Lower Lip Position Research Articles

Evaluation of Dentofacial Angles in Children with Severe Adenoid Hypertrophy.

Hypertrophy of adenoids is a common condition in childhood, resulting in obstructive symptoms such as sleep apnea, snoring, and rhinosinusitis. Adenotonsillectomy is recommended to improve prognosis and quality of life. This case-control study compared facial angles and lip position related to dentofacial and mouth growth in symptomatic children with adenoid hypertrophy and asymptomatic control groups. The study included children aged 5 to 7 who presented with obstructive symptoms and confirmed severe adenoid hypertrophy in lateral neck radiography. Standard lateral photography was taken. The Nasofacial and Nasomental angles, and upper and lower lip positions and their distance behind the Ricketts line, were measured and compared with the normal control group. This study included 54 children with severe adenoid hypertrophy and 66 normal children. Facial angles were not significantly different between the two groups, but the mean horizontal position of the upper and lower lip in children with adenoid hypertrophy was significantly lower than in the control group (P value = 0.05). The lips were too close to the Ricketts line compared with the control group. This research demonstrates that children with severe adenoid hypertrophy have more dentofacial disorders than others. Adenotonsillectomy surgery is necessary for children with obstructive symptoms caused by tonsil enlargement, and if symptoms like snoring persist post-surgery, complementary orthodontic treatments should be considered.

Quantifying Sagittal Lip Changes in Patients with Bilateral Cleft Lip Post Abbe Flap Reconstruction.

To objectively quantify results of sagittal lip changes following Abbe flap reconstruction in patients with bilateral cleft lip. Retrospective, observational study. Single institution, 8-year retrospective review. In total, 17 patients with bilateral cleft lip that underwent Abbe flap reconstruction were included in this study. Patients had lateral photographs taken prior to Abbe flap reconstruction and at least 8 months post-Abbe flap. Vegter's index, Sushner's S2 line and Burstone's B line reference lines were used for evaluation of sagittal lip changes. Wilcoxon signed rank tests were used in analysis. The mean pre-Abbe flap upper to lower lip ratio, defined as Vegter's Lip Index, was 0.906 compared to a mean of 0.946 following Abbe flap reconstruction. The mean upper to lower lip ratio for Sushner's S2 and Burstone's B line exhibited an increase in upper lip sagittal projection from -0.164 to 1.459 and 0.259 to 0.957, respectively (P < 0.001). This study quantifies sagittal changes to upper and lower lip position after Abbe flap reconstruction. These findings may aid in operative planning and patient/caregiver expectations during counseling.

Evaluation of the External Soft Tissue Changes Following the Correction of Class II Skeletal Malocclusion in the Adolescence Period Using Removable and Fixed Functional Appliances: A Systematic Review and Meta-Analysis.

In this systematic review, we aimed to assess the current evidence regarding the effectiveness of functional treatment with both removable and fixed appliances to normalize the external soft tissue for skeletal class II adolescent individuals. We performed a broad electronic search to retrieve relevant studies from nine databases to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that investigated soft tissue changes following functional treatment and evaluated the changes using 2D lateral cephalometric radiographsand 3D-optical surface laser scanning. A total of three RCTs and eight CCTs were included. Ages ranged from 11 to 16 years with the fixed functional appliances, and from eight to 12 years with the removable ones, including 689 skeletal class II patients. Version 2 of Cochran's risk-of-bias (RoB2), and the risk of bias in non-randomized studies of interventions (ROBIN-I) were used to assess the risk of bias for the included papers. Of the 11 eligible studies, three studies were included in the meta-analysis to assess the upper and lower lip position in relation to the E-line (Ricketts's aesthetic line) in addition to the nasolabial angle. The meta-analysis showed that the upper lip retracted after functional treatment with Twin-block in relation to E-line (mean difference (MD) = -1.93; 95% CI: -2.37, -1.50; p < 0.00001; χ² = 5.43; p = 0.07; I2 = 63%), while the lower lip position did not change after functional treatment with Twin-block in relation to E-line (MD = 0.03; 95% CI: -0.56, 0.61; p = 0.92; χ² = 1.74; p = 0.42; I2 = 0%). The nasolabial angle increased after Twin-block treatment (MD = 5.75; 95% CI: 4.57, 6.93;p < 0.00001; χ² = 6.77; p = 0.03; I2 = 70%). The mentolabial angle and Z-angle also increased after functional therapy, where the facial convexity angle decreased, regardless of the functional devices used. On the other hand, using the 3D-optical surface laser scanning showed that the upper lip length and the commissural width did not change following therapy, but the lower lip increased in length, as well as the total face height. More high-quality RCTs are required to obtain accurate evidence in this field.

