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Objectives: To evaluate the facial characteristics of edentulous older adults who underwent rehabilitation using complete dentures, and to compare them with dentate individuals., Background: Edentulism rehabilitation with complete dentures aims to restore occlusion and facial aesthetics., Materials and Methods: The study included 102 edentulous participants needing prosthodontic rehabilitation with complete dentures and 30 with a natural dentition (aged >65). The 3D facial scans were performed using an Artec optical scanner. Superficial facial landmarks were identified, and 16 parameters were calculated. Regional analysis with the superimposition of two scans was used to calculate the average distances and percentage of non-matching surfaces in the 11 regions. Paired and independent t-tests (α = .05) were used to test for group differences, as appropriate., Results: After rehabilitation with complete dentures, facial changes were most noticeable in the perioral region: wider rima oris, longer upper lip, wider upper vermilion, and more protruded profile. The comparison of facial regions without and with dentures showed fuller and curvier cheeks, with no direct influence of dentures. The edentulous faces with dentures appeared shorter and more retruded than those of dentate individuals. A narrower lower vermilion, retruded upper lip, and more flattened facial profile were observed in females with dentures than in their dentate peers., Conclusion: Besides the expected positive influence of rehabilitation with complete dentures on facial appearance in the perioral region, there are some unexpected changes, such as fuller cheeks, but there is still deficiency in vertical facial dimensions and a more flattened facial profile., (© 2024 The Author(s). Gerodontology published by Gerodontology Association and John Wiley & Sons Ltd.)

Introduction: This study aimed to assess the prevalence of edentulism and tooth loss in the Slovenian elderly population, along with the associated risk factors, and investigate the association between systemic and oral health., Methods: The study included 445 individuals aged 65 or older (average age: 79.7±8.9 years). Data on preserved teeth, dental history, chronic diseases, and medications were collected through clinical examinations. Height and weight were recorded in order to calculate body mass index (BMI), and the education level was also collected. Chronic systemic diseases and medications were categorized. Statistical analysis was conducted using linear regression and nonparametric tests., Results: Participants had an average of 4.7±7.7 teeth, with no significant gender differences. Higher age (β=-0.185, p<0.001) and lower education level (p<0.001) were associated with fewer teeth, while higher BMI showed no correlation (β=-0.085, p=0.325). Diabetes mellitus (p=0.031), cardiovascular diseases (p=0.025), and thyroid diseases (p=0.043) were inversely related to retained teeth. This inverse relationship also applied to individuals who recovered from malignancies, not including head and neck malignancies (p=0.019). No significant relationship was found between osteoporosis and the number of teeth (p=0.573). Notably, antidiabetic drug use was inversely related to the number of teeth (p=0.004), while analgesics showed a positive relationship (p=0.022)., Conclusions: This study highlights the association between specific sociodemographic factors, chronic diseases, and retained teeth among elderly individuals in Slovenia. High edentulism rates among the elderly emphasize the need for enhanced preventive measures and risk factor management, particularly for high-risk groups like the elderly., (© 2024 Jurij Bojan Žmavc et al., published by Sciendo.)

Purpose: The aim of the study was to compare the results of two surgical techniques for the treatment of isolated sagittal synostosis (ISS) by means of 3D stereophotogrammetry. One technique, the Renier's "H" technique (RHT) comprised a biparietal expansion, the other, the total vault remodeling (TVR) included also a frontal remodeling., Methods: The two groups of operated children were compared with a third control group of normocephalic children. The 3D scanning was performed in all children between 12 and 245 months of age. On each 3D image six measurements and indices have been made, with the aim of evaluating not only length and width of the head, but also the height. The cranial index (CI) was measured in a plane parallel to the nasion-tragus plane, at the intersection with the opisthocranion., Results: Each of the three groups (RHT, TVR, control group) included 28 children. The measurements that were influenced by the correction of the frontal bossing, namely the CI and the sagittal length, were closer to normocephaly after TVR than after RHT. Lesser or no statistical difference was documented in the measurements evaluating the biparietal aspect and the height of the vertex, indicating that the biparietal expansion is effective in both procedures., Conclusion: Based on our results TVR results in a better esthetical outcome, particularly in relation to the direct surgical remodeling of the frontal bossing., (© 2023. The Author(s).)

