Abstract During times of increasingly recognized importance of interprofessional practices, professionals in Medicine, Dentistry, and Speech Pathology areas cooperate to optimize treatment of velopharyngeal dysfunction (VPD), after primary palatoplasty for correction of cleft palate. Objective Our study aims to compare velar length, velar thickness, and depth of the nasopharynx of patients with unilateral cleft lip and palate (UCLP) with the presence, or absence, of hypernasality and nasal air emission; and to verify if the depth:length ratio, between nasopharynx and velum, would be predictive of consistent hypernasality and nasal air emission (speech signs of VPD). Methodology Cephalometric radiographs and outcome of speech assessment were obtained from 429 individuals, between 6 and 9 years of age, with repaired unilateral cleft lip and palate. Velar length, velar thickness, depth of the nasopharynx, depth:length ratio, scores of hypernasality, and scores of nasal air emission were studied and compared; grouping the radiographs according to presence or absence of hypernasality and nasal air emission. Results For the group with speech signs of velopharyngeal dysfunction (those with consistent hypernasality and nasal air emission), the velums were shorter and thinner; the nasopharynx was deeper and the depth:length ratio was larger than the group without hypernasality and nasal air emission. Velar length was significantly shorter in individuals with consistent hypernasality and nasal air emission (p<0.001) and with history of palatal fistula (p=0.032). Depth of nasopharynx was significantly greater in individuals with consistent hypernasality and nasal air emission (p<0.001). Depthlength ratio was significantly larger in individuals with consistent hypernasality and nasal air emission (p<0.001). A depth:length ratio larger than 0.93 was always associated with speech signs of VPD. Conclusion Estimated with cephalometric radiographs, a depth:length ratio greater than 0.93, between the nasopharyngeal space and the velum, was 100% accurate in predicting hypernasality and nasal air emission after primary repair of unilateral cleft lip and palate.

Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.

OBJETIVO: ciente de que a cirurgia ortognática moderna se preocupa em planejar e diagnosticar os casos clínicos utilizando medidas obtidas de grandezas do perfil tegumentar dos pacientes - com o auxílio de imagens digitais empregadas em softwares de planejamento -, no presente estudo foi proposto aferir as medidas de brasileiros leucodermas de descendência européia e compará-las com as medidas já padronizadas por Arnett, com o intuito de criar novas medidas a serem seguidas por brasileiros que utilizam o software de predição cirúrgica Dolphin Imaging 9.0. MÉTODOS: foram utilizadas radiografias cefalométricas de 31 pacientes com oclusão Classe I de Angle e harmonia facial. Todas as radiografias foram digitalizadas e inseridas no software Dolphin 9.0 e 16 pontos de tecido mole e 22 pontos do esqueleto facial foram marcados, seguindo-se exatamente as marcações da análise de Arnett e McLaughlin presentes no programa. RESULTADOS: os resultados obtidos foram avaliados estatisticamente e mostram que o perfil do brasileiro é quase totalmente diferente do perfil norte-americano, exceção feita a apenas quatro pontos para os homens e outros quatro para as mulheres. Os brasileiros apresentam uma face menos protruída, um perfil mais convexo e menor proeminência do queixo do que o grupo controle. CONCLUSÃO: esses dados mostram a necessidade de se realizar algumas mudanças nas grandezas numéricas para que um perfeito diagnóstico e planejamento possam ser realizados em brasileiros, criando assim o padrão do perfil facial do brasileiro leucoderma de descendência européia.

AIM: Considering that modern orthognathic surgery is mainly concerned in planning and diagnosing clinical cases by the use of patients' soft tissue measurements obtained from digital images used in planning software, the aim of this study is to establish Caucasian Brazilians measures and to compare them to the standard North American measures. METHODS: For this, a total of 31 Angle's Class I patients not previously submitted to orthodontic treatment and presenting harmonious facial features were invited to participate in the study as volunteers. The patients were initially photographed in frontal and lateral views and, afterwards, cephalograms were obtained. The images were digitized, adjusted and indexed in Dolphin's image software. In order to precede cephalometric analysis, a total of 16 soft tissue profile points and 22 hard tissue profile points were demarcated, accordingly to American original measurements used in Dolphin's digital image program. After, all cephalograms were again evaluated to determine intra-examiner error according to paired Student's t test. Mean and standard error measures were obtained and compared to American measures by unpaired Student's t test with 95% of confidence level. RESULTS: The results obtained have shown that all measurements, except for 4 points in male and 4 points in female, are significantly different between Brazilian and American samples. Data show that Brazilians' soft tissue profile is almost completely different from American's, with a less protrusive face, shorter chin projection and a more convex profile. CONCLUSION: This suggests the necessity of performing some changes in numerical values to obtain an ideal diagnosis and planning of orthognathic surgery in Brazilians.