Lip Length Research Articles

Enhancing Philtrum Morphology Using Fat Grafting Combined with Percutaneous Rigottomy in Repaired Unilateral Cleft Lip.

Improving the philtrum morphology of patients with a secondary cleft lip deformity has been a challenge in cleft care. Combining fat grafting with percutaneous rigottomy has been advocated for treatment of volumetric deficiency associated with a scarred recipient site. This study assessed the outcome of synchronous fat grafting and rigottomy for improvement of cleft philtrum morphology. Consecutive young adult patients ( n = 13) with a repaired unilateral cleft lip who underwent fat grafting combined with rigottomy expansion technique for enhancement of philtrum morphology were included. Preoperative and postoperative three-dimensional facial models were used for three-dimensional morphometric analyses including philtrum height, projection, and volume parameters. Lip scar was qualitatively judged by a panel composed by two blinded external plastic surgeons using a 10-point visual analogue scale. Three-dimensional morphometric analysis revealed a significant (all P < 0.05) postoperative increase of the lip height-related measurements for cleft philtrum height, noncleft philtrum height, and central lip length parameters, with no difference ( P > 0.05) between cleft and noncleft sides. The postoperative three-dimensional projection of the philtral ridges was significantly ( P < 0.001) larger in cleft (1.01 ± 0.43 mm) than in noncleft sides (0.51 ± 0.42 mm). The average philtrum volume change was 1.01 ± 0.68 cm 3 , with an average percentage fat graft retention of 43.36% ± 11.35%. The panel assessment revealed significant ( P < 0.001) postoperative scar enhancement for the qualitative rating scale, with mean preoperative and postoperative scores of 6.69 ± 0.93 and 7.88 ± 1.14, respectively. Synchronous fat grafting and rigottomy improved philtrum length, projection, and volume and lip scar in patients with repaired unilateral cleft lip. Therapeutic, IV.

Pollinator Proboscis Length Plays a Key Role in Floral Integration of Honeysuckle Flowers (Lonicera spp.).

Pollinator-mediated selection is supposed to influence floral integration. However, the potential pathway through which pollinators drive floral integration needs further investigations. We propose that pollinator proboscis length may play a key role in the evolution of floral integration. We first assessed the divergence of floral traits in 11 Lonicera species. Further, we detected the influence of pollinator proboscis length and eight floral traits on floral integration. We then used phylogenetic structural equation models (PSEMs) to illustrate the pathway through which pollinators drive the divergence of floral integration. Results of PCA indicated that species significantly differed in floral traits. Floral integration increased along with corolla tube length, stigma height, lip length, and the main pollinators' proboscis length. PSEMs revealed a potential pathway by which pollinator proboscis length directly selected on corolla tube length and stigma height, while lip length co-varied with stigma height. Compared to species with short corolla tubes, long-tube flowers may experience more intense pollinator-mediated selection due to more specialized pollination systems and thus reduce variation in the floral traits. Along elongation of corolla tube and stigma height, the covariation of other relevant traits might help to maintain pollination success. The direct and indirect pollinator-mediation selection collectively enhances floral integration.

Test and direct strength method on slotted perforated cold-formed steel channels subjected to eccentric compression

This paper aims to investigate the buckling behaviors of cold-formed steel (CFS) channels with slotted web holes determined by the Steel Stud Manufacturers Association (SSMA) under eccentric compression, and propose the simplified direct strength method (DSM) formulas for engineering practicing. An experimental study on 20 specimens was conducted, including 18 slotted perforated specimens with nine eccentricities increasing from −20 mm to 20 mm and 2 unperforated specimens subjected to axial compression. Two kinds of nominal lip lengths for cross sections were selected as 15 mm and 20 mm. The experimental results indicated that the failure modes of slotted perforated specimens subjected to eccentric compression depended on the position of the eccentricity. Compared with the slotted perforated specimens subjected to pure axial compression, the ultimate loads of specimens subjected to positive eccentric compression decreased by 21.70 % on average, while they decreased by 16.38 % on average for those subjected to negative eccentric compression. Moreover, a nonlinear elasto-plastic finite element model (FEM) was developed and validated against the experimental results. Furthermore, combined with the experimental results, extensive FE parametric analyses were conducted to predict the eccentricity impact coefficient formulas. Finally, based on DSM of unperforated CFS members subjected to pure axial compression in AISI S100-16 and the eccentricity impact coefficient formulas, the suitable DSM design formulas for slotted perforated CFS channels determined by the SSMA under eccentric compression were proposed, without the need to calculate the elastic buckling critical stress for slotted perforated CFS channels.

