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At least 127 records · Page 7Linked to original sources
PubMed2006

Neurosensory alteration in the lower lip and chin area after orthognathic surgery: bilateral sagittal split osteotomy versus inverted L ramus osteotomy.

PURPOSE: This study investigated neurosensory disturbances in patients after orthognathic surgery in relation to differences in mandibular splitting methods and degree of surgical skill. PATIENTS AND METHODS: Forty-five patients who had undergone bilateral sagittal split ramus osteotomies (SSRO), and 21 (group L) who had undergone intraoral inverted L ramus osteotomies (ILRO), were examined for postsurgical neurosensory disturbances. Twenty-two (group S1) of the SSRO patients were treated by 11 surgeons who had little experience, and the others (23 patients; group S2) were treated by 2 skilled surgeons who had considerable experience. One of the 2 skilled surgeons was the only surgeon carrying out the ILRO procedure. The neurosensory tests employed included light touching using a Semmes-Weinstein monofilament tester (SW tester), electrical stimulation, and a questionnaire to determine changes in subjective sensations, at the time of each sensory evaluation. Neurosensory examinations were carried out bilaterally (132 sides) at 1, 3, 6, and 12 months after surgery. RESULTS: More patients showed abnormal thresholds for the 2 measurement techniques in the SSRO group than in the ILRO group, and furthermore there were more such patients in group S1 than in group S2, at each measurement point. At 6 months after surgery, the number of patients with reduced sensitivity was significantly higher in group S1 than in group L (P < .05). In the SSRO group at each measurement point, the thresholds for the lower lip and chin were unrelated to the set-back (or advance) distance. By contrast, in group L only at the 1-month evaluation point, the thresholds for the lower lip and chin were significantly raised in patients whose setback distances were larger than average (P < .05). CONCLUSIONS: Postsurgical neurosensory disturbances of the lower lip and chin occur more frequently in SSRO patients treated by surgeons having little experience than in those treated by skilled surgeons, although the difference is not significant. Long-term prognosis for resolution of postsurgical neurosensory disturbances is better in ILRO patients than in SSRO patients. Although the width of movement of the split bone fragments has an influence on postsurgical neurosensory disturbances immediately after ILRO, the relationship becomes less obvious with time.

Adult↗
PubMed2005

Children with multiple disabilities and minimal motor behavior using chin movements to operate microswitches to obtain environmental stimulation.

In these two studies, two children with multiple disabilities and minimal motor behavior were assessed to see if they could use chin movements to operate microswitches to obtain environmental stimulation. In Study I, we applied an adapted version of a recently introduced electronic microswitch [Lancioni, G. E., O'Reilly, M. F., Singh, N. N., Sigafoos, J., Oliva, D., & Baccani, S., et al. (2004). Technological aids to promote basic developmental achievements by children with multiple disabilities: evaluating two cases. Cognitive Processing 5, 232-238]. In Study II, we set up a new microswitch detecting the chin-movement response through an optic sensor. Each study was carried out according to an ABAB sequence in which A represented baseline and B intervention phases. A 2-month post-intervention check also occurred. The data showed that both children increased the frequency of the chin response, thus increasing the level of environmental stimulation, during the intervention phases. This performance was retained at the post-intervention check. The overall suitability of this response and related microswitches as well as the need to explore other potential responses and microswitches for children with minimal motor behavior is discussed.

Brain Diseases↗
PubMed1997

Control of a trackball by the chin for communication applications, with and without neck movements.

The overall aim was to evaluate whether a trackball could be used for communication by people who cannot speak due to severe motor impairment. The precision of trackball control by isolated jaw movements or a combination of jaw and head movements was evaluated in 18 healthy physical-education students, free of overt symptoms of craniomandibular dysfunction. The participants were asked to operate a trackball using the chin to type a standard text of four short sentences. There were two experimental situations: nine participants performed the typewriting task with their heads fixed; the other nine performed this task with free head movements. Trackball operation moved to the cursor over an alphabetical keyboard displayed on a computer screen and character selection was made by depression of the left-hand click button using the chin. Participants were asked to perform the task as quickly and accurately as possible. Result showed that those with free head movement typed the test significantly faster than those restricted to using only their jaw muscles. The mean time per character selection was 2.4 s (SD 0.3) for the group with free head movement and 2.7 s (SD 0.3) for the group using only jaw muscles. Group scores were not significantly different with regard to accuracy. It is suggested that a chin-operated trackball could be used for communication applications both with and without neck movements.

