Poliklinik für Kieferorthopädie, Präventive Zahnmedizin und Kinderzahnheilkunde, Zentrum für Zahn- Mund- und Kieferheilkunde, Ernst-Moritz-Arndt-Universität Greifswald, Rotgerberstrasse 8, D-17475 Greifswald, Germany.
Numerous ritual acts involving the skull result in orofacial changes. The present study focuses on ritual acts of Brazilian Zoé Indians. A distinct deformation effect of the ritual act (wearing a lip-plug) on the morphology of the orofacial system is demonstrated and documented using jaw models. The studies show that the lip-plug significantly influences tooth position and jaw growth. While the maxilla displays palatal displacement of the lateral incisors and elevation of the palate, retraction occurs in the mandible depending upon plug size. Additionally, both the plug and the nutritional habits of the Indians induce marked abrasion of all teeth. Moreover, it is shown that the duration of lip-plug wear is an essential determinant of sustained orofacial changes.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Several techniques that have been described for reconstructing the lower lip often produce microstomia, commissure distortion, functional impairment, and decreased sensitivity. A technique for preserving neuromuscular tissue during a single-stage lip reconstruction is reported in this study. This technique involves the use of the vermilion myomucosal advancement flap with or without the mentolabial skin flap. METHODS: This study analyzed 17 male patients with squamous cell carcinoma. The mean patient age was 54.8 years, and incidence of lip defects after resection ranged from 20% to 85%. RESULTS: Infection, nerve damage, or the requirement for surgical revision was not observed in any patient during the follow-up period of three months. Three patients had microstomia with slight posterior enlargement of the lip. All patients had good sensitivity and adequate sphincter continence. CONCLUSIONS: The use of the vermilion myomucosal flap with or without the mentolabial skin flap resulted in a minimal risk of microstomia or functional incompetence. This procedure is performed in a single surgical stage and has good aesthetic and functional results for reconstruction of up to 80% of the lower lip.
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