Breeding System of &lt;i&gt;Thymus mongolicus&lt;/i&gt; (Lamiaceae)

Abstract—Thymus mongolicus (Ronniger) Ronniger (Lamiaceae) is a valuable medicinal and aromatic plant. T. mongolicus is the implicitly polycentric dwarf shrub widely distributed in different environments of Tuva. The breeding system of T. mongolicus was studied in three steppe and meadow habitats. Statistically significant differences between bisexual and pistillate flowers of T. mongolicus were established based on three morphological features of the flower: the length of the upper lip of the corolla and the length of stamen filament of the upper and lower stamens (p 0.0001–0.016). The length of the upper lip of corolla of the bisexual flower is 1.3 times longer than that of the pistillate flower; the lengths of stamen filaments of upper and lower stamens of bisexual flowers are 3.7 and 4.1 times longer (respectively) than the length of staminodes of pistillate flowers. The stamens of the pistillate flowers are underdeveloped and do not form fertile pollen. The frequency of females occurrence in coenopopulations is insignificant (2.1–3.4% of the total number of generative individuals), and females are absent in some phytocoenoses. Reproduction of T. mongolicus occurs both by seed and vegetatively. The distribution of T. mongolicus individuals by ontogenetic groups showed that both pregenerative individuals (33.0–38.1% of the total number of individuals) and generative individuals (31.2–63.7%) are well represented in cenopopulations. Analysis of the ratio of genets and ramets in the steppe petrophyte coenopopulation showed the significant predominance of the vegetative individuals in all ontogenetic groups: in general, there are 3.7 times more ramets than genets. In the meadow coenopopulation, the germination of seeds and the spread of generative individuals is prevented by the relatively high total projective cover of the herbage. It can be assumed that the low occurrence of T. mongolicus females is a-ssociated with a low seed renewal and specificity of offspring inheritance.

Three-dimensional Anthropometric Analysis of Racial and Ethnic Differences in Unilateral and Bilateral Cleft Nasal Deformity.

This study used three-dimensional measurements to provide a nasolabial analysis of patients with unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), and controls across different races and ethnicities. A retrospective comparative study. Tertiary care pediatric institution. The study included 90 patients with UCLP, 43 patients with BCLP, and 90 matched controls. Patients are separated as self-identified Caucasian, Hispanic, or African American. Nasal length, nasal protrusion, columellar height, columellar width, tip width, alar width, alar base width, nasolabial angle, upper lip length, philtrum length, nostril height, and nostril width. All UCLP groups had significantly greater columella and tip widths and decreased nasolabial angles than controls. All BCLP groups had significantly greater columella width, tip width, nasolabial angle, and nostril widths. Upper lip length, philtrum length, and nostril height were significantly decreased in BCLP compared to controls. Across UCLP groups, African Americans had significantly decreased nasal protrusion and columella height and a significantly increased columella width compared to Caucasians and Hispanics. Alar and alar base widths were significantly different between all groups. Across BCLP groups, the Caucasian nostril width was significantly less than the African Americans. These findings suggest that when correcting nasolabial characteristics in patients with cleft lip, it is important to consider racial and ethnic differences to achieve a normal appearance. Specifically, goals for alar width, alar base width, nasal tip, and projection should be tailored to the patient's race and ethnicity.