Facial profile esthetics and its correlation with cephalometric measurements in Class II patients before and after functional orthodontic treatment: perception of orthodontists and laypersons

Orthodontists heavily rely on cephalometric measurements to evaluate the esthetic outcomes of orthodontic treatments, while patients’ assessments of profile attractiveness are influenced by their personal esthetic preferences. The objective of this study was to compare facial esthetic evaluations between orthodontists and laypersons, examine the correlation between cephalometric measurements and assessments of facial attractiveness, and identify the cephalometric measurements that are most associated with profile attractiveness in teenage Class II patients. This study included 28 patients (17 boys and 11 girls, mean age of 11.83 ± 1.48 years) who fulfilled the inclusion criteria and were treated with activator appliances. An experienced orthodontist conducted objective cephalometric analyses before and after the treatment. The standard profiles of patients, pre- and post-treatment, were independently evaluated by 10 orthodontists and 20 laypersons. Pearson correlation analysis was used to analyze the relationships between objective cephalometric values and subjective facial esthetic ratings. The results indicated that laypersons generally assigned lower ratings to facial attractiveness compared to orthodontists. Significant differences in evaluations between orthodontists and laypersons were noted in the ratings of the upper lip position before treatment and the ratings of overall attractiveness, lower lip position and chin position after treatment. In addition, there were substantial correlations between objective measurements and the subjective scores provided by orthodontists. In contrast, the esthetic evaluations by laypersons correlated with only a limited set of objective measurements. The positions of the upper and lower incisors, the relationship of the upper and lower lip to E-line, and the Mentocervical Angle showed significant correlations with esthetic scores. In conclusion, the study reveals that laypersons were more critical of facial profiles compared to orthodontists. Notably, the positions of the upper and lower incisors, the E-line and the Mentocervical Angle had a significant impact on facial esthetics, highlighting their importance in evaluating orthodontic outcomes.

Evaluation of horizontal lip position using different soft tissue analysis in Shimla population - A cephalometric study

: 1. To study the horizontal lip position in Dentally and Dentoskeletally normal subjects of Shimla adult population using different soft tissue analysis. 2. To study the sexual dimorphism in horizontal lip position of Shimla adult population. 3. To study the differences of horizontal lip position among Dentally and Dentoskeletally normal subjects of Shimla adult population. 4. To compare the horizontal lip position of Dentoskeletally normal subjects of Shimla adult population with established norms. 5. To assess the most consistent esthetic reference line. Pre-treatment lateral cephalograms of 100 subjects aged between 18-25 years were taken, who visited the Department of Orthodontics and Dentofacial Orthopaedics Shimla, Himachal Pradesh for their orthodontic consultation for the study. In Shimla adult population retrusive upper lip in relation to Steiner’s S1 line, Ricketts’ E line and retrusive lower lip in relation to Steiner’s S1 line, Ricketts’ E line, Sushner’s S2 line was found. The norms for upper and lower lip position in relation to Burstone’s B line in Shimla adult population coincide with the established Burstone’s norms. Holdaway’s established norms for lower lip can also be applied to Shimla adult population. Shimla adult population has different cephalometric norms for horizontal lip position in relation to Steiner’s and Ricketts’ line whereas same established norms of Burstone and Holdaway can be applied to Shimla adult population.

