Patient- and clinician-reported outcomes of lower jaw contouring using patient-specific 3D-printed titanium implants

An innovative 3D hydroxyapatite patient-specific implant for maxillofacial bone reconstruction: A case series of 13 patients

The study aimed to evaluate and discuss the use of an innovative PSI made of porous hydroxyapatite, with interconnected porosity promoting osteointegration, called MyBone Custom® implant (MBCI), for maxillofacial bone reconstruction. A multicentric cohort of 13 patients underwent maxillofacial bone reconstruction surgery using MBCIs for various applications, from genioplasty to orbital floor reconstruction, including zygomatic and mandibular bone reconstruction, both for segmental defects and bone augmentation. The mean follow-up period was 9 months (1-22 months). No infections, displacements, or postoperative fractures were reported. Perioperative modifications of the MBCIs were possible when necessary. Additionally, surgeons reported significant time saved during surgery. For patients with postoperative CT scans, osteointegration signs were visible at the 6-month postoperative follow-up control, and continuous osteointegration was observed after 1 year. The advantages and disadvantages compared with current techniques used are discussed. MBCIs offer new bone reconstruction possibilities with long-term perspectives, while precluding the drawbacks of titanium and PEEK. The low level of postoperative complications associated with the high osteointegration potential of MBCIs paves the way to more extensive use of this new hydroxyapatite PSI in maxillofacial bone reconstruction.

Best Practices for FACE-Q Aesthetics Research: A Systematic Review of Study Methodology

BACKGROUND

The FACE-Q Aesthetics module is a validated patient-reported outcome measure (PROM) that evaluates perspectives on facial aesthetic treatments. Improper administration and poor study methodology can compromise the validity and interpretation of this PROM.

OBJECTIVES

This systematic review sought to evaluate the administration and scoring of the FACE-Q Aesthetics scales within the literature.

METHODS

A search of Ovid Medline, Embase, Cochrane, and Web of Science was performed on December 20, 2022, with the assistance of a health-research librarian (CRD42022383676). Studies that examined facial aesthetic interventions using the FACE-Q Aesthetics module as a primary or secondary outcome measure were included for analysis.

RESULTS

There were 114 studies included. The Face Overall (n = 52, 45.6%), Psychological (n = 45, 39.4%), and Social (n = 43, 37.7%) scales were most frequently reported. Errors in FACE-Q administration were identified in 30 (26.3%) studies. The most common error was the presentation of raw ordinal scores rather than the converted Q score (n = 23). Most studies reported a time horizon for their primary analysis (n = 76, 66.7%); however, only 4 studies provided a rationale for this selection. Sample size calculations for the primary outcome were rarely performed (n = 9, 7.9%).

CONCLUSIONS

There continues to be limitations in PROM administration and the quality of articles that report FACE-Q Aesthetic scale data. The authors suggest that future investigators using the FACE-Q refer to the User's Guide regarding administration and scoring of this scale, report a rationale for the study time horizon, and provide an a priori sample size calculation for the primary outcome of interest.

An overview of 3D printed metal implants in orthopedic applications: Present and future perspectives

With the ability to produce components with complex and precise structures, additive manufacturing or 3D printing techniques are now widely applied in both industry and consumer markets. The emergence of tissue engineering has facilitated the application of 3D printing in the field of biomedical implants. 3D printed implants with proper structural design can not only eliminate the stress shielding effect but also improve in vivo biocompatibility and functionality. By combining medical images derived from technologies such as X-ray scanning, CT, MRI, or ultrasonic scanning, 3D printing can be used to create patient-specific implants with almost the same anatomical structures as the injured tissues. Numerous clinical trials have already been conducted with customized implants. However, the limited availability of raw materials for printing and a lack of guidance from related regulations or laws may impede the development of 3D printing in medical implants. This review provides information on the current state of 3D printing techniques in orthopedic implant applications. The current challenges and future perspectives are also included.

The Use of the FACE-Q Aesthetic: A Narrative Review

INTRODUCTION

In the past decade there has been an increasing interest in the field of patient-reported outcome measures (PROMs) which are now commonly used alongside traditional outcome measures, such as morbidity and mortality. Since the FACE-Q Aesthetic development in 2010, it has been widely used in clinical practice and research, measuring the quality of life and patient satisfaction. It quantifies the impact and change across different aspects of cosmetic facial surgery and minimally invasive treatments. We review how researchers have utilized the FACE-Q Aesthetic module to date, and aim to understand better whether and how it has enhanced our understanding and practice of aesthetic facial procedures.

