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PubMed1975

The click-evoked post-auricular myogenic response in normal subjects.

The presence of the posterior auricular myogenic reflex was infectigated in healthy subjects. Click stimuli were delivered alternately to each ear and both ipsilateral and contralateral responses were recorded simultaneously. Smiling and head down position increased the number of responses. With this method, in contrast to previous findings, it was possible to demonstrate bilateral auditory reception in 89% of the 45 subjects studied.

Acoustic Stimulation↗
PubMed2006

Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations.

INTRODUCTION: Previous studies evaluated the perception of laypersons to symmetric alteration of anterior dental esthetics. However, no studies have evaluated the perception of asymmetric esthetic alterations. This investigation will determine whether asymmetric and symmetric anterior dental discrepancies are detectable by dental professionals and laypersons. METHODS: Seven images of women's smiles were intentionally altered with a software-imaging program. The alterations involved crown length, crown width, midline diastema, papilla height, and gingiva-to-lip relationship of the maxillary anterior teeth. These altered images were rated by groups of general dentists, orthodontists, and laypersons using a visual analog scale. Statistical analysis of the responses resulted in the establishment of threshold levels of attractiveness for each group. RESULTS: Orthodontists were more critical than dentists and laypeople when evaluating asymmetric crown length discrepancies. All 3 groups could identify a unilateral crown width discrepancy of 2.0 mm. A small midline diastema was not rated as unattractive by any group. Unilateral reduction of papillary height was generally rated less attractive than bilateral alteration. Orthodontists and laypeople rated a 3-mm distance from gingiva to lip as unattractive. CONCLUSIONS: Asymmetric alterations make teeth more unattractive to not only dental professionals but also the lay public.

Adult↗
PubMed1997

Occlusal cant in the frontal plane as a reflection of facial asymmetry.

PURPOSE: The purpose of this study was to compare subjective evaluation of occlusal canting in frontal photographs with objective radiographic measurements to determine the threshold at which a cant is recognized as abnormal. PATIENTS AND METHODS: Standardized frontal photographs (at rest and smiling) of two groups of orthognathic surgery patients were evaluated. Group 1 consisted of patients with a documented occlusal cant (n = 21), and group 2 consisted of patients with no cant (n = 22). Four untrained and five trained observers independently, and blind to the diagnoses, assessed patient photographs to judge the presence or absence of canting. These subjective results were compared with objective measurements of the angle of the occlusal plane to the true horizontal on each patient's posteroanterior (PA) cephalogram. RESULTS: The mean occlusal cant was 5.0 degrees +/- 1.6 degrees for group 1 and 1.4 degrees +/- 0.9 degree for group 2. The difference between groups was statistically significant (P < .01). Cants greater than 4 degrees were detected clinically with greater than 90% frequency by both untrained and trained observers. CONCLUSIONS: The results of this study indicate that 4 degrees is the threshold for recognition of an occlusal cant by 90% of observers. This information has significant implications for three-dimensional planning and outcome assessment in orthognathic and craniofacial surgery.

Adolescent↗
PubMed1993

EMG study of the anterior, superior and posterior auricular muscles in man.

Anterior, superior and posterior auricular muscles were studied electromyographically by means of wire electrodes. During ear movement the three muscles acted as a group and the movement was always directed upwards and backwards. The highest electrical activities were observed during natural smiling and yawning. Mouth opening without the drawing backwards of the comissura labiorum and the displacement of galea aponeurotica also produced electrical activity by the auricular muscles, with however, less intensity and in only 50% of the cases studied.

Adult↗
PubMed2002

Tooth loss in the very old: 13-15-year incidence among elderly Iowans.

OBJECTIVES: Very few studies have reported tooth loss incidence over a period of 10 years or more, and fewer have reported tooth loss occurrence in subjects aged 80 and older, so that the long-term pattern of tooth loss in the very old is largely unknown. This study assessed 13-15-year tooth loss incidence among a cohort of Iowans, aged 65 and older at baseline. METHODS: Oral examinations were conducted on 520 subjects beginning in 1983, and periodically until 1988, with another round of examinations conducted on surviving members of the initial cohort during 1996-98. RESULTS: Of the 73 remaining subjects, 45 subjects lost a total of 153 teeth during the period (mean=2.1 teeth lost), with a maximum of 17 teeth lost. Molars were the most commonly lost teeth, while canines and maxillary incisors were the least commonly lost. Bivariate analyses found that tooth loss was associated with untreated decay at baseline and level of periodontal attachment loss at earlier examinations. Logistic regression identified only greater severity of attachment loss as a significant risk factor for tooth loss (Adjusted odds ratio=2.4, P=0.006). The impact of tooth loss on subjects' lives was assessed using OHIP and other questions. The occurrence of tooth loss over the study period had little impact, but the number of remaining teeth significantly impacted subjects' ability to eat or chew food, swallow, or their willingness to smile. CONCLUSIONS: These results suggest that tooth loss continues in the very old, that periodontal attachment loss is associated with tooth loss in this age group, and that loss of teeth over one's lifetime does affect certain quality-of-life measures.