Comparison of upper and lower lip position, length and thickness in sagittal and vertical malocclusion

This study aimed to compare the upper and lower lips position, length, and thickness in different malocclusions, in randomly selected 180 patients’ pre-treatment lateral cephalograms. The subjects were grouped sagittally by using Steiner’s analysis and Wits appraisal and vertically based on Frankfort horizontal and mandibular plane (FHMP) angle and lower facial height. One-way ANOVA was applied to compare the upper and lower lip positions, thickness, and length in sagittal and vertical malocclusion and independent sample T test was applied for comparison between genders among soft tissue variables. Post-hoc Dunnett T3 was performed for comparison of lip variables in adjacent malocclusion groups. The level of significance was not less than or equal to 0.05 The anteroposterior position of the upper and lower lips with respect to E and S planes and upper and lower lip thicknessaried significantly (p &lt; 0.05) in all classes of sagittal malocclusion, ---Continue

Change in Lower Lip Position After Le Fort I Advancement in Patients with Bilateral vs. Unilateral Cleft Lip and Palate.

To compare lower lip changes after Le Fort I advancement surgery in patients with a cleft. Single institution, retrospective review. Academic tertiary referral hospital. Skeletally mature patients with a cleft who underwent one-piece Le Fort I advancement surgery who had a lateral cephalogram or cone-beam computed tomography (CBCT) scan preoperatively and at least 6 months postoperatively. Patients who underwent concomitant mandibular surgery or genioplasty were excluded. 64 patients were included: 45 male and 19 female, 25 with BCLP and 39 with UCLP. The mean age at surgery was 18.4 years. Single jaw one-piece Le Fort I advancement surgery. Standard lateral cephalometric landmarks of the bony skeleton and soft tissue were compared before and after Le Fort I advancement. Pearson correlation coefficients (r) were calculated to measure the correlation between lower lip position and other soft and hard tissue changes. After comparable maxillary advancements [BCLP: 7.2 mm (95% CI: 6.2-8.3 mm), UCLP: 6.4 mm (95% CI: 5.7-7.0 mm)] the horizontal upper-to-lower lip discrepancy significantly improved in both groups. The lower lip became thinner and more posteriorly positioned. Changes in lower lip position correlated strongly with mandibular bony landmarks and moderately with upper lip position, but poorly with maxillary landmarks. Le Fort I advancement results in posterior displacement of the lower lip and better lip competence, thereby improving facial harmony. This lower lip change is not predictable by degree of maxillary advancement, and does not differ in patients with BCLP vs. UCLP.

Orthodontic Assessment of Lip Prominence in Pakistani population

Introduction: Many reference planes are being used to determine prominence of upper and lower lip for orthognathic face profile. E-line and S-line are being used to determine lip position in local popuation of Multan city of Pakistan. Materials and Method: Execution of present study was done in Nishtar Institute of Dentistry, Multan during the period of November 2019-March 2020. 300 (112 Males and 188 Females) subjects were selected for this study from all provinces of Pakistan. Their radiographic records (Lateral cephalograms) were taken from radiographic department of related institution. Acetate matte sheets were used to construct reference planes by using 3H pencil. Steiner’s E-line and Rickett’s S-line were used to find Upper and Lower lip position from these reference lines. SPSS was used to analyze data after applying independent t-test. Result: Mean Upper and lower lip position from E- line was -1.74mm &amp; -0.33mm and from S-line was 0.82mm and 1.47mm Conclusion: Cephalometric lip morphology assessment in Multan, Pakistani adults by using Steiner’s and Rickettsreference planes on lateral cephalogram is slightly different as compare to other populations

Perbedaan Posisi Bibir Setelah Perawatan Ortodonti Dengan Ekstraksi Premolar Pertama Menggunakan Analisis Ricketts : Kajian pada Sefalogram Lateral di Klinik Ortodontis Bandung (Laporan Penelitian)

Background: The difference in facial profile after orthodontic treatment is important in orthodontic treatment as one of the goals of orthodontic treatment is to improve facial esthetic. Convex facial profiles that require first premolar extraction are the most common complaints of orthodontic patients in Asia. This profile is characterized by an increased lip profile procumbency. Therefore, any difference in the position of the lips from before and after orthodontic treatment is needed to be evaluated. Some studies proved that there was a significant difference in lip position after orthodontic treatment with the extraction of the first premolar teeth. Ricketts analysis is widely used to determine clinical differences in lip position. Objective: To determine the difference in lip position after orthodontic treatment with extraction of the first premolar using Ricketts analysis. Methods: This study was observational analytic with a cross-sectional study design. The study was conducted on 30 samples of lateral cephalogram radiographs before and after treatment at Orthodontist Clinic Bandung. The difference in lip position after orthodontic treatment and extraction of the first premolar teeth was determined using the Ricketts analysis. The measurement results were statistically analyzed with paired T-tests. Result: There was a difference in the position of the upper and lower lips after orthodontic treatment with first premolar extraction with p &lt;0.001. The distance of the upper and lower lips to the E-line after orthodontic treatment with first premolar extraction was different than before treatment. Conclusion: There is a significant difference of upper and lower lip position before and after orthodontic treatment with first premolar extraction.

