Oral rehabilitation of a saxophone player with orofacial pain: a case report.

This paper presents a clinical case study investigating the pattern of a saxophonist's embouchure as a possible origin of orofacial pain. The rehabilitation addressed the dental occlusion and a fracture in a metal ceramic bridge. To evaluate the undesirable loads on the upper teeth, two piezoresistive sensors were placed between the central incisors and the mouthpiece during the embouchure.

Effect of Splinting on Orthodontic Mini-Implant Tipping and Bone Histomorphometric Parameters: An In Vivo Animal Model Study.

This study aimed to address the stability of orthodontic mini-implants submitted to an immediate orthodontic functional load, in splinted or unsplinted conditions, further characterizing the histomorphometric parameters of the neighboring bone tissue, in an experimental model. Mini-implants (1.4 × 6.

The Challenge of Dental Education After COVID-19 Pandemic - Present and Future Innovation Study Design.

The present work suggests research and innovation on the topic of dental education after the COVID-19 pandemic, is highly justified and could lead to a step change in dental practice. The challenge for the future in dentistry education should be revised with the COVID-19 and the possibility for future pandemics, since in most countries dental students stopped attending the dental faculties as there was a general lockdown of the population. The dental teaching has an important curriculum in the clinic where patients attend general dentistry practice.

Tooth Position in Wind Instrument Players: Dentofacial Cephalometric Analysis.

Background: Specific dentofacial characteristics in wind instrumentalists should be taken in consideration when analyzing physiological and anatomical issues regarding the musician's embouchure, posture, and biomechanics during musical performance.

Objectives: To compare tooth cephalometric characteristics between wind instrument players and string players (overjet, overbite, lower facial height, facial convexity, lower incisor inclination, and interincisal angle).

Methods: In total, 48 wind instrumentalists (67%) and 24 string instrumentalists (33%).

Orofacial Trauma on the Anterior Zone of a Trumpet's Player Maxilla: Concept of the Oral Rehabilitation-A Case Report.

Background: The occurrence of an orofacial trauma can originate health, social, economic and professional problems. A 13-year boy suffered the avulsion of tooth 11 and 21, lost at the scenario.

Methods: Three intraoral appliances were manufactured: A Hawley appliance with a central expansion screw and two central incisors (1), trumpet edentulous anterior tooth appliance (2) and a customized splint (3) were designed as part of the rehabilitation procedure.

Craniofacial morphology of wind and string instrument players: a cephalometric study.

Background: Playing an instrument may promote a parafunctional behavior within the cranio-cervical-mandibular-complex with unknown repercussions. The aim of this study was to find any association between the dental inter-arch relationship and the practice of a wind or string instrument.

Methods: A sample of 77 musicians, divided in two groups of wind (n = 50) and string instrumentalists (n = 27), had a lateral cephalogram taken to compare six cephalometric parameters following the Rickett's analysis (maxilla position, mandible position, facial type, skeletal class, upper incisor and lower incisor inclination).

Infrared thermography of the crânio-cervico-mandibular complex in wind and string instrumentalists.

Purpose: Musculoskeletal disorders can be common in wind and string instrumentalists. The musical gesture technique associated to musical performance can promote an asymmetrical isometric contraction with the hyperactivity of specific muscular groups and the overload of articular surfaces which can cause discomfort or pain. The aim of this investigation was to assess specific anatomical regions of interest within the cranio-cervico-mandibular complex in order to determine and evaluate the presence of muscular hyperactivity associated to musical performance.

Integrating piezoresistive sensors on the embouchure analysis of the lower lip in single reed instrumentalists: implementation of the lip pressure appliance (LPA).

Background: It is essential to understand, characterize, and measure the embouchure mechanism of a wind instrumentalists, where the applied forces on the perioral tissues can usually promote discomfort or pain.

Methods: The sample consisted of five clarinet players and five saxophone players. The embouchure force measurements at the lower lip area were assessed using a piezoresistive sensor (FlexiForce, Tekscan, Boston, USA, 0.

A new classification of wind instruments: Orofacial considerations.

Background/objective: Playing a wind instrument implies rhythmic jaw movements where the embouchure applies forces with different directions and intensities towards the orofacial structures. These features are relevant when comparing the differences between a clarinettist and a saxophone player embouchure, independently to the fact that both belong to the single-reed instrument group, making therefore necessary to update the actual classification.

Methods: Lateral cephalograms were taken to single-reed, double-reed and brass instrumentalists with the purpose of analyzing the relationship of the mouthpiece and the orofacial structures.

Combined Acquisition Method of Image and Signal Technique (CAMIST) for Assessment of Temporomandibular Disorders in Performing Arts Medicine.

Objective: This pilot study investigated the morphological and functional aspects of an English horn player, who presented at a dental appointment with temporomandibular disorder (TMD), using the "combined acquisition method of image and signal technique" (CAMIST) in the diagnosis.

Methods: Cephalometric analysis was obtained after carrying out three lateral cephalograms using a standardized radiographic technique. The first one was taken with the teeth in the normal occlusion and the lips relaxed, the second with the oboe embouchure, and the last was performed with the English horn.

