Percorrer por autor "Sánchez-Ayala, Alfonso"
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- Efficacy and durability of the association of botox and skinvive in the treatment of moderate/severe wrinkles in the periorbital region : a randomized, controlled, double-blind, split-face clinical studyPublication . Neves, Maria Luiza Boechat Borges; Thome, Cecilia; Silva Junior, Silvio Ventura da; Machado, Thalita; Sánchez-Ayala, Alfonso; Câmara-Souza, Mariana Barbosa; Canales, Giancarlo De la TorreBackground: The combined efficacy and durability of botulinum toxin A (BTX) and hyaluronic acid fillers (HA) for canthal wrinkles have not been thoroughly evaluated in randomized clinical trials. Aims: This study evaluated the efficacy, safety, and durability of the combined treatment protocol of onabotulinumtoxinA and Juvederm Volite VYC-12 (Skinvive) for moderate and severe canthal lines. Methods: This randomized double-blinded split-face trial included 25 women with periorbital dynamic wrinkles at severity levels II–IV according to the Merz 5-point scale. After bilateral onabotulinummtoxinA injections, the sides of the participants' faces were randomized to receive HA injections or a simulated injection. Assessed variables included electromyography activity (EMG), Merz 5-point crow's feet scale, and FACE-Q appraisal on crow's feet lines. Assessments were performed at baseline, 1, 2, 3, and 6 months. For differences in EMG and satisfaction scores, the two-way repeated measures ANOVA and Bonferroni's post hoc analyses were conducted. Wrinkle severity scores were analyzed with the Mann–Whitney U test. Results: Inter-treatment comparisons revealed no significant differences between treatment protocols in all assessed periods for EMG (p = 0.86). For severity of canthal wrinkles, onabotulinumtoxinA + VYC-12 exhibited lower canthal wrinkle severity in rest and contracted positions after 3 (p = 0.04), and 3 (p = 0.007) and 6 (p = 0.001) months, respectively. Additionally, satisfaction with BTX-HA treatment was significantly higher after 3-month (p = 0.001) and 6-month (p = 0.001) follow-ups compared to BTX treatment. Conclusions: Higher improvements in canthal wrinkles could be enhanced by using onabotulinumtoxinA and VYC-12 in association as a treatment protocol.
- Trial data for precision analysis of a three-dimensional mandibular mechanical advantagePublication . Carneiro, Dominique Ellen; Canales, Giancarlo De La Torre; Lagravère, Manuel Óscar; Campanha, Nara Hellen; Urban, Vanessa Migliorini; Sánchez-Ayala, AlfonsoThe data presented in this manuscript describe craniofacial landmark coordinate values, muscle and load moment arm lengths, and mechanical advantage rates for constructing a three-dimensional model of masticatory muscles. Cone-beam computed tomography scans from 30 subjects (aged 12–19 years, 16 females) were used. Thirty-six craniofacial landmarks were identified. Subsequently, the moment arms for 7 muscles and their corresponding load moment arms at incisor and molar positions were determined. Then, the three-dimensional mechanical advantage for each muscle and tooth position was calculated as the ratio of muscle moment arm to load moment arm. This procedure was repeated three times by a main examiner and once by two other examiners. The Friedman test and the square root of the 'method of moments' variance estimator were used to compare data among examiners and calculate random errors, respectively. Although the values for the craniofacial landmark coordinates and biomechanical variables are very close, differences were found between measurements, especially in the interexaminer comparisons. Values served as the basis for reliability (intraclass correlation coefficient) and errors (average mean of absolute differences) analysis in the research paper titled “A three-dimensional method to calculate mechanical advantage in mandibular function: Intra- and interexaminer reliability study,” published in the Journal of Orofacial Orthopedics.
- Who is the patient with resistant myofascial temporomandibular disorders pain? A somatosensory, psychosocial, and genetic characterizationPublication . Canales, Giancarlo De la Torre; Poluha, Rodrigo Lorenzi; Soares, Flávia Fonseca Carvalho; Ferreira, Dyna Mara Araújo Oliveira; Sánchez-Ayala, Alfonso; Bonjardim, Leonardo Rigoldi; Ernberg, Malin; Conti, Paulo César RodriguesBackground: Resistance to treatments have been assessed in chronic conditions such as migraine, but not in temporomandibular disorders (TMD). This study aimed to identify factors that influence treatment outcome in patients with myofascial TMD pain. Methods: Seventy-two females were divided into three groups: TMD successfully treated (TMD-S, n = 24), TMD resistant to treatment (TMD-R, n = 24) and Controls without TMD (n = 24). Criteria for resistance included: less than 30% pain reduction after three months of conservative treatment and an average pain intensity > 50 mm (VAS) during the last month. Quantitative sensory testing (QST), psychosocial status and genetic polymorphisms were examined. ANOVA on ranks (psychosocial variables) with Dunn’s test as post-hoc or ANOVA (age and somatosensory variables) with Tukey test as post-hoc test, and Dwass-Steel-Critchlow-Fligner test (genetic variables) were used for univariate groups comparisons. Multivariate statistics were used to identify outcomes that separated the groups. Results: QST assessment revealed lower baseline pressure pain threshold and higher wind-up ratio in the trigeminally and spinally innervated areas in the TMD-R group compared with the other groups (p = 0.01). Also, the TMD-R group presented higher values in all assessed psychosocial variables (p < 0.01) and higher prevalence of the HTR1A polymorphism rs6295 (p = 0.02) compared with the other groups at baseline. Multivariate analysis showed that the three variables that distinguished the best between TMD-R and TMD-S were sleeping quality, central sensitization, and depressive symptoms. Conclusion: Psychosocial, somatosensory, and genetic alterations are related to unsuccessful treatment response in myofascial TMD patients.