Adult↗
PubMed2000

Examination of the chin or lower abdomen only for the prediction of hirsutism.

OBJECTIVE: To test the hypothesis that scoring terminal hair growth on only the chin or abdomen can serve as a reliable predictor for hirsutism. DESIGN: A prospective observational study. PATIENT(S): Six hundred and ninety-five consecutive hyperandrogenic women seen between June 1987 and December 1997. MAIN OUTCOME MEASURE(S): All hirsutism exams were performed by one examiner. Hirsutism was scored using a modification of the Ferriman-Gallwey (F-G) method. An F-G score of > or = 8 defined hirsutism. RESULT(S): Of the 695 women examined 352 (50.1%) had hirsutism scores of 8. Thirty percent (79 of 344) of women who had an F-G score of <8 had previously underwent electrology. If either the chin or lower abdomen hair growth score was > or = 2, the sensitivity was 100% for the prediction of hirsutism, although the specificity was 27%. The positive predictive value (PPV) for hirsutism using a hair score of > or = 2 at either of these sites was 58%. CONCLUSION(S): A hair growth score of > or = 2 on the chin or lower abdomen only was found to be a highly sensitive predictor for hirsutism. However, because of its very low PPV, this screening method is virtually useless in populations where the hirsutism frequency is expected to be low, about 5%. However, this screening method for the detection of hirsutism would be useful for the study of high-risk populations with an expected hirsutism prevalence of >20% (e.g., family studies).

Abdomen↗
PubMed2000

Numb chin syndrome as the presenting symptom of metastatic prostate carcinoma.

We report a case of the numb chin syndrome as the presenting symptom in a patient with metastatic prostate carcinoma. The numb chin syndrome is characterized by facial numbness along the distribution of the mental branch of the trigeminal nerve. Most cases of this syndrome that are not dental in origin have been associated with diffuse metastatic disease, particularly with underlying lymphoproliferative and breast cancer. Although axial and vertebral bone metastases are common in patients with carcinoma of the prostate, mental nerve involvement is rare. We present a case of the numb chin syndrome as the initial clinical manifestation in a patient with metastatic prostate adenocarcinoma.

Aged↗
PubMed1981

Sagittal chin rotation of the prognathic edentulous mandible.

In edentulous patients with a prognathic mandible, a pronounced chin and extensive resorption of the lower alveolar ridge, the commonly used techniques of ramus osteotomy and chin reduction will not give optimal results in the majority of cases. The solution of this problem can be obtained by mandibular body ostectomy and a sagittal rotation of the frontal part of the lower jaw. By this operation the originally horizontally orientated upper plane of the chin area is placed in a more vertical position. This operative technique gives a better predictable facial contour than the conventional methods. It causes no unfavorable displacement of the lower lip and, which is very important, it gives an absolute increase of height of the lower alveolar ridge and a more favorable inclination of the frontal part of the alveolar process from a prosthetic point of view. The problems encountered and the results obtained by this technique will be demonstrated by a short case presentation.

Adult↗
PubMed1998

"Effective condylar growth" and chin position changes in Herbst treatment: a cephalometric roentgenographic long-term study.

In 98 Class II Division 1 malocclusions treated with the Herbst appliance "effective condylar growth" (a summation of condylar remodeling, glenoid fossa remodeling, and condylar position changes within the fossa) and its influence on the position of the chin was analyzed. Lateral head films in habitual occlusion from before and after 0.6 years of Herbst treatment as well as 0.6 years and 3.1 years posttreatment were evaluated. All patients were treated to Class I or overcorrected Class I dental arch relationships. During the treatment period, effective condylar growth was relatively more backward directed and about three times larger than that in untreated subjects with ideal occlusion (Bolton Standards). During the first posttreatment period of 0.6 years, effective condylar growth recovered with respect to both the direction and amount of changes. During the second posttreatment period of 2.5 years, effective condylar growth was "normal." The corresponding chin position changes during the different examination periods were a mirror image of effective condylar growth provided no mandibular autorotation occurred. In cases with anterior mandibular autorotation, relatively more forward and in cases with posterior mandibular autorotation relatively more backward directed chin position changes resulted.

