Large erupting complex odontoma: a case report.
(49/184)
Odontomas are the most common odontogenic tumours. They are usually asymptomatic and are often discovered during routine radiography. We report a case of a large erupting complex odontoma that caused pain, infection and facial asymmetry. This case is significant as there are few reports of complex odontoma erupting in the oral cavity. (+info)
Cervical pain and headache in patients with facial asymmetries: the effect of orthognathic surgical correction.
(50/184)
AIM: Facial asymmetries are often associated with cervicobrachial pain and headache. The aim of the study was to evaluate the influence of surgical orthognathic correction of facial asymmetries on the intensity of cervicobrachial pain and headache in the short and long term. METHODS: Thirty-two patients affected by maxillomandibular asymmetries associated with pain referred to occipital, cervical, dorsal and scapulohumeral areas who were undergoing orthodontic surgical correction were enrolled in the study. The pain intensity at rest and on fibromyalgia trigger points was assessed using a 0-10 Visual Analogue Scale (VAS) preoperatively (T(0)) and 5 days (T(1)), 6 months (T(2)) and 12 months (T(3)) after surgery. Functional limitation was evaluated by the same method at T(0),T(2) and T(3). RESULTS: VAS scores at rest were significantly lower at T(1), T(2) and T(3) compared to T0 in every area to which pain was referred. After 12 months (T(3)), pain at rest was completely absent in 23 patients (71.8%) in the occipital region, in 23 patients (71.8%) in the cervical area, in 22 patients (68.7%) in the dorsal area, and in 28 patients (87.5%) in the scapulohumeral area. In the other patients, the pain scores in all areas were < 1 (0.77, 0.83, 0.95, 0.5 in the occipital, cervical, dorsal, and scapulohumeral areas respectively). The VAS at neck fibromyalgia points were significantly reduced at T(1), T(2), T(3) and functional limitation was improved at T(3) and T(4) (P=0.00). CONCLUSION: This study appears to demonstrate the utility of orthognathic surgery when facial asymmetry is associated with cranial-cervicobrachial pain syndrome, presumably through a new musculoskeletal rearrangement of stomatognathic apparatus. Indeed, the surgical correction has resulted in morphological, functional and symptomatic effects. (+info)
Crossed hemifacial hyperplasia: a diagnostic dilemma.
(51/184)
Crossed hemifacial hyperplasia is a rare condition producing facial asymmetry and overgrowth of the extremities of the opposite side. Very few cases are reported in literature. A case of an 11-year-old female is presented here to supplement existing clinical knowledge with many of the reported clinical and orofacial findings. Emphasis is placed on diagnosis of the condition by thoughtful elimination and the necessity of a multi-disciplinary approach to its management. (+info)
Quantitative evaluation of lip symmetry in skeletal asymmetry.
(52/184)
The objective of this study was to investigate whether skeletal mandibular asymmetry associated with unilateral and anterior crossbite will lead to lip asymmetry. The subjects were 26 females, 13 controls and 13 true skeletal asymmetric age-matched patients (24-50 years). The study group was diagnosed as asymmetric according to visual and panoramic radiographic examination and exhibited a unilateral anterior crossbite, an asymmetric mandible, and a deviation of the chin. The control group was visually symmetric and exhibited all forms of tooth malalignment without the presence of a crossbite. Digitized images of the frontal facial photographs of all the subjects, taken in an intercuspal contact position, were analysed for upper and lower lip symmetry pre- and post-orthodontic treatment. The upper and lower lips were subdivided into two quadrants each and the surface area of each quadrant was measured and expressed as a percentage of the total surface area of the relevant lip. The degree of lip asymmetry was obtained by calculating the difference in percentage area between the two quadrants of each lip. In the study group, the lower lip quadrant on the crossbite side was increased pre-treatment (56.85 +/- 1.75 per cent), while the contralateral side was reduced (43.15 +/- 1.75 per cent, P < 0.005), resulting in 13.7 per cent asymmetry. After treatment, the respective lip areas were 52.12 +/- 0.64 and 47.88 +/- 0.64 (P < 0.01) and asymmetry was significantly reduced (4.25 +/- 1.29 per cent). In the control group, the differences between the lower lip quadrant areas (range 48.5-51.5 per cent) were small (less than 3 per cent asymmetry) and did not change post-treatment. The findings demonstrate that in this study group, lower lip symmetry was mainly controlled by the support provided through the dental interarch relationships and less by skeletal factors. (+info)
Transmission of Proteus syndrome from father to son?
