact planning should be adapted with three-dimensional planning devices to avoid significant differences.

Topics: Adolescent; Adult; Cephalometry; Female; Follow-Up Studies; Forecasting; Humans; Imaging, Three-Dimensional; Male; Mandible; Maxilla; Middle Aged; Models, Anatomic; Nose; Open Bite; Orthognathic Surgical Procedures; Osteotomy; Osteotomy, Le Fort; Patient Care Planning; Prognathism; Retrognathia; Retrospective Studies; Sella Turcica; Software; Surgery, Computer-Assisted; Treatment Outcome; Vertical Dimension; Young Adult

The aim of this study was to evaluate 3-dimensional facial shells by incorporating a population-specific average template with a group of Class III subjects preparing to have orthognathic surgery.. The Class III group included 14 male (MCIII) and 15 female (FCIII) subjects. We used 43 male and 44 female Class I subjects to construct average male (AvM) and female (AvF) faces. Coordinates of 3 points on the facial templates of groups MCIII and FCIII and the templates AvM and AvF were compared. MCIII-AvM and FCIII-AvF superimpositions were evaluated for differences.. Vertical distances (sella to soft-tissue pogonion) were statistically significantly higher for the AvM (9.1%) and MCIII (10.1%) than for the AvF and FCIII, respectively (P < 0.05). The distances of soft-tissue pogonion in the horizontal x-axis were positive in 80% of the FCIII group and 85.7% of the MCIII group. The Class III subjects differed from the average face in the lower two thirds, but, in 50% (MCIII) and 60% (FCIII), they differed also in the upper facial third.. (1) The average and Class III Slovenian male morphologic face heights are statistically significantly higher than those of the female subjects. (2) The Slovenian Class III male and female subjects tend toward a left-sided chin deviation. (3) Differences between Class III patients and a normative data set were determined.

Topics: Adolescent; Adult; Cephalometry; Chin; Face; Facial Asymmetry; Female; Holography; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Lip; Male; Malocclusion, Angle Class III; Mandible; Maxilla; Models, Anatomic; Nose; Prognathism; Sella Turcica; Sex Factors; Slovakia; Vertical Dimension; Young Adult

Our aims in this study were to determine the anteroposterior facial relationship that is regarded as most attractive by Japanese laypersons in a questionnaire survey and to evaluate which analysis of the soft-tissue profile is most suitable for Japanese people.. We showed 262 Japanese laypersons (121 male, 141 female) 9 morphed profile images with Point B and menton anteriorly or distally moved by software and asked them to number them sequentially according to their attractiveness. To examine which analysis best reflects facial attractiveness as judged by laypersons, we made 5 types of analyses of the facial profile with 11 variables in the 9 images.. The normal face was judged favorably; however, an attractive profile might be different for each subject. The 3 highest ranking profiles (normal face and moderate mandibular retrusions) were often favorites, and 2 profiles (severe mandibular protrusions) were liked the least for most subjects. However, the other images showed a wide range of distribution. Mandibular retrusion was generally more favored than mandibular protrusion and bimaxillary protrusion (severe chin retrusion) had a high attractiveness ranking and was well accepted in the Japanese population.. To evaluate the profiles of Japanese subjects, it is important to evaluate not only the esthetic line defined by the nose and chin, but also the balance of the upper and lower lips defined by the posterior reference line--ie, Burstone's Sn-Pog' line.

Topics: Adult; Asian People; Attitude; Beauty; Cephalometry; Chin; Esthetics; Face; Female; Humans; Image Processing, Computer-Assisted; Japan; Male; Mandible; Nose; Prognathism; Retrognathia; Young Adult

Traditional cephalometric radiographs can analyze facial soft-tissues 2 dimensionally. Because they cannot provide information about the nose, lips, cheeks, and mouth, another method is needed to analyze these soft tissues. We introduce a new method for analyzing the 3-dimensional (3D) shape and size of facial soft-tissue morphology.. A 3D average face model was constructed based on 3D computed tomography images of Japanese male and female adult volunteers who had well-balanced faces and normal occlusions. To test the feasibility of evaluating the quantitative effects of surgery, preoperative and postoperative 3D computed tomography images of facial soft tissues of 1 man and 1 woman were superimposed on the average faces.. This quantitative assessment provided a comprehensive evaluation of the characteristics that separate size and shape. It was possible to view the superimposed images from any desired angle on a personal computer.. This method provides easy-to-understand information for patients and appears to be useful for clinical diagnosis and pretreatment and posttreatment soft-tissue morphologic evaluations of patients with jaw deformities.

