Lip Profile Research Articles

Reference points to evaluate changes in the upper lip after labial incisor movement between tipping and translation in crowding patients: A retrospective study

ObjectiveThis study aimed to compare the changes of reference points on the labial surface of upper incisors (U1) to upper lip (UL) after U1 labial movement between a translation group (TSL) and tipping group (TIP). Correlations between changes in U1 and UL were determined. MethodsLateral cephalometric radiographs were selected and divided into TSL and TIP groups by pre- and post-treatment superimpositions. Skeletal, dental, and soft tissue of pre- and post-treatment treatment and variables were evaluated. Independent t-test and Wilcoxson test were applied for the statistical analysis between TSL and TIP. Spearman’s correlation coefficients and multiple linear regression analysis were used to verify the association between lip profile changes and other variables in TSL and TIP group separately. ResultsAfter U1 labial movement, the incisal edge (LaU1e), middle (LaU1m), and cervical (LaU1c) points of TSL moved evenly labially, whereas the TIP group had incisal edge that moved greater labially than the middle and cervical points. UL moved more labially in TSL (0.87–1.05 mm) than the TIP (0.31–0.41 mm). UL changes to the E-line in TSL showed significant positive correlations to all three LaU1(e, m, c)-SnTV changes. In the TIP group, only a positive correlation presented for the LaU1m-SnTV and LaU1c-SnTV changes. Nevertheless, Multiple linear regression analysis indicated the unfeasibility of predicting the upper lip changing ConclusionLaU1e in TSL and TIP moved almost equally labially but less labially in TIP at the middle and cervical points. The UL moved more labially in TSL than TIP. Rather than using the incisal edge to estimate upper lip changes, it would be better to use the middle and cervical points of U1, which coincide with Labrale superioris (Ls).

Esthetic analysis of upper lip morphology variation after the cross-arch fixed restoration of maxillary implant-supported prostheses via radiographic methods

Objective: To measure and analyze upper lip morphology variation before and after the cross-arch fixed restoration of the maxillary implant-supported prostheses using cone- beam CT (CBCT) to provide an esthetic objective reference for maxillary edentulous patients. Methods: There were 32 maxillary edentulous patients selected in the Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University from January 2010 to December 2023. The CBCT data of patients with maxillary full-arch implant-supported fixed prostheses were retrospectively collected before implantation (T0), at the time of radio-guide insertion (T1), and after final repair (T2). The length and thickness of the upper lip were measured and analyzed at each time point, and the correlation between the upper lip contour data and facial esthetic parameters was analyzed. Results: After the final prosthodontic treatment, the length of the upper lip was significantly increased from (21.72±2.84) mm to (24.98±2.93) mm (t=-8.13, P<0.001) compared with that before implant treatment. The widths of the middle and vermilion of the upper lip (Sm-Hm/Ls-UP), were reduced from (13.24±1.41), (12.81±1.67) mm to (11.36±1.67), (10.21±1.69) mm, with significant differences (t=7.79, P<0001; t=9.37, P<0.001). The lower face height (Sn-Gn) was increased from (54.52±4.95) mm to (58.70±4.42) mm, with significant differences (t=-11.05, P<0.001). However, the nasolabial angle reduced significantly from 95.35°± 7.70°to 90.53°±7.28°(t=7.68, P<0.001). The width of the middle of the upper lip with a radiation guide was (10.94±1.24) mm, and it increased significantly compared with that after the final prosthesis treatment (t=-0.76, P<0.05). The proportion of straight upper lip profiles accounted for 59% (19/32), and the proportion of concave upper lip profiles accounted for 41% (13/32) after the final prosthesis treatment. In addition, the results of correlation analysis showed that the nasolabial angle variation was weak and negatively correlated with residual bone height (r=-0.37, P=0.490). Conclusions: After the treatment of the maxillary full-arch implant-supported fixed prosthesis, the length of the upper lip increases, and the thickness of the upper lip becomes significantly thin. The maxillary full-arch implant-supported fixed prostheses support upper lips to improve the patients' side appearances.

Experimental investigations on cooling characteristics of different trailing-edge cutback geometries

One important method for enhancing the performance of modern engines is to increase the turbine inlet temperature. Due to the high velocity near the throat, the heat transfer to the blade trailing edge is high, particularly on the pressure side near the trailing edge. Therefore, the design methodology for cooling structures becomes critical for the thinner trailing edge compared to other parts of the blade. Trailing-edge cutback is a common cooling structure that guides cold air to form an effective film near the blade pressure side. However, the cutback lip induces strong and unsteady shedding vortexes, which significantly reduce the downstream coolant effectiveness.Previous studies have explored the film cooling performances of cutback structures and the interaction between coolant and mainstream using experimental and numerical methods. Experimental results were obtained using Pressure-Sensitive Paint (PSP) and Particle Image Velocimetry (PIV) in a large-scale wind tunnel, while the Delayed Detached Eddy Simulation (DDES) with the Shear Stress Transport (SST) turbulence model was employed for capturing the unsteady flow field.In this paper, further investigation will be conducted on the lip profiles of the fillet structure to improve the effectiveness of the film coolant. The rounded lip design delays boundary layer separation, thereby reducing the scale and intensity of shedding vortices. This improvement in the effectiveness of the rounded lip nozzle model is observed across all blowing ratios. Furthermore, at low or medium blowing ratios, the rounded lip design significantly reduces momentum exchange, inhibiting the mixing between the mainstream flow and cooling air. This leads to a more pronounced enhancement in cooling effectiveness.