Adolescent↗
PubMed1998

Placement of endosteal implants combined with chin bone onlay graft for dental reconstruction in patients with grafted alveolar clefts.

Endosteal implants were inserted into grafted alveoli after particulate cancellous bone and marrow grafting in seven patients with cleft lip or palate in conjunction with simultaneous chin bone onlay grafting. In these patients, the alveolar bone height of the bony bridge was insufficient when evaluated by both computed tomographic and periapical radiographic images. The age at first implant surgery ranged from 14 to 28 years. Although four of the seven patients had an uneventful course, three had wound dehiscence, and in all but one of them the exposed chin bone underwent partial or total necrosis. Ultimately all seven implants integrated into the bone, and the alveolar bone height was increased in all but one patient. The results indicate that chin bone onlay grafting with simultaneous implant insertion is useful in patients with cleft lip or palate with insufficient alveolar bone height.

Adolescent↗
PubMed2002

Effects of a modified acrylic bonded rapid maxillary expansion appliance and vertical chin cap on dentofacial structures.

The aim of this study was to determine the sagittal, transverse, and vertical effects of a modified acrylic bonded rapid maxillary expansion (RME) device used with a vertical chin cap on dentofacial structures. The study group consisted of 34 patients (25 girls and 9 boys) who were selected without regard to their skeletal class and gender. All subjects had permanent dentition (mean age, 12.7 years) and needed maxillary expansion. Study Group I (RME only) was composed of 17 subjects, and study Group II (RME with vertical chin cap) was composed of 17 subjects. Twenty-nine measurements were made on the patients' cephalometric films and plaster models. The means and standard deviations for linear and angular cephalometric measurements were analyzed statistically, and intra-group and inter group changes were evaluated by paired and Student's t-tests using SPSS 10.1 for windows. We found that the maxilla moved anteriorly relative to the anterior cranial base. The nasal width, maxillary width, intercanine width, mandibular intermolar width, maxillary intermolar width, and overjet all increased, while the upper molars tipped buccally in both groups. In Group I, the mandible rotated posteriorly, the lower anterior facial height increased, and the overbite decreased. These effects were reduced in Group II. We conclude that the vertical chin cap is an effective appliance for preventing the adverse vertical effects of RME in patients with a crossbite and a vertical growth pattern.

Acrylic Resins↗
PubMed2005

Chin cup treatment outcomes in skeletal Class III dolicho- versus nondolichofacial patients.

This study examines cephalometric differences and sex differences in the long-term outcome of chin cup treatments of Class III subjects with two facial patterns. Seventeen nondolichofacial and 16 dolichofacial Class III male patients and 16 nondolichofacial and 16 dolichofacial female patients were treated by either bicuspid extraction or nonextraction. Rapid palatal expansion without maxillary protraction was performed on 11 male cases and 15 female cases. The borderline between the two groups was drawn either at 39 degrees mandibular plane angle or 132 degrees (male subjects) or 130 degrees (female subjects) gonial angle. Dolichofacial subjects were treated with either an occipital or a high-pull chin cup force during the first two years, followed by high-pull force during night-time wear for the subsequent three years. All treated cases showed excellent results in the retention records with acceptable posterior occlusion as well as excellent skeletal and soft-tissue profiles. In addition, patient compliance was excellent. The treatment outcomes of the two groups showed significant improvement of the skeletal Class III malocclusion. This study indicated that the treatment period and wear time of the chin cup appliance in nondolichofacial (mostly mesiofacial pattern) patients could be shorter than those of dolichofacial patients. Although all subjects showed significant improvement in the Class III malocclusion, the treatment outcome in the two groups maintained the original characteristic skeletal morphology at retention.