Aged↗
PubMed1999

Intraindividual variability in infant behavior.

Longitudinal observational data of infant crying, fretting/fussing, and smiling and the time spent in physical contact with the mother were used in a study on behavioral variability. The infants were followed weekly for a 15-month period. Evidence was found of an important intraindividual variability in the studied behaviors, specifically between the ages of 0 and 5 months, 5 and 10 months, but not between 10 and 15 months. Results are discussed and analyzed in the light of earlier literature. The possible functions and the factors underlying variability in development as well as its methodological implications are discussed.

Crying↗
PubMed2004

Mothers' behavior modifications during pretense and their possible signal value for toddlers.

An important issue for understanding early cognition is why very young children's real-world representations do not get confused by pretense events. One possible source of information for children is the pretender's behaviors. Pretender behaviors may vary systematically across real and pretend scenarios, perhaps signaling to toddlers to interpret certain events as not real. Pretender behaviors were examined in 2 experiments in which mothers were asked both to pretend to have a snack and really to have a snack with their 18-month-olds. Episodes were analyzed for condition differences in verbal and nonverbal behaviors, including smiling, looking, laughter, and functional movements. Reliable differences were found across conditions for several variables. In a 3rd experiment, children's apparent understanding of pretense in relation to their mothers' behaviors was examined, and significant associations were found with some of the mothers' behavioral changes but not others. This work provides a first inroad into the issue of how children learn to interpret pretense acts as pretense.

Attention↗
PubMed2003

Bodily distalization of molars with absolute anchorage.

Palatal implants have been used over the last two decades to eliminate headgear wear and to establish stationary anchorage. In this case report, the stability of a palatal implant for distalization of molars bodily and for anchorage maintenance was assessed. The implant was a stepped screw titanium (4.5 mm diameter x 8 mm length), and it was placed in the palatal region for orthodontic purposes. A surgical template containing a metal drill housing was prepared. Angulation of the drill housing was controlled according to the radiologic tracing of the maxilla transferred to a plaster cast section in the paramedian plane. The implant was placed using a noninvasive technique (incision, flap, and suture elimination) and left transmucosally to facilitate the surgical procedure and to reduce the number of operations. The paramedian region was selected (1) to avoid the connective tissues of the palatine suture and (2) because it is considered to be a suitable host site for implant placement. After three months of healing, the implant was osseointegrated and orthodontic treatment was initiated. For molar distalization, the Keles Slider appliance was modified and, instead of a Nance button, a palatal implant was used for anchorage. The results showed that the molars were distalized bodily at five months, and no anchorage loss was observed. At the end of the treatment, the smile was improved, and an ideal Class I molar and canine relationship, an ideal overbite, and an ideal overjet were all achieved. In conclusion, palatal implants can be used effectively for anchorage maintenance and in space-gaining procedures. Use of a three-dimensional surgical template eliminated implant placement errors, reduced chair time, minimized trauma to the tissues, and enhanced osseointegration. This method can be used effectively to achieve distalization of molars bodily without anchorage loss.

Adolescent↗
PubMed1997

Recognition of veneer restorations by dentists and beautician students.

Three types of veneer restorations (VRs) were evaluated for recognition by two groups of observers to study the aesthetic result. The different types of VRs were: porcelain, direct resin composite and indirect resin composite. One month after insertion of the VRs, colour transparencies were made of smiling patients randomly selected from a group of 112 patients participating in a clinical trial. The slides were evaluated by five dentists who were not familiar with the patients and by 25 beautician students (BS). Dentists were asked to locate the VRs which were present in the patients and to specify the type of VR. BS were only asked to locate the VRs. To trace a possible relationship between the aesthetic result of the treatment and a number of variables, ANOVA was applied to evaluate the variables: 'discolouration of the teeth' before treatment, 'type of VR' and 'number of VRs'. Agreements in judgement were expressed in Cohen-Kappa coefficients. The results showed that the dentists could locate the VRs quite well (Kappa coefficient 0.64 +/- 0.28) but for BS this was lower (Kappa coefficient 0.43 +/- 0.27). The more VRs were made in one patient, the more difficult it was to locate them correctly. The other variables had no significant effect on the recognition of the VRs. It was not possible for the dentist observers to differentiate between the types of VRs.

Adult↗
PubMed2006

[Interceptive treatments for deformities in the vertical dimension].