METHODS

We performed a systematic search of the literature. Publications that used the FACE-Q Aesthetic module to evaluate patient outcomes were included. Publications about the development of PROMs or modifications of the FACE-Q Aesthetic, translation or validation studies of the FACE-Q Aesthetic scales, papers not published in English, reviews, comments/discussions, or letters to the editor were excluded.

RESULTS

Our search produced 1189 different articles; 70 remained after applying in- and exclusion criteria. Significant findings and associations were further explored. The need for evidence-based patient-reported outcome caused a growing uptake of the FACE-Q Aesthetic in cosmetic surgery and dermatology an increasing amount of evidence concerning facelift surgery, botulinum toxin, rhinoplasty, soft tissue fillers, scar treatments, and experimental areas.

DISCUSSION

The FACE-Q Aesthetic has been used to contribute substantial evidence about the outcome from the patient perspective in cosmetic facial surgery and minimally invasive treatments. The FACE-Q Aesthetic holds great potential to improve quality of care and may fundamentally change the way we measure success in plastic surgery and dermatology.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Psychometric and Perceptometric Comparisons of the Perspectives of Orthodontists, Oral and Maxillofacial Surgeons, and Laypeople of Different Ages and Sexes towards Beauty of Female Jaw Angles (Intergonial Widths and Gonial Heights) on Frontal and Three-Quarter Views

Objectives

The jaw angle plays an important role in facial beauty. Therefore, this study is aimed at comparatively determining the range of most attractive female intergonial widths and gonial heights on Perceptometric frontal-view and three-quarter-view images, from the perspective of orthodontists, oral maxillofacial (OMF) surgeons, and laypeople of different ages and sexes.

Methods

This prospective multivariate Perceptometric study was performed on 4191 esthetic scores given by 127 individuals to 33 Perceptometric face images. Frontal view and three-quarter-view photographs of a normal young woman were modified by image editing software to create two Perceptometric sets, one for the 24 gradual changes of intergonial width on the frontal view, and the other for the 9 vertical changes of the jaw angle on the three-quarter view. An online questionnaire was designed including 24 frontal and 9 oblique view photographs. The questionnaires' internal consistencies were almost perfect. Enrolled were 127 raters, including 33 orthodontists, 32 OMF surgeons, and 62 laypeople. The esthetics of different images were compared across different professions, across different ages, and between the sexes using 2-way MANCOVA, ANCOVA, and Bonferroni; the zones of esthetic jaw angles and also the sensitivity of judges to Perceptometric anatomical changes were assessed using 2-way RM-ANCOVA and Bonferroni (α = 0.05, α = 0.0056, α = 0.0021, and β = 0.05).

Results

Orthodontists and surgeons gave the highest attractiveness scores to intergonial: interzygomatic ratio of 72.53%, while the best ratio was 74.45% for the laypeople. The range of beautiful intergonial is as follows: interzygomatic ratio was 72.53% to 86.03%. OMF surgeons and orthodontists gave the highest score to a gonial height of 4.5 mm above the mouth corner, while the laypeople gave the highest score to the gonial height of 4.5 mm below the mouth corner. The range of beautiful gonial height was from 4.5 mm above the mouth corner to 9 mm below the mouth corner. The education of observers may affect their perception of beauty; orthodontists tended differ from laypeople, overall and also specifically in the case of the highly attractive frontal images concerning the intergonial width changes. However, no such differences were detected between surgeons with orthodontists or laypeople. Although age did not affect the overall esthetic scores, it did affect the sensitivity of the judges to the anatomic changes. So did expertise, i.e., the expertise of judges affected their sensitivity to anatomical changes; orthodontists showed steeper slopes of esthetic preference alterations to anatomical changes, while laypeople had the gentlest slope of preference changes. Judges' sex did not affect either their overall esthetic preferences or their sensitivity to anatomic changes.

Conclusion

Narrower female jaw angles and jaw angles that are vertically close to the level of the mouth corner may be unanimously more desirable. Thus, treatments aiming at widening the jaw angle of a woman or lowering it should be discouraged, at least in Persians. Orthodontists, but not surgeons, are more sensitive than laypeople to anatomic changes of the jaw angle. The judges' age can affect this perceptive sensitivity, but their sex cannot.