Topics: Adult; Cephalometry; Ear Canal; Eye; Face; Feasibility Studies; Female; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Jaw Abnormalities; Male; Malocclusion, Angle Class III; Mouth; Nose; Orbit; Osteotomy; Osteotomy, Le Fort; Prognathism; Software; Tomography, X-Ray Computed

The purpose of this study was to examine asymmetry of the lips in patients with jaw deformity and facial asymmetry.. Pretreatment and posttreatment frontal facial photographs of 17 patients who had mandibular prognathism with facial asymmetry were analyzed. Linear and angular measurements were made on the photographs to assess the asymmetry of the lips. The upper and lower vermilion borders of the lips were divided into quadrants according to the y-axis, and each was measured. In addition, skeletal deviation (position of menton) was determined from the frontal cephalograms.. The pretreatment linear and angular measurements showed asymmetry of the lips, but this significantly improved after treatment, and the lip form was almost symmetrical. The areas of vermilion border in the upper and lower lips became almost even during treatment. The ratio of the areas on the 2 sides was nearly 1.00. There was little correlation between the horizontal skeletal changes of menton and lip form.. Asymmetry of the lips caused by deviation of the mandible can be almost completely corrected by orthognathic treatment.

Topics: Adolescent; Adult; Cephalometry; Chin; Esthetics, Dental; Eye; Facial Asymmetry; Female; Humans; Image Processing, Computer-Assisted; Lip; Male; Mandible; Nose; Photography; Prognathism; Young Adult

To determine what therapeutic effects can be expected in the case of early treatment of Class III relations with removable appliances with or without face masks.. Records available at the university clinic of Tübingen for 41 patients who had undergone early treatment because of prognathic abnormalities were retrospectively evaluated. Lateral cephalograms taken and casts obtained at baseline and at the end of early treatment were included in the analysis. Two treatment strategies were compared. The first group included removable functional orthopedic appliances only (FOA group), while the second group was treated with removable appliances and with face masks mounted on a cemented maxillary expansion appliance (face mask group).. Positive changes were achieved in both groups for overjet (FOA group: +1.3 mm; face mask group: +2.2 mm) and Wits values (FOA group: +0.4 mm; face mask group: 1.7 mm). Moreover, a change in mean ANB values was achieved in the face mask group (+0.9 degrees ). The FOA group exhibited a reduction in mandibular angles. Changes in maxillary inclination with reduced inclination angles led to increases in overjet and overbite. The face mask group showed dorsal rotation of the mandible with reduced SNB values (-0.8 degrees ).. Early treatment of prognathism is a meaningful option, as demonstrated by the dentoskeletal (and hence functional) improvements observed in the present study.

Topics: Cephalometry; Child; Chin; Extraoral Traction Appliances; Female; Follow-Up Studies; Humans; Incisor; Male; Malocclusion, Angle Class III; Mandible; Maxilla; Models, Dental; Nose; Orthodontic Appliances, Removable; Orthodontics, Interceptive; Palatal Expansion Technique; Prognathism; Retrospective Studies; Rotation; Sella Turcica; Time Factors

The aim of this study was to assess long-term changes in position of soft tissue landmarks following mandibular advancement and setback surgery.. Twenty-seven patients (14 women, 13 men; mean age, 36 years) who had undergone either mandibular advancement (15 patients) or setback surgery (12 patients), were available for a long-term follow-up an average of 12 years postoperatively. In all of these cases, lateral cephalometric radiographs taken immediately before operation, at 1 week, 14 months, and 12 years postoperatively, were studied.. During the 14 months postoperatively, soft tissue chin and mentolabial fold followed its underlying hard tissue in all patients. A continuous skeletal relapse was observable 12 years after mandibular advancement, but soft tissue chin moved more in an anterior direction. After mandibular setback, soft and hard tissue landmarks remained almost unchanged. Over the entire observation period, a thickening of soft tissue at pogonion was generally seen, and particularly a thickening of the whole chin in the setback group. All patients showed a significant lengthening and thinning of the upper lip. In all except 2 males, the patient's body weight increased markedly.. In contrast to the immediate postoperative stage, soft tissue changes observed an average of 12 years after the primary operation do not directly follow the movements of the underlying skeletal structure. The soft tissue profile changes observed over such a long term seem to be influenced not only by the underlying skeletal structure but also by other factors such as weight gain and aging process.