Adolescent↗
PubMed2001

Importance of chin evaluation and treatment to optimizing neck rejuvenation surgery.

The chin is the keystone linking the aesthetics of the face and neck but is often neglected in the analysis. Procedures related to the chin play an important role in defining neck anatomy. Alloplastic implants can provide the illusion of a longer jaw line in a patient with retrogenia. Even greater anatomic changes to the neck result when a sliding genioplasty is performed. This effect is primarily due to the digastric attachments from the mentum and mastoid. Advancing the mentum may have a more direct effect of elevating the position of the hyoid, which sharpens the angle between the jaw and neck. Finally, the diagnosis of a witch's chin is also discussed for the patients who present for aging neck surgery.

Chin↗
PubMed1997

Sonographic imaging of the fetal face and the establishment of normative dimensions for chin length and upper lip width.

Sonographic imaging of the fetal face is important because a number of chromosomal aberrations are associated with facial malformations. Prenatal diagnosis of abnormalities of the fetal chin and lips have been based on subjective assessment. The purpose of the current study was to establish normative dimensions for the objective assessment of the fetal face. A cross-sectional study was performed in 200 normal healthy singleton pregnancies between 16 and 38 weeks' gestation. Inclusion criteria included performance of a first or early second-trimester scan to confirm gestational age (GA). Exclusion criteria included birth weight < 10th or > 90th percentile for GA, and medical complications of pregnancy. Ultrasound measurements were made in the mid-sagittal plane and included chin length (CL) and upper lip width (ULW). A first-degree linear growth function was observed throughout pregnancy between GA and ULW (r = 0.87) and CL (r = 0.91). All measured data are expressed as mean +/- 2 SD. In conclusion, these results provide normative dimensions throughout gestation for the fetal upper lip and chin. These data are expected to serve as a basis for the objective assessment of the fetal face in high-risk conditions.

Anthropometry↗
PubMed2006

Anterior open bite treated with a palatal crib and high-pull chin cup therapy. A prospective randomized study.

The aim of this prospective randomized clinical study was to cephalometrically investigate the dentoalveolar and soft tissue changes produced by a removable appliance with a palatal crib associated with high-pull chin cup therapy in children with an Angle Class I anterior open bite (AOB) malocclusion. Thirty children (8 males and 22 females) with an initial mean age of 8.3 years and a mean AOB of 4.1 mm were treated with a removable appliance composed of a palatal crib associated with chin cup therapy for 12 months. A control group of 30 individuals (7 males and 23 females) closely matched for age, initial mean age 8.6 years, gender, and ethnicity with a mean AOB of 4.6 mm was followed without treatment. The measurements (means and standard deviations) were statistically analysed using a paired t-test. The results showed no significant differences in the level of molar eruption or in lower anterior face height, suggesting that the vertical control expected from the chin cup therapy did not occur. Dentoalveolar changes at the anterior region were evident, with statistically significant extrusion, retrusion, and lingual tipping of the maxillary and mandibular incisors (P < or = 0.05). However, these hard tissue changes did not imply soft tissue changes and the variables related to the soft profile were not statistically significantly different between the groups. The dentoalveolar changes at the anterior region of the dental arches were mainly responsible for closure of the AOB in patients treated in the mixed dentition.

Cephalometry↗
PubMed2000

Chin augmentation with a bone graft from the mandibular region.

The prominent, square angles of the mandible are not generally considered an alluring virtue in Asian women because a square chin is thought to be masculine, and sunken cheeks are thought to be ill-fated. An oval, slender face is customarily preferred. A 28-year-old single woman requested reduction of the mandibular angle and concomitant chin augmentation. Each scalene triangular piece of the bone from both mandibular angles was carved and shaped like an obtuse triangle. One side of its surface was serrated to effect a curve, and the revision was fixed with a miniplate. The pieces were placed on top of each other, set on the symphysis menti, and were immobilized with screws. The excised fragments of the mandible were used as bone grafts to augment the chin during the same operation.

