Background: The evaluation of surgical outcomes is needed to achieve excellence in nasal reconstruction of patients with complete bilateral cleft lip and palate (BCLP). The study objective is to evaluate the quality of nasal aesthetics after the columella elongation surgery. Methods: The sample of this study consisted of 70 patients with complete BCLP, operated on columella elongation surgery and analyzed at 6 to 12 years. The system for evaluation of nasal appearance after the columella elongation surgery was performed by objective and subjective analyses. Anthropometric Measurements: Four anthropometric nose measurements were performed directly on the faces, and the same was performed in control group (60 children without oral clefts), paired by age and sex with the experimental group. The measurements were repeated 3 times (triplicate). Subjective Analysis: Scores to evaluate nasal width, nasal tip projection, and length of the columella were applied before and after the columella elongation surgery by 5 raters from the rehabilitation team. Interrater and intrarater agreement was calculated by means of the kappa test. Results: Nasal width in BCLP group was higher when compared to the control group ( P < 0.05). Nasal tip projection (subnasal–pronasal) and columella length (subnasal–columella) were decreased in BCLP group compared to that of the controls ( P < 0.05). Columella width was similar in both study groups ( P > 0.05). All scores of nasal aesthetics significantly improved after the columella elongation surgery. Conclusions: Nose of the patients with BCLP is wider, is less projected, and has the shorter columella compared to that of the noncleft subjects. After secondary columella elongation surgery in BCLP, nasal width, nasal projection, and columella length significantly improved.

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Orthodontic treatment requires ethical and legal attitudes from professionals since the first contact with the patient. Thus, this study assessed professional profile, legal obligations in provision of care, and the conduct of orthodontists in terms of litigation prevention during their professional practice. Questionnaires were emailed to 1653 Brazilian orthodontists, asking for information such as: age, gender, graduate orthodontic education, time of work in orthodontics, place of graduate education, time since graduation, and information regarding the legal criteria involved in the orthodontic treatment. Data were tabulated using absolute and relative frequencies. The chi-square test (p<0.05) was used to verify the association among nominal qualitative variables. Only 163 orthodontists participated in the study, wherein men represented 60.5% and women 39.5% of the sample. It was clear that professionals most recently graduated are the ones that mostly use the care provision contract, and the ones that mostly request teleradiographs. The female gender offered more treatment options, clarified the estimated treatment time more often, and was less involved in legal issues. On the other hand, the male gender requested cephalometry more often. Most professionals request the control radiograph, and all of them file the medical records of patients. Few professionals use the professional liability insurance. The results of the present study indicate a highly heterogeneous professional profile. The female gender dominates the field of expertise, and they seem to be more careful regarding legal obligations.

A má-oclusão de Classe III é uma anomalia dento-facial, descrita inicialmente por Angle e caracterizada pela relação incorreta dos molares superiores e inferiores. Apesar da baixa incidência da má-oclusão de Classe III, sua correção é complexa, sobretudo em fases tardias do surto de crescimento ósseo. Nesses casos as opções são a compensação dentária ou a cirurgia ortognática. Nesse sentido, a ancoragem esquelética tem sido cada vez mais utilizada na Ortodontia e Ortopedia Facial devido à possibilidade de movimentações mais complexas, com maior e melhor controle da mecânica, bem como mínimos efeitos dentários indesejados. Dessa forma, este trabalho tem como objetivo relatar a correção da Classe III em paciente com dentadura permanente jovem com uso de expansor e mini-implantes extra alveolares pela Terapia MAMP. Paciente do gênero feminino, 13 anos e 11 meses, leucoderma, insatisfação estética e funcional decorrente da má-oclusão presente.