Topics: Adult; Aged; Aging; Body Weight; Cephalometry; Chin; Face; Female; Follow-Up Studies; Humans; Lip; Longitudinal Studies; Male; Mandible; Mandibular Advancement; Middle Aged; Nose; Osteotomy; Prognathism; Retrognathia; Retrospective Studies; Weight Gain

This study was an analysis of the soft and hard tissue changes of the facial profile after bilateral sagittal splitting osteotomy for mandibular setback of Taiwanese patients.. We collected pre- and postsurgical lateral cephalographs of 64 patients (28 males, 36 females) with skeletal Class III malocclusion who received combined orthodontic-surgical treatment with bilateral sagittal splitting osteotomy mandibular setback at Taipei Veterans General Hospital between 1994 and 2000. Nineteen cephalometric parameters of (14 linear, 4 angular, and the BS index) soft and hard tissues were measured at 1 week before treatment, and 2 months and 1 year after surgery, and analyzed by paired t test.. Mean patient age was 20.0 +/- 1.6 years. The patients underwent an average of 7 mm mandibular setback at the osseous pogonion (Pog). Average setbacks at Pog and soft tissue pogonion (pog) were 5.54 mm and 4.85 mm, respectively, at 1 year after surgery. The setback ratio of Pog/pog was 1:0.88. The hard tissue relapse at Pog was 21% at 1 year after surgery. Improvement in prognathic profile was demonstrated by significant changes in the positions of Pog and pog, ANB angle, the distance from lower lip to esthetic line (E-L lip), and the BS index after surgery. However, compared with parameters obtained from a normal Taiwanese population, the cephalometric data of Pog, pog, and BS index still indicated mild prognathism.. Although mandibular prognathism could be grossly improved by bilateral sagittal splitting osteotomy mandibular setback, a significant amount of relapse occurred within 1 year after surgery. The extent of the postoperatively preserved features showing mandibular prognathism should be a concern for both patients and physicians.

Topics: Adult; Cephalometry; Chin; Face; Female; Follow-Up Studies; Humans; Lip; Male; Malocclusion, Angle Class III; Mandible; Maxilla; Nose; Osteotomy; Prognathism; Recurrence; Retrospective Studies; Taiwan

The purpose of this study was to determine the effect of chin cap therapy combined with an upper tongue guard in the early treatment of class-III malocclusion on the nasomaxillary complex and mandible. The subjects of this study consisted of 40 patients aged 5-13 years (mean age of 8.5 +/- 2). All of them possessed an anterior cross bite and/or concave profile. The mean force of chin cap was determined to be 200 g on each side for 18 h/day and the mean treatment period was 22 months. The cephalometric analyses including skeletal, dental, and soft tissue analysis were carried out before and after treatment. The analysis of the cephalometric measurements revealed a negative correlation between the combination effects of chin cap therapy upper tongue guard. This effect appeared in the early stages of treatment. It was a case-control study and Wilcoxon test was used for statistical analysis. The comparison of dependent variables revealed that skeletal effects of chin cap therapy were more than dental and soft tissue effects. Changes in the upper and lower pharyngeal spaces were not significant. A reduction of nasolabial angle occurred due to the protrusion of upper incisors. Finally, it was shown that the combination of chin cap and upper tongue guard could be more effective in the early treatment.

Topics: Adolescent; Age Factors; Case-Control Studies; Cephalometry; Child; Child, Preschool; Extraoral Traction Appliances; Face; Female; Follow-Up Studies; Humans; Male; Malocclusion, Angle Class III; Mandible; Mandibular Condyle; Maxilla; Nose; Orthodontic Appliance Design; Orthodontic Appliances, Functional; Pharynx; Prognathism; Sella Turcica; Stress, Mechanical; Time Factors

Topics: Adult; Cartilage; Cephalometry; Female; Follow-Up Studies; Humans; Male; Maxilla; Maxillary Fractures; Nasal Septum; Nose; Osteotomy; Plastic Surgery Procedures; Prognathism; Rhinoplasty; Surgical Flaps; Treatment Outcome