Correlation between collum angle and lower lip position in different Class II malocclusions - A retrospective cephalometric study

ABSTRACT Purpose: Significance of analysing collum angle in class II malocclusions with respect to lip position may lend greater credibility to variable torque brackets (mainly in the anteriors) that are fast gaining traction. Determine the magnitude of collum angle of maxillary central incisors in Class II division 1, division 2 malocclusions and changes in measurement brought about by variations in lower lip position and incisal contact. Materials and methods: 154 lateral cephalograms were divided into three groups- 55(Angle’s class I), 52 (Angle’s class II division 1) and 47 (Angle’s class II division 2). The collum angle was measured along with lower lip line (in Class II division 2) and lower lip contact (in Class II division 1) malocclusions. Results: The mean collum angles were 2.12 ± 1.43°, −0.84 ± 0.87° and 4.67 ± 2.23° in Groups 1, 2, and 3, respectively. Mean collum angle is significantly increased when the lower lip was found to contact the middle-third of the central incisor(in Group 3)and significantly decreased when the anterior one-third of the lower lip was in contact with the incisal edge of the central incisor (in Group 2). ANOVA followed by Tukey HSD test was carried out to determine statistically significant differences (p < 0.05). Conclusion: Collum angle is significantly decreased in Class II division 1 malocclusions necessitating variable torque prescriptions and segmental mechanics of maxillary anteriors. Appropriate alveolar bone support must be assessed prior to en-masse retraction and intrusion respecting the cortical boundaries. KEY MESSAGES: Variable torque brackets are rapidly gaining credence for their ability to provide sufficient alveolar bone support in different clinical scenarios. In this study, we have emphasized upon utilizing similar mechanics to treat class II malocclusions by utilizing the lower lip position as a reference guide.

Linear correlation between tooth movement and facial profile change in patients with class Ⅱ division 1 malocclusion

Objective: To investigate the correlation between tooth movement and profile change in patients with class Ⅱ division 1 malocclusion. Methods: Pre- and post-treatment lateral cephalograms of 42 patients [10 males and 32 females, (23.8±6.3) years old, mean treatment time: 1.9 years] with class Ⅱ division 1 malocclusion were collected in Department of Oral & Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from June 2012 to November 2017. The patients were treated with extraction of four first premolars or two maxillary first premolars. Cephalometric analysis was carried out before and after treatment. Thirty parameters were measured. The changes of soft and hard tissue after orthodontic treatment and their correlations were analyzed using bivariate linear regression. Related factors affecting the upper and lower lip, nasolabial angle (NLA) and mentolabial angle (MLA) were analyzed according to the standardized regression coefficient (Beta). Results: Among all the 30 parameters, 18 parameters were statistically different before and after treatment. After treatment, upper central incisor sagittal distance [(63.87±7.14) mm] and upper lip sagittal distance [(77.73±7.60) mm] were significantly decreased (P<0.05). The changes in 14 parameters after treatment showed linear relationship including strong positive correlation between upper lip sagittal retraction and upper central incisor sagittal retraction (r=0.649, P<0.01). There were moderate positive correlations between upper lip and upper central incisor vertical movement (r=0.544, P<0.01). While the sagittal change of gnathion and the Y-axis angle showed moderate negative correlations (r=0.537, P<0.01). The stepwise multiple linear regression showed that the retraction of upper lip process was correlated with the retraction of upper central incisor, the increase of occlusal plane angle and the increase of upper central incisor angle, which was most correlated with the retraction of upper central incisor (Beta=0.79). The downward displacement of upper lip process was correlated with the downward displacement of upper incisor, the decrease of upper central incisor angle, the decrease of the distance between maxillary first molar and palatal plane, and the increase of occlusal plane angle, which was more correlated with the downward displacement of upper incisor and the increase of occlusal plane angle (Beta=0.59). The downward displacement of lower lip process was correlated with the downward displacement of upper incisor and lower incisor, which was more correlated with the upper incisor (Beta=0.36). Conclusions: The relationship among nose, lips and chin was more coordinated. Incisor retraction had significant influence on lip prominence, and the lower lip position was highly related to the movement of upper incisor in sagittal and vertical dimension after orthodontic treatment in patients with class Ⅱ division 1 malocclusion. However, tooth movement had limited impact on the chin position.