Purpose: To evaluate the soft tissue changes of the face between two positions of occlusion: maximal intercuspal position (MIP) and physiologic rest position (RP)., Materials and Methods: In this study, facial surface scans of 83 volunteers in two mandibular positions (MIP and RP) were obtained using a 3D optical scanner. On each 3D image, 21 cephalometric soft tissue landmarks were identified and then compared using t test for various facial parameters (widths, heights, depths, angles, and ratio). Additionally, a regional analysis of the facial surface differences in each patient between the two mandibular positions was performed using a whole scan shell best-fit method and the regional forehead best-fit method., Results: In MIP, facial heights with the nasion-gnathion distance shortened by approximately 1.2 mm (due to the vertical shrinkage of both lips together by 0.8 mm), and the mouth width was significantly widened, while other facial widths displayed no change. The labiomental angle and the upper vermilion arch were altered correspondingly, and regional analysis confirmed the findings with evident changes in the mandibular and subnasal areas with deviations amplified toward the facial midline., Conclusions: By applying 3D facial-scanning technology, this study displayed changes of facial appearance in different mandibular positions (MIP and RP), highlighting the need to instruct and monitor the patient's mandibular position more consistently to achieve accurate and repeatable data in a 3D facial analysis.

Background: Facial ageing is a result of superficial wrinkling combined with changes to the underlying soft tissues and skeleton. The influence of tooth loss, as a geriatric characteristic, on facial appearance is still poorly explained. The aim was to evaluate the facial characteristics of older adults, correlate these characteristics with the dentition and make comparisons with young adults using a non-invasive 3D methodology., Methods: 90 participants older than 65 years, classified into 3 subgroups (edentulous, partially edentulous, toothed) and 30 young adults were evaluated. Their faces were scanned with an optical Artec 3D-scanner. Cephalometric analyses were made using the RapidForm computer program. An independent t-test and ANOVA were used for the comparisons. Pairwise, post-hoc tests were applied with respect to the significant differences (P < 0.05)., Results: The faces of older adults are wider and longer because of the longer middle facial height. Older adults also have a longer upper lip, a larger nose, a smaller nasolabial angle (due to the nasal ptosis), narrower upper- and lower-lip vermilions and larger facial and lower-facial-height angles, resulting in a flat facial profile. The facial changes due to ageing are the most pronounced in the edentulous. In comparison with the toothed, they have a smaller facial height due to the smaller lower facial height, larger nasolabial angle, smaller mouth width, shorter upper lip and narrower lip vermilions. Their profile is flatter and their lips are more retruded., Conclusions: The proportions of the whole face are changed in older adults and they are the most expressed when this is combined with tooth loss., (© 2022. The Author(s).)

Background: The abnormal facial features in maxillary transverse deficiency (MTD) are minimal and limited to a deficiency of the middle facial third, narrow nares and nasal base, and deepened nasolabial folds. The surgical expansion of the narrow maxilla has most obvious effects on widening of the maxillary dental arch and expansion of the maxillary and palatal structures in the transverse plane, however sagittal changes also occurs. The purpose of this observational study was to evaluate the three-dimensional (3D) facial soft tissue changes following surgically assisted rapid maxillary expansion (SARME)., Methods: In 15 skeletally mature patients with severe maxillary transverse deficiency, the planned maxillary expansion (on average 8.8 mm ± 2.3 mm) was achieved with a bone-borne palatal distractor. The 3D optical scans of the facial surface were obtained before and six months after SARME. In the first part, we defined different anatomical landmarks on both scans and compared cephalometric measurements. In the second part, we registered both 3D scans in the same workplace using the regional best-fit method (forehead, supraorbital and nasal root regions were selected for the superimposition) and conducted surface analysis., Results: The largest differences between the pre- and post-operation scans were observed in the paranasal and cheek area (1.4 ± 1.0 mm). Significant differences occurred for an increased nasal width, a decreased upper-face height with an unchanged lower height, an increased vertical philtrum height and an increased nasolabial angle. A significant increase in the facial profile angle was also observed, resulting in an increased facial convexity and anterior displacement of the upper-lip area., Conclusions: The widening of the nose and increased projection in the cheek and paranasal area in the lateral direction after maxillary expansion were confirmed; moreover, facial convexity increases, reflecting the underlying advancement of the maxilla., (© 2022. The Author(s).)

Introduction: Sphenoid dysplasia is a distinctive marker of neurofibromatosis 1. It is a malformation of the sphenoid bone characterized by an enlargement of the superior orbital fissure, through which the intracranial content herniates, leading to a facial disfigurement and exophthalmos and to a potential visual deterioration. Surgical treatment has the aim of separating the intracranial from the intraorbital space., Methods and Results: We present a new technique for the repair of sphenoid dysplasia, based on the preoperative planning on a 3D print of the skull base., Conclusions: The use of a 3D skull base model allows an effective surgical planning and a precise modelling of the titanium mesh, which is implanted to separate the intracranial from the intraorbital space.