Floral and genetic divergence across environmental gradients is moderated by inter-population gene flow in Platanthera dilatata (Orchidaceae)

Understanding how natural selection acts on intraspecific variation to bring about phenotypic divergence is critical to understanding processes of evolutionary diversification. The orchid family is well known for pollinator-mediated selection of floral phenotypes operating among species and along environmental or geographic gradients. Its effectiveness at small spatial scales is less understood, making the geographic scale at which intraspecific floral variation is examined important to evaluating causes of phenotypic divergence. In this study, we quantified phenotypic variation in the orchid Platanthera dilatata across 26 populations in coastal Southeast Alaska and compared this to edaphic and genetic variation at microsatellite loci. We sought to determine (1) if flower morphological variation is structured at smaller geographic scales, (2) the extent of genetic divergence in relation to phenotypic divergence, (3) the scale at which inter-population gene flow occurs, and (4) the relative importance of geographic distance and abiotic factors on population genetic structure. Two morphological groups were found to separate based on lip and spur length and are restricted to different habitats. Small-flowered forms occur in muskeg bogs, whereas large-flowered forms occur in fens and meadows, and rarely in sub-alpine habitat. Genetic analyses were concordant with the morphological clusters, except for four small-flowered populations that were genetically indistinguishable from large-flowered populations and considered to be introgressed. In fact, most populations exhibited some admixture, indicating incomplete reproductive isolation between the flower forms. Pollinators may partition phenotypes but also facilitate gene flow because short-tongued Noctuidae moths pollinate both phenotypes, but longer-tongued hawkmoths were only observed pollinating the large-flowered phenotype, which may strengthen phenotypic divergence. Nevertheless, pollinator movement between habitats could have lasting effects on neutral genetic variation. At this small spatial scale, population genetic structure is only associated with environmental distance, likely due to extensive seed and pollinator movement. While this study corroborates previous findings of cryptic genetic lineages and phenotypic divergence in P. dilatata, the small scale of examination provided greater understanding of the factors that may underlie divergence.

Hollow denture fabrication using putty index: A case report

Severely atrophic ridges are a challenge to prosthodontist for rehabilitation. Severe resorption leads to increased inter-arch space, long lip length, increased weight, and height of maxillary denture. These situations disrupt the retention, stability, and support of denture. Overloading of soft and hard tissues leads to further resorption. Hollowing of prosthesis reduces its weight. By reducing weight of the prosthesis, these severely atrophic ridges can be handled in a better way. This article describes a technique of fabricating a hollow maxillary complete denture.

Association of Body Mass Index (BMI) with Lip Morphology Characteristics: A Cross-Sectional Study Based on Chinese Population

Lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery to ensure facial aesthetics. Body mass index (BMI) has proved to have influence on facial soft tissue thickness, but its relationship with lip morphology is unclear. This study aimed to evaluate the association between BMI and lip morphology characteristics (LMCs) and thus provide information for personalized treatment. A cross-sectional study consisted of 1185 patients from 1 January 2010 to 31 December 2020 was conducted. Confounders of demography, dental features, skeletal parameters and LMCs were adjusted by multivariable linear regression to identify the association between BMI and LMCs. Group differences were evaluated with two-samples t-test and one-way ANOVA test. Mediation analysis was used for indirect effects assessment. After adjusting for confounders, BMI is independently associated with upper lip length (0.039, [0.002-0.075]), soft pogonion thickness (0.120, [0.073-0.168]), inferior sulcus depth (0.040, [0.018-0.063]), lower lip length (0.208, [0.139-0.276]), and curve fitting revealed non-linearity to BMI in obese patients. Mediation analysis found BMI was associated with superior sulcus depth and basic upper lip thickness through upper lip length. BMI is positively associated with LMCs, except for nasolabial angle as negatively, while obese patients reverse or weaken these associations.

Comparison of Mean Upper Lip Length in Individuals with Competent Lips, Lips Apart and Incompetent Lips