Wind Instrumentalists and Temporomandibular Disorder: From Diagnosis to Treatment.

Introduction: Temporomandibular disorders (TMD) involve the presence of pain or dysfunction on certain areas of the Cranio-Cervico-Mandibular Complex (CCMC), such as the masticatory muscles, the temporomandibular joint (TMJ) and associated structures like the postural muscles of the cervical region, can be considered as a sub-group of musculoskeletal disorders. Wind instrument players, as a consequence of their musical performance and its relation with the CCMC, can develop a TMD associated to muscle hyperactivity of certain elevator muscles, or even an increase of the intra-articular pressure in the functioning of the TMJ throughout musical activity.

Aim: The objective of this paper is to describe the necessary and elementary steps in the diagnoses and treatment of a wind instrumentalist with a temporomandibular disorder, with the introduction of infrared thermography during this procedure.

A Prosthodontic Treatment Plan for a Saxophone Player: A Conceptual Approach.

Introduction: A wind instrumentalist was diagnosed with a periapical lesion on tooth 21. The prosthetic rehabilitation options were considered with respect to the embouchure mechanism of the saxophonist. The underlying mechanism associated with the embouchure of the saxophone player was observed in this particular case in order to understand if asymmetrical forces were transmitted to the upper central incisors.

Fascicular Phrenic Nerve Neurotization for Restoring Physiological Motion in a Congenital Diaphragmatic Hernia Reconstruction With a Reverse Innervated Latissimus Dorsi Muscle Flap.

Congenital diaphragmatic hernia is a severe developmental anomaly characterized by the malformation of the diaphragm. An innervated reversed latissimus dorsi flap reconstruction for recurrent congenital diaphragmatic hernia has been described as an alternative to prosthetic patch repair to achieve pleuroperitoneal separation. However, there is very little supporting scientific data; therefore, there is no real basic understanding of the condition of the phrenic nerve in the absence of diaphragmatic muscle or even the neurotization options for restoring neodiaphragmatic muscle motion.

Associated injuries in pediatric patients with facial fractures in Portugal: Analysis of 1416 patients.

Background: The authors performed a retrospective study to clarify the occurrence, causes, severity and predictors of concomitant injuries in pediatric patients with facial fractures in Portugal.

Methods: The clinical records of children and adolescents (0-18 years) with facial fractures treated by the Department of Plastic, Reconstructive, and Aesthetic Surgery and of Maxillofacial Surgery of São João Hospital, in Porto, Portugal, over a period of 20 years (1993-2012) were reviewed.

Results: A total of 1416 patients with facial fractures were included in this study.

Chimeric flaps and "their variations": different options for immediate reconstruction of massive facial defects.

The reconstruction of massive head and neck defects is a difficult challenge, requiring restoration of bone, skin, and oral lining. Their complex three-dimensional nature often dictates the need of more than a single osteocutaneous flap for intra- and extra-oral reconstruction.Conventional reconstructive options can be considered, but there is no single ideal osteocutaneous free or pedicled flap providing an unlimited length of bone and skin paddle, or that could orient the skin paddle independently of the vascularized bone.

Pediatric Facial Fractures: A Review of 2071 Fractures.

Background: Facial fractures are infrequent in children and adolescents, and there are only few reports that review a significant number of patients. The objective of this study was to analyze the pattern of maxillofacial fractures in pediatric patients of Portugal.

Study Design: We reviewed the clinical records of a series of 1416 patients 18 years or younger with facial fractures, treated by the Department of Plastic Reconstructive, Aesthetic and of Maxillofacial Surgery of São João Hospital, Porto, Portugal, between 1993 and 2012.

Microsurgical reconstruction for radiation- and bisphosphonate-induced mandible osteonecrosis based on patient-specific physiopathologic mechanisms.

Background: Radiation- and bisphosphonate-induced mandible osteonecrosis have distinct underlying physiopathologic mechanisms, but both can constitute a serious problem and lead to functional impairment and facial disfigurement.

Methods And Results: We describe different clinical situations related to several grades of osteonecrosis, where different options of free transfer should be considered based on case-specific physiopathologic mechanisms. We propose a simple clinical grading system to predict the best treatment option.

A facegram for spatial-temporal analysis of facial excursion: applicability in the microsurgical reanimation of long-standing paralysis and pretransplantation.

Background: There are several techniques available for facial reanimation, but clinicians do not have a simple tool to provide an objective and quantitative spatial-temporal analysis of facial movement in order to compare medical, surgical and physical therapy.

Methods: We developed specialized software capable of simultaneously tracking the position over time of a number of anatomical points. This method was tested in 5 different clinical situations: one normal subject, and 4 patients with facial disfigurement.

External mandibular distraction in unusual pediatric syndromes with micrognathia and airway obstruction.

Mandibular hypoplasia is a craniofacial malformation that can cause airway obstruction and may affect the eating process. This anomaly is common in many polimalformed Syndromes, including the Pierre Robin Sequence and the Moebius Syndrome. It is also common in cases related to the dysgenesis of the brainstem.