Rickett’s and Holdaway analysis following extraction of four premolars and orthodontic treatment in bimaxillary protrusion female Malays

Aim: To quantify the amount of soft-tissue changes in Malaysian female patients treated with the extraction of first four premolars. Materials and Methods: This is a retrospective study involving 24 Malaysian female patients age between 18 and 24 years treated with extraction of the upper and lower first premolars and bonded by 0.22 × 0.28′′ standard edgewise technique. The average of treatment time was 22 months. Pre and posttreatment lateral cephalograms of patients were traced on a cephalometric tracing software CASSOS (Soft Enable Technology Limited, Hong Kong). Linear and angular measurements were made. Data were analyzed using paired t-test to determine the difference between two means. Results: All linear and angular measurements of hard- and soft-tissue changes showed significant differences except L1 to A-pogonion (A-pog) angle (P = 0.05), and the mean change has decreased to almost 1.0mm posttreatment. The Pearson’s correlation test showed that the lower lip contacts both the upper and lower incisors; hence, the lower lip position would be impacted not only by the lower incisor retraction but also by the upper incisor retraction. Conclusion: In Malaysian females, significant changes were found in soft-tissue profile post-orthodontic treatment with corresponding simultaneous change in the underlying hard tissue.

Bilateral Facial Weakness in a Syndromic Patient: Cadaveric Fascia Lata Graft for Lower Lip Deformity Correction

Fazio-Londe syndrome is a rare neurodegenerative disorder caused by riboflavin transporter deficiency. Clinical presentation includes variable hypotonia or muscle weakness, sensory gait ataxia, optic atrophy, sensorineural hearing loss, and bulbar palsies. We described the case of a 37-year-old patient with a suspected Fazio-Londe syndrome who was referred to us for oral incompetence with dysarthria and drooling and impaired facial expression. First, we provided static sling suspension of the lower lip with Silhouette sutures (Silhouette Lift). Due to recurrent sutures exposure, we had to remove the sutures and insert a bilateral fascia lata graft to resuspend the lower lip. Two months postoperatively, the patient had good oral competence and there were no complications. In our opinion, this is a simple and minimally invasive procedure that can restore the right lower lip position in challenging patients.

Cephalometric Soft Tissue Characteristics of Unilateral Cleft Lip and Palate Patients in Relation to Missing Teeth.

Objective This study aimed to evaluate cephalometric soft tissue characteristics in individuals with unilateral complete cleft lip and palate (UCCLP) both with and without missing teeth. Design A retrospective investigation of patient records, who are being treated at the cleft lip and palate (CLP) clinics at the College of Dentistry. Ninety-six consecutive records of nonsyndromic UCCLP subjects were recruited (33 subjects without missing teeth and 63 subjects with missing teeth). Linear and angular soft tissue measurements obtained from lateral cephalometric radiographs were evaluated and compared among the studied samples. Results Lower lip was significantly retruded and shorter (p = 0.037), p = 0.015, respectively; in addition to the fact that shallower mentolabial sulcus (p = 0.05) was found in the subjects with missing teeth, the rest of the soft tissue was not significantly different between the two groups. Conclusion In subjects with a UCCLP anomaly, missing teeth have an effect on lower lip position and length, which influenced the mentolabial sulcus. Lower lip position and length differ between cleft patients who present with either multiple missing teeth or with no missing teeth, and this needs to be considered during orthodontic treatment planning and surgical management for the cleft defect.