Background: The human lips are the essential structure for speech, facial expression and oral functions like eating, drinking and breathing. The orthodontic treatment is very crucial for the advancement of the facial expression Lip incompetence is a condition in which the lips fail to close adequately leading to negative effects on speech, facial esthetics and oral functions. Study design: It is a retrospective study conducted at WATIM Dental College Rawat, Rawalpindi and Altamash Institute of Dental Medicine, Karachi for the duration of six months from Jan 2022 to June 2022. Material and Methods: The patients were divided into three groups. The patients that did not follow the inclusion criteria were excluded from the study. Group I had patients with competent lips, group II had patients with their lips apart and group III had incompetent lips. There were 45 patients in each group. Results: The length of group I members was 19.8 mm for men and 18.7 mm for women, which was less than group III individuals with 20 mm and 18.9 mm average upper lip length for males and females. Group II patients had a length of 17.5mm for male patients and 16.4 mm for female patients. The P-value was calculated and the results were statistically significant. Conclusion: The length of group I members was 19.8 mm for men and 18.7 mm for women, which was less than group III individuals with 20 mm and 18.9 mm average upper lip length for males and females. Group II patients had a length of 17.5mm for male patients and 16.4 mm for female patients. Keywords: Lip incompetence and competent lips.

A Modified Approach in Lip Repositioning Surgery for Excessive Gingival Display to Minimize Post-Surgical Relapse: A Randomized Controlled Clinical Trial.

Lip repositioning surgeries are performed to treat patients with excessive GD (EGD). This study aimed to explore and compare the long-term clinical results and stability following the modified lip repositioning surgical technique (MLRS) with the addition of periosteal sutures compared to the conventional lip repositioning surgery (LipStaT®) in order to address EGD. A controlled clinical trial with female participants (n = 200) intended to improve their gummy smile were divided into control (n = 100) and test (n = 100) groups. The gingival display (GD), maxillary lip length at rest (MLLR), and maxillary lip length at maximum smile (MLLS) were measured at four time intervals (Baseline; 1 Month; 6 Months, and 1 Year) in millimeters (mm). Data were analyzed by t-tests, Bonferroni-test, and regression analysis using SPSS software. At the one-year follow-up, GD for the control and test groups were 3.77 + 1.76 mm and 2.48 + 0.86 mm, respectively, and their comparisons showed that GD was considerably lower (p = 0.000) in the test group compared to the control group. The MLLS measurements taken at baseline, one-month, six-month, and one-year follow-up showed no significant differences (p > 0.05) between the control and test groups. At baseline, one-month, and six-month follow-up, the mean and standard deviation for the MLLR were almost similar, with no statistically significant difference (p = 0.675). The MLRS is a successful and viable treatment option for the treatment of patients with EGD. The current study showed stable results and no recurrence with MLRS until the one-year follow-up compared to LipStaT®. With the MLRS, a 2 to 3 mm decline in EGD is usually to be expected.

Reconstruction of Macrocheilia on the Lower Lip Through Bilateral Limited Excision and a Stepwise Single-Stage Approach (BLESS).

The surgical management of macrocheilia secondary to port-wine stains is complicated. This study aimed to propose an innovative method for treating macrocheilia on the lower lip. Patients who underwent the reconstruction of macrocheilia on the lower lip through the innovative approach were examined. Their preoperative and postoperative standard photographs were taken to evaluate the changes in lip length and thickness. The scores on Vancouver scar scale (VSS) and visual analog scale (VAS) were evaluated. Thirty-two patients who underwent the reconstruction of macrocheilia were examined. A follow-up of 12.2 months (6-36 months) was conducted. The lower lip contour and the mentolabial groove were reconstructed to normal appearance. The lip length was shortened from 5.38 ± 0.49 cm pretreatment to 4.59 ± 0.30 cm posttreatment (p = .016). The exposed vermilion was shortened from 2.05 ± 0.48 cm to 1.26 ± 0.12 cm posttreatment (p < .01). The mean VSS and VAS scores were 2.2 ± 1.5 and 8.4 ± 1.3, respectively. The bilateral limited excision and stepwise single-stage approach were safe and effective for reconstructing prominent macrocheilia on the lower lip. The technique was also easy to command for the beginners.

Manipulation of multiple floral traits demonstrates role in pollinator disease transmission.