Vertical dimension deformities result from an interference of multiple etiological factors acting during the growth period. They include maxillary and mandibular growth, dento-alveolar compensations as well as the functional environment. These deformities do not work in total isolation, but usually combine with others present in sagittal and transverse dimensions. Our intervention has to be three-dimensional and take into consideration the interaction of the three dimensions of space. It must address soft tissue components as well as the dento-alveolar and the skeletal ones of the maxilla and the mandible. Interceptive treatment of vertical dimension deformities rests on two pillars: the diagnosis and therapeutics. The diagnostic pillar aims to show how different structures relate to each other as well as with neighboring structures. These structures consist of the soft tissue components that will eventually control the smile, the dento-alveolar component that influences occlusal plane inclination and the skeletal component that determines the vertical facial type. Using this analysis, we classify our patients in categories that facilitate our later therapeutic intervention. The therapeutic pillar is constructed in an attempt to find solutions for the list of problems established during diagnosis and to encourage development of logical individualized thinking, independently of the orthodontic technique used. All of this underlines the importance of choosing an Individualized Orthodontic Therapy based upon concepts that respond to different individual clinical situations and work most effectively to achieve treatment objectives.

Cephalometry↗
PubMed1978

Mother-stranger discrimination in three-month-old infants and subsequent Gesell performance.

The amount of vocalization, motor activity, and smiling in response to vocal stimulation by the mother and by a stranger was recorded from 14 normal male infants when they were 3, 5, 7, and 9 months old. The Gesell Developmental Schedules were administered to them at age 9 months. High Gesell developmental quotient infants showed different vocalization and motor activity responses to the mother versus the stranger as early as 3 months. These differences diminished progressively to a minimum at 9 months. Low Gesell developmental quotient infants showed no differential responses to mother versus stranger. The results suggest that mother-stranger discrimination at age 3 months may be used as an indicator of subsequent cognitive development, and further suggest that bright babies may attain permanence for the mother's schema as early as 3 months of age.

Age Factors↗
PubMed1987

Cognitive task influence on relative hemispheric motor control: mouth asymmetry and lateral eye movements.

While strictly verbal cognitive tasks showed a strong left-hemisphere dominance, the presence of visualization and emotion in cognitive tasks resulted in increased involvement of the right hemisphere in motor control of speech as measured by mouth asymmetry. Spontaneous smiles showed right-hemisphere dominance. Lateral eye movements showed an unexpected shift to left gaze during speech which may suggest a dual task interference between speech and gaze motor control.

Adolescent↗
PubMed1999

Evaluation of muscle graft using facial nerve on the affected side as a motor source in the treatment of facial paralysis.

To acquire symmetry of the cheek when smiling, we carried out 39 free vascularised grafts of the muscle, the motor nerve of which was sutured to a stump of the ipsilateral facial nerve, for 39 patients with facial paralysis. We used two methods: an as healthy and fresh as possible facial nerve stump (method 1A, n = 17), or an incompletely affected stump (method 1B, n = 22). The results are classified into grade 1 to 5 indicating increasing efficiency of muscle function. All patients who had method 1A and 14 patients who had method 1B were evaluated grade 4 or better. Both an incompletely affected facial nerve stump and the proximal stump of a facial nerve that had previously been resected have sufficient function to provide contraction in the grafted muscle.

Adult↗
PubMed1989

Aesthetic treatment of the columella.

Through a transfixion incision, a rhomboidal portion of both the depressor muscle of the nasal septum and the orbicular muscle of the mouth are excised. The remaining columellar tissues are brought nearer to each other by means of a mattress suture tied over a double-foam bolus. This simple procedure yields three advantages: (1) Tip projection, (2) nasolabial angle opening, (3) Interalar distance reduction, especially in the black population, avoiding the Weir-Joseph procedures. This simple and harmless procedure renders better results than the use of cartilage grafts or silicone implants aiming to project the tip or to open the nasolabial angle. Also, in some cases the patients' smile is enhanced.

Facial Muscles↗
PubMed1998

Major depression: behavioral markers of depression and recovery.

The concepts of psychosocial and psychomotor inhibition characteristic of major depression are based primarily on clinical observations. It is possible to describe and define these two types of inhibition by means of a systematic, quantitative ethological (behavioral) approach, which singles out precise and significant behavior markers. This investigation focuses on the behavioral features of psychosocial and psychomotor inhibition in 11 hospitalized depressed subjects and their changes during clinical recovery. The hypothesis that major depression is characterized by a significant reduction of social interaction is tested (psycho-intellectual inhibition is not addressed). Results show significant behavioral differences between depressed and recovered subjects with depression being characterized by a significant reduction of social interaction, whereas self occupation and body mobility are reduced to a lesser degree. Behavior markers for depression include nonspecific gaze, withdrawal, no mouth movements, no eye region movements, and social inactivity. Behavior markers for recovery include socially interested, social smile, verbal social initiative, speech, nod, raised eyebrows, wrinkled eyebrows, social laughter, gesticulation, drum one's fingers, point, and help. Findings point to tendencies toward two types of major depression and two types of recovery. A companion paper (Schelde, this journal) addresses theoretical issues.