A fifty years old woman hailing from Purbadhala of Netrokona district complaining of gradual enlargement of hands, feet, nose and other acral parts of the body for about last eight years. She noticed coarsening of the skin and gradual protrusion of her lower jaw. She complained of headache, vertigo, frequent passage of urine, increased thirst, weight loss and fatiguability. She was found hypertensive having blood pressure 200/110 mm of Hg. Her appearance was coarse with rough skin. There were enlargement of hands, feet, nose, lower jaw with prognathism and enlargement of other acral parts. Investigations revealed high plasma glucose level, both fasting and 2 hrs. after glucose, high level of growth hormone, failure of suppression of growth hormone during OGTT. Thyroid function tests of the patient were found normal with increased heel pad size and enlarged sella turcica in all diameters. She was diagnosed as a case of acromegaly due to growth hormone hypersecretion.

Topics: Acromegaly; Blood Glucose; Female; Foot; Hand; Humans; Hypertension; Middle Aged; Nose; Prognathism; Radiography; Skin; Skull

A boy aged 11 years presented with dental pain, several carious teeth and a localized area of acute necrotizing ulcerative gingivitis (ANUG). Developmental absence of the premolar teeth was notable and additional anomalies included mid-facial hypoplasia, mandibular prognathism, transposed teeth and delayed exfoliation of the deciduous teeth. These abnormalities have significant oral, dental, orthodontic and orthognathic implications.

Topics: Anodontia; Bicuspid; Child; Craniofacial Abnormalities; Dental Caries; Gingivitis, Necrotizing Ulcerative; Humans; Male; Maxilla; Nose; Palate; Patient Care Planning; Prognathism; Tooth Eruption, Ectopic; Tooth Exfoliation; Tooth, Deciduous

Topics: Abnormalities, Multiple; Adult; Female; Fingers; Hair; Humans; Nose; Prognathism; Syndrome

A cephalometric analysis according to Hasund, supplemented by special obstructive sleep apnoea syndrome (OSAS) parameters, was performed on 169 patients who had been referred from the sleep laboratory. Statistical analysis showed a correlation between specific cephalometric landmarks including posterior airway space (PAS), a soft palate length, hyoid position and posterior growth development of the mandible and OSAS severity. A principal component analysis differentiated between four subgroups of OSAS patients: (1) orthognathic obese subjects; (2) patients with a long soft palate and low-positioned hyoid; (3) retrognathic patients with narrow PAS; and (4) prognathic ones. Lateral cephalometry is an important contribution to OSAS diagnostics and oral and maxillofacial therapy procedures.

Topics: Adult; Age Factors; Aged; Cephalometry; Female; Humans; Hyoid Bone; Hyperplasia; Male; Mandible; Maxilla; Middle Aged; Nasopharynx; Nose; Obesity; Palate, Soft; Palatine Tonsil; Prognathism; Retrognathia; Sleep Apnea Syndromes

A morphometric analysis of changing proportions in the developing mandible was undertaken in 18 human embryos and fetuses of both sexes (developmental age from 8 to 14 weeks, crown-rump length, CRL, from 34 to 110 mm), previously cleared and stained with a specific method for bone (alizarin red S). Reference points were located on the mandible, i.e. condylar process (Pcl), coronoid process (Pco), gnathion (GN), gonion (GO), superior symphyseal point (SSP), for measuring linear dimensions, i.e. Pcl-GN, Pcl-Pco, Pco-GN, GO-GN, SSP-GN. The gonial (Pcl-GO-GN) and the (Pcl-GN-Pcl) angles were also measured. All linear dimensions were correlated with the CRL by bivariate allometry (1n y = 1n a+b 1n x): they all grew with positive allometry, except GO-GN with isometry. The mandibular ramus grew relatively faster than the body, both in length and height, and the greatest growth rate was found for ramus height. The relation between mandibular shape and the craniofacial structures was investigated using scale drawings obtained from photographs of fetal skulls in lateral view. In the youngest fetuses the mandible was prognathic, then became retrognathic. During the period investigated the zygomatic process and squama of the temporal bone were in a lower and more inclined position in relation to the transverse plane passing through the zygomatic arch than in the newborn and adult. This study identifies parameters fitting changing trends in height, length and shape of the human mandible during the prenatal period (8-14 weeks); moreover, it emphasizes that the mandibular growth patterns differ significantly from those of successive development periods.