Plants modulate multitrophic ecological interactions, and variation in plant traits can affect these interactions. Pollinators are exposed to pathogens at flowers and acquire or transmit pathogens at different rates on different plant species, but the traits mediating those interactions are almost entirely unknown. We experimentally manipulated five plant traits that span scales including flower, inflorescence, and plant, to determine their effects on pathogen transmission between foraging bees. Specifically, we manipulated two morphological traits (corolla lip length and flower orientation within an inflorescence) and three resource distribution traits (inflorescence nectar, plant patch nectar, and plant aggregation) in tents to test how plant traits affect bee pathogen transmission. We also quantified foraging behavior and fecal deposition patterns as potential mechanisms driving differences in transmission, and assessed trait manipulation consequences for bee reproduction. We found that pathogen transmission was reduced when we trimmed the corolla lip, evenly dispersed nectar distribution within an inflorescence, or aggregated plants in space. Some traits also affected bee reproduction; tents with trimmed corollas had more larval production than control tents, and tents with evenly distributed nectar across plant patches had more larval production than tents with clumped resources. Thus, some trait manipulations both reduced transmission and increased bee microcolony reproduction, although our design does not allow us to discern whether these are related or separate effects. Taken together, our results demonstrate causal effects of several floral traits on pathogen transmission and pollinator reproduction, indicating the importance of intraspecific plant trait variation for pollinator health and population dynamics.

Classification and surgical treatment methods for partial traumatic upper lip deformity.

Establish a classification method for partial traumatic upper lip deformity and verify the classified repair method is superior to the traditional non-classified method. Lip deformities caused by partial tissue defects of less than one-third of total lip length were classified into three types and conducted corresponding surgery based on philtrum ridge and orbicularis oris muscle involvement as well as the extent of roll line discontinuity. In this review, 42 cases were non-classified historical controls before the classification was devised, and 67 cases were classified. Data were collected 12months after surgery. The pre- and post-operative data of all patients were compared. In classified patients, the scar width decreased significantly, from 3.1± 0.6 mm to 1.2± 0.2 mm; the height difference of the groove line was significantly reduced from 3.3± 0.9 mm to 0.9± 0.1 mm; the ratio of the vermilion area of the affected to healthy side decreased significantly from 1.37 ± 0.31 to 1.05 ± 0.17; the ratio of the lip peak height of the affected to healthy side in type III decreased significantly from 1.91 ± 0.32 to 1.07 ± 0.12; patient satisfaction rate was about 98.5 percent. Clinical outcomes showed significant improvement of lip aesthetics with a high patient satisfaction rate in the classified group than the non-classified group.

Assessment of soft- and hard-tissue changes following combined anterior segmental bi-jaw orthognathic surgery.

Anterior segmental Bi-jaw orthognathic surgery is indicated primarily for the correction of dentoalveolar protrusion. They are also indicated for correcting apertognathia, closing interproximal spaces between segments and can be incorporated with other osteotomies to obtain better results. The aim of this study was to analyze and compare the soft- and hard-tissue changes in patients who underwent combined anterior segmental bi-jaw orthognathic surgery. To compare and evaluate soft- and hard-tissue changes before and after combined anterior segmental bi-jaw orthognathic surgery by assessing (a) parameters in vertical dimension and (b) parameters in horizontal dimension and patient satisfaction was also assessed following surgery at 6 months' time interval. It is a prospective, single center and analytical study with sample size of 20 patients. It required routine setup for orthognathic surgery and manual tracing of lateral cephalograms. The surgical outcomes were assessed by hard tissue (Sella Nasion Point A (SNA) angle, Sella Nasion Point B (SNB) angle, Point A Nasion Point B (ANB) angle, NAPg, U1-NF, L1-MP angles; NA, NB, B-Pg, Nasion-Anterior nasal spine (N-ANS) distance, Anterior nasal spine-Gnathion (ANS-Gn) distance, and overjet and overbite) and soft tissue (facial convexity, NL, LM angles; LM fold, UL and LL protrusions, Upper lip length (ULL), Lower lip length (LLL), Sn-A, Si-B, Pg-Pg*, Ls-U1, Li-L1 distances, interlabial gap, and U1 exposure) variables pre and postsurgery. Descriptive statistics involved the mean and standard deviation, and recorded data were subjected to the statistical analysis using IBM SPSS 20 statistical package. The paired t-test, Pearson correlation coefficient were used. The level of significance P < 0.05 was taken as statistically significant and P < 0.01 as very significant. Overall improvement after surgery in both hard- and soft-tissue parameters was observed and significant changes were seen in every variable, except Si-B (P > 0.05). Correlations between soft- and hard-tissue changes were significant in both sagittal and vertical planes. Patients' satisfaction score showed that all patients had the high overall rate of satisfaction. Our study concludes that combined anterior segmental bimaxillary orthognathic surgery is a simple technique with minimal postoperative complications and limited relapse. The changes in facial esthetics and occlusion following orthognathic surgery depend highly on the stability achieved during the postoperative period.

