Meropi N. Spyropoulos

Hyoid bone position and orientation in Class I and Class III malocclusions

Various studies have documented a variability of hyoid bone position in relation to changed mandibular position or head posture. The aim of this study was to investigate the hyoid bone position and inclination on the cephalometric radiographs of two groups of patients exhibiting Class I and Class III malocclusions. The radiographs were taken in both centric occlusion and wide-opened mandibular position, and 17 measurements were performed on both tracings. The findings reveal a statistically significant difference in the position and inclination of the hyoid bone in the two groups; Class III patients, especially the boys, show a more anterior position of the hyoid bone and also a reverse inclination. This might have an implication on the function of the suprahyoid and infrahyoid muscles and thus on the direction of mandibular growth.

Configuration of facial features influences subjective evaluation of facial type

INTRODUCTION Clinical assessment of facial type and facial proportions is an important element of orthodontic diagnosis and subsequent treatment planning. Because of the subjective nature of this procedure, it is important to identify factors that could affect final judgment. One such factor that has been shown to affect facial perception in general might be the configural relationship of internal parts of the face. Our aim in this study was to assess whether configural changes in a face affect the subjective evaluation of facial type. METHODS The frontal photographs of 2 white boys, aged 12 years, with harmonious face were used. The photographs were manipulated by computer to produce realistic images of faces with various configural relationships of the features. The modifications were interocular distance enlarged by 3 mm or reduced by 3.6 mm, mouth width enlarged by 4.5 mm or reduced by 4.2 mm, and mouth moved vertically upward or downward by 2.8 mm. Two images with a true change of the frontal facial height by 4 mm were also produced. The images were presented in pairs to 20 experienced orthodontists. Each judge evaluated 36 pairs of images (including pairs of identical images), all belonging to the same patient, in a random sequence. The judges were unaware of the changes that had been made to the photographs and were asked to evaluate which of the 2 faces appeared longer. RESULTS The judges correctly identified pairs of identical images with an accuracy of 42%. Reduction of the interocular distance and downward movement of the mouth caused the illusion of a longer face. The opposite changes had the reverse effect. Enlargement of the width of the mouth did not appear to influence the subjective impression of facial type, but reduction of mouth width had a statistically significant result, giving the impression of a longer face. CONCLUSIONS Configural relationships among the constituent features of a face can influence our judgment about external facial proportions. Because of the importance of these factors in treatment planning, clinical evaluation of faces should be accompanied by objective assessment (measurement) of photographs, so that any illusory visual effects can be identified.

Communication between doctor and patient in contemporary times

ince ancient times and even in primitive societies, Sthe persons involved with the care of sick people— whether mythological divinities, “magicians,” or true doctors—have always had some special privileges and were deeply respected by the others. Hence, the explanation of the well-known verse from Homers Iliad, when Achilles asks the old doctor Idomeneus to give priority and special care to a specific wounded warrior, Mahaon, by saying “for he is a doctor, a man worthy of many others.” In ancient Greece, 2500 years ago, Hippocrates, the “Father of Medicine,” in addition to his splendid medical observations and proposals and to his belief that “the profession of all those who are practicing medicine is philanthropy,” incorporated his high ethical code for the behavior of those who practice medicine in his famous oath that is universally renowned and time resistant. It is an oath that, in essence, constitutes an eternal legacy, worthy of the nobility of the Greek spirit. On the basis, however, of the knowledge stemming from the astonishing evolution of medicine through the ages, it becomes obvious that, in contemporary times, things have changed. Due to the vast invasion and the irresistible attraction of modem technology, in collaboration with other factors, the communications between doctors and patients have acquired many new, different, and often impersonal, alienating, and strange parameters, that are hardly understandable or appreciated by the patients. I am well aware that our profession has some specific characteristics that differentiate it from other medical and dental specialties. For example, we are dealing mostly with young patients and the parents behind them, and our services—whether to young or Every medical action is, ultimately, the cooperation between a conscience and a confidence.