Topics: Adult; Anthraquinones; Cephalometry; Chin; Coloring Agents; Crown-Rump Length; Embryonic and Fetal Development; Female; Gestational Age; Humans; Infant, Newborn; Male; Mandible; Mandibular Condyle; Maxilla; Nose; Prognathism; Retrognathia; Temporal Bone; Zygoma

Two studies have shown that there are morphologic differences in the nasopharynx between the major racial groups. This investigation was conducted to see whether these morphologic differences affected nasal respiration. Twenty-two West Indian and 24 white children (mean age of 13 years 11 months) were studied to examine the relationship between nasorespiratory function and nasopharyngeal and dentofacial structure. The nasorespiratory function was measured in terms of nasal respiratory resistance, NRR, (Pascals/cm3 per second), both by anterior and posterior methods, with a computerized rhinomanometer. Nasopharyngeal structure was described in terms of cephalometric variables. The West Indian cephalometric profile generally conformed to its existing description in the literature including prognathic jaws and bimaxillary proclination; in addition, the West Indians were found to have a greater bony nasopharyngeal width (posterior nasal spine-basion) and shallower nasopharyngeal roof angle (posterior nasal spine-hormion-basion). All rhinomanometric measurements were significantly lower in the West Indian group, especially when posterior rhinomanometry was used. The correlation coefficients between the cephalometric and the rhinomanometric measurements were statistically significant but low. In addition, the measure of mandibular prognathism (angle SNB) was also found to be significantly correlated with the nasorespiratory resistance.

Topics: Adolescent; Airway Resistance; Black People; Cephalometry; Female; Humans; Male; Nasal Obstruction; Nasopharynx; Nose; Prognathism; United Kingdom; West Indies; White People

The finite element method is used to predict facial deformation following orthognathic surgery for mandibular prognathism. The deformation is calculated using a model that assumes severe skeletal class III malocclusion. The possibilities and limitations of this method for clinical application are described.

Topics: Cartilage; Elasticity; Face; Facial Muscles; Humans; Lip; Mandible; Models, Biological; Mucous Membrane; Nose; Orbit; Prognathism; Skin; Stress, Mechanical

Different headform types establish different lines of craniofacial growth resulting in anatomic sub-groupings of Classes I, II, and III with characteristic morphologic features. Several key basicranial and facial relationships are involved, with the nasal region particularly significant in group distinctions.

Topics: Adolescent; Adult; Black People; Cephalometry; Child; Face; Humans; Male; Malocclusion, Angle Class I; Malocclusion, Angle Class III; Mandible; Maxilla; Nose; Prognathism; Retrognathia; Skull

Recent application of computer graphics, using standardized cephalometric analyses, have allowed the surgeon to visualize the predicted surgical outcome on the computer video monitor. Stereolithographic models constructed from digital image data (computed tomography and magnetic resonance) will allow the surgeon to view the external and internal anatomy prior to surgery. This article describes the development of such technology and reports its use in one case.

Topics: Adult; Artificial Intelligence; Bone Diseases, Developmental; Cephalometry; Computer Graphics; Computer Systems; Data Display; Face; Facial Bones; Humans; Image Processing, Computer-Assisted; Male; Malocclusion, Angle Class III; Maxilla; Models, Structural; Nose; Osteotomy; Patient Care Planning; Plastics; Prognathism; Tomography, X-Ray Computed

A retrospective study of 33 patients was undertaken to investigate the changes occurring in the facial profile following surgical correction of mandibular prognathism. The parameters measured included surface area, shift of selected points, facial outline length and directional measurement in relation to the sella-nasion plane. The calculation of linear regression equations enabled prediction of the shift of selected soft tissue points and facial outline length. It is considered, that the analysis provides an accurate picture of the behaviour of the soft tissues in response to a given amount of bony movement following correction of the deformity.