Photographic Facial Soft Tissue Analysis by Means of Linear Measurements in Adult Pakistani Population

Background: Achieving pleasant and well balanced face is primary objective of orthodontic management. Comprehending facial tissues and acceptable range of structures, allows formulation of treatment plan. Objectives: This study rationale was to establish mean linear photogrammetry norms for adult Pakistanis, to aid in diagnosis, planning of treatment, esthetics and stability in the therapy results, for local population. Methods: A cross sectional study, on 78 subjects from Fatima Memorial Hospital and undergraduate scholars of Fatima Memorial College of Dentistry. Gathered data was logged and examined in SPSS 20. Quantitative variables were expressed as mean and standard deviation. Categorization ofgender and age was carried out to check distractors and independent t-test was used, with p-value ≤ 0.05 as significant statistically. Result: Result of this research exhibited marked variation in genders for length of lower lip, which was shorter in females than males. The length of lower lip which was significant on the basis of gender, was statistically insignificant on the basis of age. All other parameters showed statistically insignificant difference on the basis of gender and age. Conclusion: This research concluded that average values for gender and age for linear parameters must be used while planning cases for orthodontic therapy ofpatients of Pakistani origin. Keywords: Photogrammetry, Esthetics, Soft Tissue, Orthodontics, Treatment Planning, Diagnosis.

DYNAMIC SMILE EVALUATION IN ALL THREE SKELETAL PATTERNS

OBJECTIVES: To compare the different smile variables amongst patients with varying vertical skeletal patterns, and to find whether there is a correlation between the dynamic contributing factors and the vertical smile parameters. METHODS: This cross-sectional study was conducted at department of Orthodontics, Nishtar Institute of Dentistry, Multan, Pakistan from 01-10-2020 to 01-04-2021. The posed smiles of 120 participants, aging 15-25 years, having well-aligned dental arches were videotaped for objective measurements and comparisons with their underlying vertical skeletal growth patterns. RESULTS: The evaluation of smile parameters showed a significantly decreased inter-labial gap in patients with skeletal low angle in males (8.92±3.6mm) and females (9.44±2.58 mm) [p&lt;0.004]. Upper lip length was significantly decreased in low angle (16.23±1.59 mm) cases for males as compared to vertically high (18.57±1.47 mm) and normal angle (18.24±2.08 mm) cases. Inter commissural width was increased significantly in the low angle cases (63.39±8.14 mm) when compared with the high angle cases (58.24±5.44 mm) in females. Maximal Incisal Display was significantly increased in high angle cases (9.03±1.31 mm) p&lt;0.001 as compared to the low angle cases (7.64±1.98 mm). A 65.8% (n=79) of the sample showed a flat smile arc with 26.7% (n=32) having consonant smiles while 7.5% (n=9) showed a reverse smile arc. CONCLUSION: Smile dynamics are influenced by underlying skeletal patterns. Individuals with skeletally high angles showed an increased incisal display and an increased upper lip elevation upon smiling. While the low angle patterns displayed a decreased inter-labial gap and majority showed a flat smile arc.