Adult↗
PubMed1979

Pseudo-paralysis of the mandibular branch of the facial nerve after platysmal face-lift operation.

With the increasing popularity of platysmal face lifts, the anatomy of the cervical branch of the facial nerve should be noted. The postoperative appearance of lack of ability to retrude the corner of the mouth, in someone who had a "full denture" smile preoperatively, could possibly be due to severance or stretching of the rami of the cervical branch of the facial nerve--rather than an injury of the facial nerve of the marginal mandibular branch.

Aged↗
PubMed1997

Quantitative analysis of facial motion components: anatomic and nonanatomic motion in normal persons and in patients with complete facial paralysis.

The maximal static response assay of facial motion, described in 1994, enables the simultaneous measurement of multiple facial motions by tracking the positions of specific facial points. While the maximal static response assay provides accurate measurement of facial motion, the analysis of these data lacks the simplicity of a single-number scale such as the House-Brackmann system, a subjective scale traditionally used to classify facial function. The purpose of this study was to develop a simplified numerical index capable of summarizing the data generated by the maximal static response assay in a clinically meaningful way. We also wanted to develop a method whereby only anatomic motion or nonanatomic motion in the paralyzed face could be quantitated. Anatomic motion is the motion of the specific facial points studied by the maximal static response assay that can be attributed solely to the pull of the regional facial muscles that govern the movement of those points. Nonanatomic motion is motion that is secondary to the pull of the unaffected contralateral muscles that is transmitted to the paralyzed hemiface. Thirty-four patients with complete facial paralysis were studied. The maximal static response assay was performed on all patients on presentation to the Facial Nerve Center at the University of Pittsburgh Medical Center or after development of complete facial palsy postoperatively. The data from these patients were compared with maximal static response assay data from 26 unaffected controls. The anatomic index of facial motion and the nonanatomic index of facial motion were calculated for all study participants. The anatomic index of facial motion measures anatomic facial motion, and the nonanatomic index of facial motion measures nonanatomic facial motion. To calculate the anatomic index of facial motion, the vector magnitudes of the supraorbital, infraorbital, and modiolar motions during brow lift, eye closure, and smile are summed. The anatomic index of facial motion represents a ratio of this sum on the affected side to the corresponding sum on the unaffected side using only anatomic motions. The nonanatomic index of facial motion is a similar ratio using nonanatomic motion only (i.e., motions in directions that cannot be produced by the ipsilateral muscles). The anatomic index of facial motion represents a single number that can be used to assess facial motion. The value of the anatomic index of facial motion for patients with complete facial paralysis is 0.07 +/- 0.08. The anatomic index of facial motion for normal individuals is 1.05 +/- 0.13 (p < 0.0001, Mann-Whitney rank-sum test). The nonanatomic index of facial motion in normal individuals is 0.05 +/- 0.08; in patients with complete facial paralysis, it is 0.34 +/- 0.32 (p < 0.0001, Mann-Whitney rank-sum test). During recovery from complete facial paralysis, the anatomic index of facial motion and the nonanatomic index of facial motion each revert steadily toward normal values. The anatomic index of facial motion and the nonanatomic index of facial motion are single numbers based on the maximal static response assay, which quantitatively describes anatomic motion and nonanatomic motion in patients with complete facial paralysis. Although patients with complete facial paralysis have motion on the paralyzed hemiface, the motion is primarily nonanatomic. Both indices can be used to track recovery from complete facial paralysis.

Adolescent↗
PubMed1998

One-stage transfer of the latissimus dorsi muscle for reanimation of a paralyzed face: a new alternative.

The two-stage method combining neurovascular free-muscle transfer with cross-face nerve grafting is now a widely accepted procedure for dynamic smile reconstruction in cases with long established unilateral facial paralysis. Although the results are promising, the two operations, about 1 year apart, exert an economic burden on the patients and require a lengthy period before obtaining results. Sequelae such as hypoesthesia, paresthesia, and conspicuous scar on the donor leg for harvesting a sural nerve graft also cannot be disregarded. To overcome such drawbacks of the two-stage method, we report a refined technique utilizing one-stage microvascular free transfer of the latissimus dorsi muscle. Its thoracodorsal nerve is crossed through the upper lip and sutured to the contralateral intact facial nerve branches. Reinnervation of the transferred muscle is established at a mean of 7 months postoperatively, which is faster than that of the two-stage method. In our present series with 24 patients, 21 patients (more than 87 percent) believed that their results were excellent or satisfactory, which also compares well with the results of the two-stage method combining free-muscle transfer with cross-face nerve graft.

Adolescent↗