Topics: Adolescent; Adult; Cephalometry; Chin; Face; Female; Humans; Lip; Male; Mandible; Maxilla; Middle Aged; Nose; Osteotomy; Probability; Prognathism; Retrospective Studies; Vertical Dimension

Maxillary hypoplasia and retrusion is complex. It may involve the dentoalveolar area, or it may involve the whole midface. It may be difficult to recognize, since the patient may come only with the complaint of nasal deformity, and the occlusion may be normal. It may be difficult to treat, as in the severe Binder's syndrome, where in addition to the bony deformity, the facial mask is deficient and obviously in the wrong position. To treat the condition the surgeon must have an aesthetic sense. It is not like the situation when only the maxilla is involved; this tends to be mechanical and is related to dental malocclusion. In these patients, an aesthetic appreciation of the nose and its relationship to the maxilla, infraorbital rims, and frontal area is paramount. Unless this complete approach is used, the patient will be undertreated and end up unhappy. Patients can readily appreciate the position and the contours of the nose, but they do not understand the subtleties of the lack of a bony foundation when there is maxillary hypoplasia. Not only does this involve a high degree of aesthetic appreciation on the part of the surgeon, it also necessitates a considerable ability to convey to the patients that the problem is not the simple one that they had first imagined. When all of these subtleties are appreciated, it is possible to develop a degree of sophistication in the treatment of these patients that will yield excellent results.

Topics: Humans; Maxilla; Nose; Osteotomy; Patient Care Planning; Prognathism; Rhinoplasty; Surgery, Plastic; Surgical Flaps; Syndrome

Profile analysis was performed on 180 Thai female subjects with ages ranging from 16 to 21 years. Seventy were of Chinese origin. The determination of the profile analysis mean values was based on the methods of Schwarz, Subtelny, Ricketts, Burstone, and Schwartz. The results were compared to Caucasian standards and to the findings of our previous study on a Javanese population. For the profile forms, our investigated groups showed mainly prognathic faces (75% to 84%). A "shift backward" profile flow dominated. We found a "prognathic face" combined with a "shift backward" in 50% to 60% of the Asian subjects analyzed. Our soft-tissue profile results (approximately 165 +/- 6 degrees) showed less convexity than that of the Caucasians and there was no significant difference in overall profile between the 2 Thai groups (approximately 134 +/- 5 degrees); this is in the range given by Subtelny (141 degrees to 131 degrees) except for that of the Javanese subjects. For the lip analysis, we listed a posterior position or a lip position upon the esthetic line between 60% to 70% of both Thai groups with respect to the upper lip and only 28% to 33% for the lower lip. The Javanese group, however, showed 90% anterior position of the upper lip and 93% of the lower lip to this line. It is significant that proper blending of the integumentary profile produces an esthetically pleasing face and this varies in different ethnic groups. A good combination could even make a "prognathic face shift backward" very acceptable as illustrated by a profile analysis of Miss Thailand, 1984.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Cephalometry; Chin; China; Esthetics, Dental; Ethnicity; Face; Female; Humans; Lip; Nose; Prognathism; Thailand

A new lateral photometric analysis, used as a new diagnostic aid in surgical orthognathic treatment and aesthetic surgery, is described. The normal facial features of one male and one female were analysed and then assessed to provide examples of the "normal". Seven cases with aesthetic-orthognathic problems were also analysed and diagnosed according to this newly-described technique and these represented examples of the "abnormal". The benefits of using this diagnostic aid are obvious to the maxillo-facial/aesthetic surgeon or orthodontist. He should be able to plan his treatment beyond the limitation set by model studies and cephalometrics only.

Topics: Cephalometry; Esthetics, Dental; Face; Female; Forehead; Humans; Male; Mandible; Maxilla; Nose; Orthognathic Surgical Procedures; Photography; Prognathism; Retrognathia

Topics: Adolescent; Adult; Cephalometry; Diagnosis, Differential; Female; Humans; Lip; Male; Malocclusion; Malocclusion, Angle Class II; Middle Aged; Nose; Patient Care Planning; Prognathism

An anatomical reconstruction of the protruded premaxillary segment of an infant with bilateral cleft of the primary palate was made from serial histological sections and described in comparison with reconstruction columella, alar cartilages, nasal septum, and premaxillae of a neonatal control specimen. Most of the bilateral cleft abnormality was seen in the premaxillary bones which were advanced on the nasal septum and whose alveolar process protuded anteriorly into the columellar area. The medial crura of the alar cartilages and the nasal septum in the cleft specimen showed an essentially normal structure. Underdevelopment of the columbella was considered as primarily failure in the development of columellar skin caused by the invasive obstruction by the premaxillary bones.