Assessment of Smile Dimensions in an Adult Moroccan Population

Background: This study aimed to assess the smile dimensions according to gender, age, and the perception of the overall quality and attractiveness of the smile. Methods: A cross-sectional study including 204 Moroccan men and women distributed over five age categories was conducted between January and September 2021. Gender, age, satisfaction and auto-evaluation of the smile were collected using questionnaire. Then, two images of each participant, one at rest and one upon the largest smile were taken. The following distances were measured on the images: length of the lips and width of the mouth at rest and upon smile, gingival and maxillary central incisor displayed upon smile. Results: Dimensions were significantly more important in men. Women displayed significantly more gingiva. With age, the length of the upper lip at rest increased significantly until the age of 50 and the width of the mouth upon smile continued increasing significantly. 74% of the participants were satisfied with their smile. Participants' satisfaction with their smile was not associated with the degree of gingival display. Conclusion: Males have more important dimensions of the lips and the mouth. Females display more gum than males. Age influences the upper lip length at rest which increases up to the age of 50, and the mouth width upon smile which continues to increase with age. Practical Implications: The definition of specific facial norms for each ethnic group considering gender and age groups is essential to establish diagnoses and orthodontic treatment plans.

Electromyographic Evaluation of Superior Orbicularis Oris Muscle Activity in Patients With Complete Cleft Lip and Cleft Palate Before and After Vestibuloplasty Using Carbon Dioxide Laser Therapy.

Introduction: Cleft lip and cleft palate are the most typical congenital craniofacial anomalies. Post-surgical scars in cleft lip patients can cause shallow upper labial sulcus and reduced upper lip length. The aim of the present study was to evaluate the impact of CO2 laser vestibuloplasty on the electromyographical (EMG) activity of patients' superior orbicularis oris muscle, depth of labial sulcus, and upper lip length, and their satisfaction with the procedure and its results. The CO2 laser is an effective vestibuloplasty procedure, is safe and highly acceptable for patients, and has little effect on muscle contraction. Methods: A total of 15 cleft lip and cleft palate patients participated in this study. Vestibuloplasty was performed using carbon dioxide laser therapy in one session in such a way that EMG activity in the upper lip muscle, depth of labial sulcus, and upper lip length were measured two times: before (T0) and twenty days after surgery (T1). Patients' satisfaction surveys were also recorded using a patient questionnaire at T1. Results: The mean values for vestibular depth at T0 and T1 were 2.00±1.71 and 4.52±1.43, respectively. The mean values for upper lip length at T0 and T1 were 6.90±2.32 and 8.00±2.40, respectively, suggesting a significant change in vestibular depth and upper lip length. The vestibular depth and upper lip length significantly increased at T1. The EMG recording of the upper lip muscle experienced a moderate decrease after laser treatment, both at rest and at maximum lip protrusion. Moreover, patients' satisfaction with the surgical procedure was 82% positive. Conclusion: Using the CO2 laser increased the vestibular depth and upper lip length successfully and made small changes in the EMG activity of the superior orbicularis oris.

The influence of tissue redraping after Le Fort I type osteotomy

Elongation of the upper lip, in particular the philtrum, and nose widening are common postoperative changes after a Le Fort I osteotomy. These changes can be induced by the transection of soft tissue and loosening of the underlying musculature. A methodology for soft tissue redraping was developed to limit these undesirable nasolabial changes. This study evaluates the effectiveness of the technique and influence of maxillary translocation on the nasolabial form. Anthropometric measurements, lip, philtrum length, and nose width, were taken two weeks prior to, and one year after, surgery. The mean postoperative changes were minimised to less than 1mm except for lip length in the extrusion groups, which was less than 1.5mm. Statistical analysis showed a stable result for lip length after maxillary advancement and/or intrusion as limited lengthening mainly occurred at the vermilion. Conversely, lip lengthening after extrusion mainly occurred at the philtrum. The mean nose width was maintained after maxillary advancement, decreased after extrusion, and increased after intrusion. The type of maxillary translocation only influenced the nasolabial soft tissue in case of intrusion and extrusion, not after advancement.

Evaluation of Upper lip length in vertical growth pattern individuals with and without gummy smile

Background and Aim :The most esthetic smile is when the entire length of the crown of the tooth and 2 mm of the gums are visable. Most of it is not aesthetically pleasing and is called gummy smile or gingival smile.Upper lip length is one of the factors influencing the gummy smile. The aim of the present study was to investigate the upper lip length in patients with vertical growth pattern, with and without gummy smile and related factors.