Aim: The aim of this study was to quantify gender-specific facial characteristics in younger and older adults and to determine how aging and body characteristics, such as height and body-mass index (BMI), influence facial sexual dimorphism., Methods: The cohort study included 90 younger adults of Caucasian origin (average age of 45 females 23.2 ± 1.9 and 45 males 23.7 ± 2.4 years) and 90 older adults (average age of 49 females 78.1 ± 8.1 and 41 males 74.5 ± 7.7 years). Three-dimensional facial scans were performed with an Artec MHT 3D scanner. The data were analyzed using the software package Rapidform®. The parameters to evaluate facial symmetry, height, width, profile, facial shape, nose, eyes and mouth characteristics were determined based on 39 facial landmarks. Student's t-test was used to calculate the statistical differences between the genders in the younger and older adults and a multiple-linear-regression analysis was used to evaluate the impact of gender, age, body-mass index and body height., Results: We found that the female faces were more symmetrical than the male faces, and this was statistically significant in the older adults. The female facial shape was more rounded and their faces were smaller, after normalizing for body size. The males had wider mouths, longer upper lips, larger noses and more prominent lower foreheads. Surprisingly, we found that all the gender-dependent characteristics were even more pronounced in the older adults. Increased facial asymmetry, decreased facial convexity, increased forehead angle, narrower vermilions and longer inter-eye distances occurred in both genders during aging. An increased BMI was associated with wider faces, more concave facial profiles and wider noses, while greater body height correlated with increased facial heights and wider mouths., Conclusion: Facial sexual dimorphism was confirmed by multiple parameters in our study, while the differences between the genders were more pronounced in the older adults., Competing Interests: The authors have declared that no competing interests exist.

Background: The immune system has a known role in the aetiology, progression and final treatment outcome of oral squamous cell cancers. The aim of this study was to evaluate the influence of radical surgery and radiotherapy on advanced oral squamous cell carcinoma blood counts, lymphocyte subsets and levels of acute inflammatory response markers., Methods: Blood samples were obtained from 56 patients 5 days before and 10 days after surgery, 30 days and 1 year after radiotherapy. The whole blood count, lymphocyte subsets and inflammatory response markers (C-reactive protein, erythrocyte sedimentation rate, leukocyte count, expression of index CD64 and index CD163 on neutrophils and monocytes) were measured, statistically analysed and correlated with clinical treatment outcomes., Results: The post-operative period was characterised by the onset of anaemia, thrombocytosis, lymphopenia with reduced B lymphocyte, T helper cell and NK cell counts, and a rise in acute phase reactants. Immediately after radiotherapy, the anaemia improved, the lymphopenia worsened, and thrombocyte levels returned to pre-treatment values. There was a drop in counts across the T and B cell lines, including a reduction in B lymphocytes, naïve and memory T cells with reduced CD4+ and CD8+ counts and a decreased CD4/CD8 ratio. One year after radiotherapy all the lymphocyte subsets remained depressed, the only exception being NK cells, whose levels returned to pre-treatment values., Conclusions: We concluded that surgery resulted in a stronger acute phase response than radiotherapy, while radiotherapy caused a long-lasting reduction in lymphocyte counts. There was no correlation between any of the pre-treatment parameters and the clinical outcome.

The aim of this prospective study was to correlate the postoperative 3-dimensional facial changes in skeletal class III deformity with sagittal jaw movements in 84 patients who had been treated by one piece Le Fort I maxillary advancement only (n=18), mandibular setback only (n=38), or both procedures (n=28). At the times of evaluation before and six months after operation all patients had fixed orthodontic appliances. Soft tissue changes were evaluated on optical 3-dimensional scans, while lateral cephalograms were superimposed to assess sagittal jaw movements. Three-dimensional surface facial scans were divided into 11 regions. We modelled soft tissue changes in each region by linear regression with maxillary (point A) and mandibular (point B) sagittal movements as predictors, and adjusted for sex, age, body mass index, type of operation, and interincisal angle. We found the highest values of regression coefficients (around 0.5) for the sagittal movements of the variables points A and B within the regions of the upper and lower lips. This meant that for each mm of maxillary advancement and mandibular setback, the soft tissue moved 0.5mm. In the sides of the face the regression coefficients were between 0.1 and 0.3, as were those within regions indirectly affected by the operations., (Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The decision is not always straightforward as to which orthognathic procedure is best for a good aesthetic result; three-dimensional imaging has brought new insight into this topic. The aim of this prospective study was to verify objectively whether postoperative changes occur within those regions not directly affected by surgical movements of the underlying jaw bones. The study included 83 young adults with skeletal class III deformities. They were classified into three groups according to the type of surgery: bilateral sagittal split osteotomy set-back of the mandible (BSSO), Le Fort I advancement of the maxilla, or a combination of both. Pre- and postoperative optical scans were registered as regional best-fits on the areas of the foreheads and both orbits. The shell to shell differences were measured and the average distances between the observed regions were calculated. As expected, changes were greatest in the regions where the underlying bones had been moved, but regardless of the operation performed, changes were found over the whole face. Changes in the nose, cheek, and upper lip regions in the BSSO group and in the lower lip and chin region in the Le Fort I group confirmed the concept of the facial soft tissue mask acting as one unit., (Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)