Distal movement of the mandibular dentition in the treatment of patients with Class III skeletal pattern

To evaluate the outcome of patients with skeletal Class III malocclusion treated with extraction of mandibular third molars and distalization of molars using implant anchorage combined with MBT appliance. Fifteen patients (mean age 24.0 ± 5.8) with skeletal Class III malocclusion were selected. The mandibular third molars were extracted and the mandibular molars were moved distally using implant combined with MBT appliance. Cephalometric analysis was carried out before and after treatment. After active treatment, ANB, Wits distance, AB-NP and the distance between upper and lower lip position to SnPg' increased by 1.65° ± 1.04°, (4.39 ± 1.93) mm, 3.20° ± 1.61° and (1.13 ± 0.99) mm, respectively. The differences were statistically significant (P < 0.05). The skeletal Class III patients in the permanent dentition could be treated successfully with extraction of mandibular third molars and distalization of mandibular molars using implant anchorage combined with MBT appliance. The soft-tissue profile was improved.

Hard and soft tissue correlations in facial profiles: a canonical correlation study.

BackgroundThe purpose of this study was to analyze the relationship between facial hard and soft tissues in normal Saudi individuals by studying the canonical correlation between specific hard tissue landmarks and their corresponding soft tissue landmarks.MethodsA retrospective, cross-sectional study was designed, with a sample size of 60 Saudi adults (30 males and 30 females) who had a class I skeletal and dental relationship and normal occlusion. Lateral cephalometric radiographs of the study sample were investigated using a series of 29 linear and angular measurements of hard and soft tissue features. The measurements were calculated electronically using Dolphin® software, and the data were analyzed using canonical correlation.ResultsEighty-four percent of the variation in the soft tissue was explained by the variation in hard tissue.ConclusionThe position of the upper and lower incisors and inclination of the lower incisors influence upper lip length and lower lip position. The inclination of the upper incisors is associated with lower lip length.

Soft tissue facial profile and anteroposterior lip positioning in Iranians

Objective: Since orthodontic and orthognathic treatment planning in each ethnic group must be done according to the soft tissue facial characteristics regarded as beauty, they thus vary from country to country. The main purpose of this articlewas to determine the mean range of the middle third of soft tissue facial profile and anteroposterior lip positioning using 3angular and 2 linear measurements in adult male and female Iranians to compare with European standards.Methods: After clinical examination of 180 dental students, 70 Iranian adults who had normal occlusion aged between 21 to 29 years (mean:24.5 years) were selected(35 males and 35females). After obtaining consent form, lateral cephalograms were taken in natural head position (NHP) (as seen in a mirror) and analyzed according to the Rickets(E-Line),Tweed-Merrifield(Z-angle) and Holdaway (H-angle).For comparison of data with standards, the One-Sample-t-test and for comparison of measurements between groups, Independent Sample-t-test was used.Results: Radiographic evaluation revealed that all Iranian samples had significant differences with European standards with no differences between males and females. In the Rickets (E-Line) analysis, both upper (p<0.001)and lower(p<0.01) lips were behind the E-line. In the Tweed- Merrifield (Z-angle) analysis this angle in the Iranian sample was smaller (p<0.001) and in the Holdaway (H-angle) analysis our sample had smaller H-angle as well (p<0.001).Conclusion: Iranian adults have retruded upper and lower lip position in both sexes and more convex profile than European standards; thismay be due to a more retruded position of the chin and lips or more prominence of the nose in Iranian samples.

The Impact of Extraction vs Nonextraction Treatment on Soft Tissue Profile in Borderline Class I Malocclusion: A Cephalometric Study