(53/184)
We present a male infant with cranial hemi-hypertrophy, a lymphangioma, a lipoma, and epidermal naevi. A diagnosis of Proteus syndrome was made. His father had had a large lymphangioma resected from the right side of the face as a child. We propose that Proteus syndrome has been transmitted from father to son. (+info)
Auriculo-condylar syndrome: mapping of a first locus and evidence for genetic heterogeneity.
(54/184)
Auriculo-condylar syndrome (ACS), an autosomal dominant disorder of first and second pharyngeal arches, is characterized by malformed ears ('question mark ears'), prominent cheeks, microstomia, abnormal temporomandibular joint, and mandibular condyle hypoplasia. Penetrance seems to be complete, but there is high inter- and intra-familial phenotypic variation, with no evidence of genetic heterogeneity. We herein describe a new multigeneration family with 11 affected individuals (F1), in whom we confirm intra-familial clinical variability. Facial asymmetry, a clinical feature not highlighted in other ACS reports, was highly prevalent among the patients reported here. The gene responsible for ACS is still unknown and its identification will certainly contribute to the understanding of human craniofacial development. No chromosomal rearrangements have been associated with ACS, thus mapping and positional cloning is the best approach to identify this disease gene. To map the ACS gene, we conducted linkage analysis in two large ACS families, F1 and F2 (F2; reported elsewhere). Through segregation analysis, we first excluded three known loci associated with disorders of first and second pharyngeal arches (Treacher Collins syndrome, oculo-auriculo-vertebral spectrum, and Townes-Brocks syndrome). Next, we performed a wide genome search and we observed evidence of linkage to 1p21.1-q23.3 in F2 (LOD max 3.01 at theta=0). Interestingly, this locus was not linked to the phenotype segregating in F1. Therefore, our results led to the mapping of a first locus of ACS (ACS1) and also showed evidence for genetic heterogeneity, suggesting that there are at least two loci responsible for this phenotype. (+info)
Experts' clinical diagnosis test as a gold standard for cephalometric evaluation of vertical facial excess.
(55/184)
OBJECTIVE: Cephalometric measures are used to evaluate vertical facial excess (VFE), however anyone of them have been validated against a gold standard to this purpose. Also, there are differences between cephalometric results and clinical evaluation. This study pretends to validate experts' clinical diagnosis test (ECDT) as gold standard for severe VFE, with the purpose of validating further against it the cephalometric measures results. METHODS: A consensus (Delphi method) was done to determine if ECDT could be used as gold standard for evident VFE (n=12 experts). A scale of 9 items was initially built from literature. VALIDITY: A convenience sample was used (n=24), which were tested by 3 experts twice. Principal factor analysis was made. Internal consistency was evaluated with Cronbach's alpha coefficient. Inter-observer and intra-observer agreement was measured using Kendall concordance coefficient. ECDT's medians were compared between groups with VFE, using Kruskal Wallis test. RESULTS: Eleven of the twelve experts agreed that clinical diagnosis can be used as a gold standard for VFE. After Principal factor analysis a 6 items' scale was made. Internal consistency was high (Cronbach's alpha= 0.8051). ECDT's medians were different in groups with different qualitative appreciation of VFE by experts, in first (p<0.0001) and second evaluation (p<0.0001). A significant interobserver agreement was found (Kendall taub, p<0,01), and a significant intra-observer agreement too (Kendall tau-b, p<0.0005). CONCLUSIONS: Experts' clinical diagnosis test (ECDT) could be used as gold standard for VFE. Later on, Cephalometric measures should be evaluated using the experts' clinical diagnosis as gold standard. (+info)
Linear mixed models for longitudinal shape data with applications to facial modeling.
(56/184)