Topics: Alveolar Process; Cleft Lip; Cleft Palate; Humans; Incisor; Infant, Newborn; Maxilla; Nasal Septum; Nose; Prognathism

Oral and maxillofacial surgeons now have the capabilities to plan a total treatment for the entire face. In some instances, a team may be formed to deal with ancillary areas of expertise. Patients may be directed to members of the team who are cognizant of each other's capabilities. In this manner, the most complete type of treatment plan may be suggested to the patient.

Topics: Adult; Beauty Culture; Cephalometry; Dentures; Esthetics, Dental; Face; Female; Humans; Male; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Models, Dental; Nose; Patient Care Planning; Patient Care Team; Periodontium; Photography; Prognathism

A case of facial duplication with its surgical correction in childhood and the consequences on facial growth is reported. It is a unique case in the duration of observation. The following structures were fully duplicated: the nose, the premaxilla, the cribriform plate, the crista galli. In addition there was an enormous facial cleft including lip, alveolus and palate. Additionally there were two rudimentary eye sockets, eyes, and two supplementary eyebrows. The monstrous hypertelorism with the facial duplication was corrected at the age of ten. The surgical procedure is described and the postoperative complications are discussed. Gross lack of growth of the middle third of the facial skeleton was observed. This was probably the consequence of the initial corrective surgery. Overgrowth of the mandible created a gorilla-like appearance by the end of the growth period. This was corrected in one operation by advancement of the middle third in three sections and repositioning of the mandible as a whole together with the mandibular anterior alveolar segment. Finally all parts of the lower half of the nose had to be enlarged, both soft tissues as well as the cartilaginous framework. A pharyngoplasty in addition to the correction of the intermaxillary abnormalities did much to improve the speech quality of the patient. A large secondary cranial defect was successfully reconstructed with the use of 14 halved ribs. In spite of the removal of four ribs from one side and three ribs from the other, there were no postoperative respiratory problems. Spontaneous rib regeneration was found where ribs had been removed one year earlier.

Topics: Adolescent; Alveolar Process; Child; Cleft Palate; Face; Hematoma; Humans; Infant; Male; Mandible; Maxilla; Maxillofacial Development; Nose; Orbit; Osteotomy; Patient Care Planning; Postoperative Complications; Prognathism; Radiography; Retrognathia; Sepsis; Skull; Speech; Vision, Ocular

Topics: Adult; Female; Fluorocarbon Polymers; Humans; Mandible; Maxilla; Nose; Polytetrafluoroethylene; Prognathism

Topics: Animals; Cephalometry; Dental Occlusion; Maxillofacial Development; Nasal Septum; Nose; Prognathism; Rats

Topics: Alveolar Process; Cephalometry; Humans; Inuit; Maxilla; Nose; Paleodontology; Prognathism

Topics: Adaptation, Physiological; Black People; Dental Arch; Humans; Maxilla; Nose; Prognathism; White People

Topics: Animals; Body Weight; Cephalometry; Face; Malocclusion; Mastication; Maxillofacial Development; Nasal Septum; Nasopharyngeal Diseases; Nose; Prognathism; Rabbits; Suppuration; Tooth Eruption

Topics: Animals; Facial Bones; Jaw Abnormalities; Malocclusion; Maxillofacial Development; Nasal Septum; Nose; Prognathism; Rabbits

Topics: Animals; Bone Development; Cartilage; Ethmoid Bone; Mandibular Diseases; Nasal Septum; Nose; Nose Deformities, Acquired; Prognathism; Rabbits

Topics: Adolescent; Cephalometry; Child; Humans; Malocclusion; Nose; Prognathism

Topics: Breast Diseases; Congenital Abnormalities; Humans; Nevus; Nevus, Pigmented; Nose; Nose Deformities, Acquired; Obesity; Plastics; Prognathism; Skin Neoplasms; Surgery, Plastic

Topics: Adolescent; Cephalometry; Child; Craniofacial Dysostosis; Female; Follow-Up Studies; Humans; Male; Malocclusion; Maxillofacial Development; Models, Dental; Nose; Osteochondrodysplasias; Prognathism; Radiography, Dental

Topics: Bone Transplantation; Chin; Cleft Lip; Face; Humans; Jaw; Nose; Nose Deformities, Acquired; Orthodontics; Plastics; Prognathism; Rhinoplasty; Skin Transplantation; Surgery, Plastic