Introduction: The continuous controversy concerning extraction of premolar teeth and its supposed effects on the facial profile led to the origin of this study, which compares the pretreatment and post-treatment facial profiles of patients who underwent premolar extraction with those of patients who did not undergo extraction. Objective: To analyze the soft tissue changes between the two different treatment groups, equally susceptible to both treatment options (extraction and nonextraction) and to compare the changes taking place in the soft tissue variables from one group to another using the cephalometric analysis. Materials and methods: The diagnostic extraction and treatment decisions were based on a total space analysis with differential extraction protocols. The pretreatment and posttreatment cephalograms of the borderline sample (100 female patients, 50 of the patients were treated with premolar extraction and 50 were treated without premolar extraction) were then subjected to a thorough soft tissue cephalometric analysis. Results: The results indicated that the three variables that played the most important role in the clinician’s treatment decision were indicators of lower crowding, soft tissue convexity and lower incisor protrusion. Significant differences (p < 0.05) regarding upper and lower lip protrusion, upper lip thickness (p < 0.05) and the nasolabial angle (p < 0.05) occurred after treatment. Conclusion: Extraction treatment of Class I borderline malocclusions led to significant soft tissue changes in relation to the upper and lower lip position and thickness as well as the nasio labial angle, whereas the nonextraction treatment resulted in significant upper lip retraction and lower lip protraction.

Cephalometric Assessment of Lips in Skeletal Class II Patients by Steiner’s Line

Abstract Introduction: Steiner's (S) Line has been used as reference line to assess antero-posterior position of lips cephalometrically and has been an effective diagnostic aid in this era of soft tissue paradigm. Norms for S-line has been established for different populations and it has been used widely to assess treatment outcomes in Skeletal Class II malocclusion, however antero-poste-rior position of lips and determinants of lip position in Skeletal Class II has not been explored. Study Design: This Prospective study was aimed to find out the antero-posterior position of lips on cepha-lograph using S-line in patients with retrognathic pro-file and to establish correlation between determinants of lip prominence. Data was collected using non-pro-bability convenience sampling technique following the selection criteria. Materials and Methods: The study was conducted on 65 subjects, with retrognathic profile as judged by orthodontists in consensus and confirmed by lateral cephalogram (ANB > 4°). S-Line was drawn on lateral cephalograph to assess the prominence of upper Lip and lower lip. SPSS 17.0 was used for statistical evalu-ation. Results: Antero-posterior position of upper and lower lip in patients with retrognathic profile with reference to S-line was 1.96 ± 2.6 mm and 3.09 ± 3.16 mm res-pectively. Moreover it was found that statistically sig-nificant correlation existed between lower lip promi-nence as assessed by S-line and upper lip prominence using the same reference line (r = 0.411), Lower inci-sor inclination (r = 0.535) and Skeletal Class II as as-sessed by ANB angle (r = 0.27). Upper lip prominence as assessed S-line was found to be statistically signi-ficantly correlated with lower incisor inclination and lower lip prominence. Discussion: Results were compliant with the previous studies. Conclusion: In the present study both upper and low-er lips were more prominent in Skeletal Class II patie-nts as compared to Steiner's norms for skeletal class I. Keys: Retrognathic Progile, Skeletal II Class Maloc-clusion, Lip Prominence, S-Line.

Associations between orbicularis oris thickness and skeletal and dental variables in mixed dentition

AIM: To evaluate the association between orbicularis oris thickness and skeletal and dental variables in children with mixed dentition. MATERIAL AND METHOD: A convenience sample of 22 children, aged 7 to 12 years, with skeletal Class I and Class II malocclusion and subdivisions were selected. The upper and lower fascicles of the orbicularis oris thicknesses were measured using ultrasound (US) by one calibrated examiner, at rest and in the contracted state. Cephalometric radiograph measurements of the hard and soft tissues were calculated by one trained examiner. The results were analyzed by the Pearson and Spearman coefficients. RESULT: The upper and lower fascicles of the orbicularis oris in the contracted state showed a negative correlation with the distance between Ricketts' E-line and the labrale superius (E ┴ Ls). There were positive correlations between the lower face height and the distance between the AB plane and the labrale superius (AB-Ls) and between the ANB angle and the distance between E ┴ Ls and Ricketts' E-line and the labrale inferius (E ┴ Li). The lower-incisor distance from the N-Pg plane correlated positively with the distance between AB-Ls and the distance between the E ┴ Ls and E ┴ Li. Overbite and interincisal angle were negatively correlated with the distance between the pogonion and the soft tissue pogonion and the distance between E ┴ Li, respectively. CONCLUSION: Skeletal and dental variables were associated with upper and lower lip position and pogonion thickness, while the upper and lower fascicles of the orbicularis oris thicknesses in the contracted state were associated only with upper lip retrusion.