Adult↗
PubMed1991

Reconstruction of the lower lip and chin with the composite radial forearm-palmaris longus free flap.

Four cases of total lip and chin reconstruction are presented. In three, the composite radial forearm-palmaris longus free flap was used for reconstruction. In the fourth case, the palmaris longus was separated from the flap but still used as a lower lip sling. In all cases, the entire lower lip and the soft tissue of the chin were reconstructed in one stage. All patients healed primarily, and the three who underwent radiotherapy tolerated it without complications. Lip seal and speech were good, and there was no problem with drooling. Postoperative results emphasize the importance of respecting the aesthetic unit of the lower lip and chin.

Adult↗
PubMed1996

Alteration in facial sensibility in adolescents following sagittal split and chin osteotomies of the mandible.

Static two-point discrimination, pressure, and vibratory threshold values were measured bilaterally at standard coordinates in the area of the face innervated by the mental nerve in 115 adolescents (230 nerves). The patients were divided into four groups: normal adolescents who had not undergone any orthognathic surgery (group I controls, n = 134 nerves, mean age 18 years, SD = 3), those 1 year after undergoing bilateral sagittal split osteotomies of the mandible (group II, n = 14 nerves, mean age 19 years, SD = 2), those 1 year after undergoing an osteoplastic genioplasty (group III, n = 40, mean age 19 years, SD = 3), and those 1 year after undergoing a combination of bilateral sagittal split osteotomies and an osteoplastic genioplasty (group IV, n = 42 nerves, mean age 19 years, SD = 3). Subjective residual numbness at the 1 year postoperative interval was reported by 2 of 7 patients in group II, 2 of 20 patients in group III, and 14 of 21 patients (67 percent) in group IV. Long-term subjective numbness involved only the chin skin in 16 of 18 patients experiencing residual numbness and was perceived as problematic in the remaining 2 (group IV) patients whose subjective numbness also was measured objectively in the chin, lower lip (mucosa and skin), and gingiva. Objectively, the mean threshold values of the three sensory modalities tested were higher in group IV patients than in the remaining groups at all coordinates tested, but significant differences (p < 0.05) were found only between the mean two-point discrimination of group IV patients and the control group in the region of the chin skin. The high percentage of patients documented to have subjective and objective sensory disturbance after undergoing a combination of sagittal split osteotomies of the mandible and an osteoplastic genioplasty (group IV) may be explained by the "double crush syndrome."

Adolescent↗
PubMed2004

Galloping ophthalmoplegia and numb chin in Burkitt lymphoma.

A 57-year-old man developed complete bilateral ophthalmoplegia over a period of 10 days, together with bilateral facial pain and numbness of the chin. He had no other clinical manifestations. Findings on brain magnetic resonance imaging and spinal fluid formula from the first lumbar puncture were normal, but cerebrospinal fluid flow cytometry disclosed a kappa restriction monoclonal B-cell population, indicating malignant lymphoma. Computed tomography of the chest, abdomen, and pelvis then revealed multiple enlarged lymph nodes. Biopsy of an inguinal node showed findings consistent with Burkitt lymphoma. Within six weeks, intravenous and intrathecal chemotherapy resolved all neurologic findings except a partial right-side sixth nerve palsy and mild chin numbness. Eighteen months after disease onset, the patient remained in remission. Meningeal spread of Burkitt lymphoma is not commonly a presenting feature in immunocompetent adults. Chin numbness, a characteristic feature caused by infiltration of the mental nerve, should facilitate earlier recognition, which may be life saving.

Antimetabolites, Antineoplastic↗
PubMedDate not supplied

Numb chin syndrome in Ewing sarcoma.

The numb chin syndrome consists of unilateral hypesthesia of the chin and lower lip. In adults, it is often associated with metastatic disease to the mandible, base of the skull, or leptomeninges. In children, it has been associated with infiltration of the inferior alveolar nerve by leukemic cells. We describe two cases of numb chin syndrome in children with Ewing sarcoma. In a child with a solid tumor, this symptom seems to have an ominous meaning and should lead to the investigation of progressive skeletal involvement.

Adolescent↗