IJCM_377A: Socio-demographic and clinical profile of Lip, Oral cavity and Pharyngeal cancer in an urban cancer centre in Coimbatore

Background: Cancer ranks as a leading cause of death and a major barrier to increasing life expectancy in every country of the world. The incidence and demographic data of cancer are important for cancer prevention. Lip, oral cavity, and pharyngeal cancers (LOCP) has multiple risk factors and a varied geographic distribution. Objectives: This study aims to describe and compare the epidemiological and clinical profile of LOCP cancers. Methodology: Results: A total of 441 LOCP cases were recorded, of which most cases belonged to the age group of 51-70 years and male gender. The most common subtype among LOCP cancers is mouth (27%), followed by the tongue (25%). Histo-pathologically, squamous cell carcinoma is the most common type contributing to 425 (96.5%) of cases. Nearly 267 patients (60.1%) were smokers, and 206 patients (46.7%) used alcohol whereas 266 patients (60.3%) used Smokeless tobacco products. Majority of the patients underwent a combination therapy of surgery and radiotherapy (69.6%). Conclusion: The increased incidence of LOCP cancer and its subtypes associated with smoking and tobacco points to the pivotal role of these risk factors in the pathogenesis of LOCP cancers. Hence better awareness and stringent measures are the need of the hour to decrease the ongoing burden of these cancer types.

Aerodynamics and aeroacoustics of ducted propellers: A study on the design and geometry effects

Ducted propellers present broad applicability in urban air mobility vehicles due to their enhanced operational safety, improved aerodynamic performance, and potential to mitigate noise emissions. This study proposes a numerical approach for designing adequate duct geometries, focusing on the duct's lip profile, expansion ratio, and tip clearance, aiming to provide valuable design guidance for ducted propellers. The simulations are validated through experimental data, showing reasonable agreement in terms of thrust generation and far-field noise. The mean flow and generated thrust are characterized with a parametric study using steady simulations, while delayed detached eddy simulations are employed to capture transient flow characteristics and investigate noise generation. The noise levels were computed using the integral solution of the Ffowcs-Williams and Hawkings equation. The lip geometry impacts the flow distribution and generated thrust, modifying the tonal noise. Furthermore, slightly divergent ducts can increase the total thrust by minimizing flow separation on the duct wall while increasing the suction on the duct lip. The primary noise sources are identified at the propeller's leading edge and tip. The results reveal that divergent ducts effectively reduce tonal noise at all observer angles but increase broadband noise, attributed to the noise sources at the leading edge of the propeller and the interaction with the duct lip. Additionally, reducing the tip clearance from 2 to 1 mm enhances the total thrust by more than 20% without causing extra noise generation.

Study on the prediction of high-speed rotary lip seal wear in aero-engine based on heat-fluid-solid coupling

PurposeThis paper aims to investigate the effect of frictional heat on the wear of high-speed rotary lip seals in engines.Design/methodology/approachIn this research paper, the authors focus on the high-speed rotating lip seal of aircraft engines. Using the hybrid lubrication theory, a thermal-fluid-solid coupled numerical simulation model is established to investigate the influence of parameters such as contact pressure distribution, temperature rise and leakage rate on the sealing performance under different operating conditions. By incorporating the Rhee wear theory and combining simulation results with experimental data, a method for predicting the wear of the rotating seal lip profile is proposed. Experimental validation is conducted using a high-speed rotating test rig.FindingsThe results indicate that as the speed increases, the rise in frictional heat leads to a decrease in the sealing performance of the lip seal contact region. The experimental results show a similar trend to the numerical simulation results, and considering the effect of frictional heat, the predicted wear of the lip seal profile aligns more closely with the actual wear curve. This highlights the importance of considering the influence of frictional heat in the analysis of rotating seal mechanisms.Originality/valueThis study provides a reference for the prediction of wear profiles of engine high-speed rotary lip seals.

Epidemiological Profile of Cleft Lip and Palate Cases in A Libyan Neonatal Unit at Al Wahda Teaching Hospital, Derna: A Comprehensive Analysis

Aim. This study aims to assess the prevalence and associated risk factors of Cleft lip and palate (CLP) among neonates in Derna, Libya, over a six-year period from 2016 to 2021. Methods. This retrospective observational study analysed data from the neonatal unit registry at Al Wahda teaching hospital in Derna, Libya. The study population comprised neonates admitted to the hospital from 2016 to 2021. Inclusion criteria specified Libyan neonates diagnosed with CLP, while exclusion criteria excluded stillbirths and non-Libyan neonates. Data analysis involved calculating incidence rates, descriptive statistics, and subgroup analyses to identify demographic characteristics and associated risk factors. Results. Out of 2,887 neonatal records reviewed, 10 cases of cleft lip ± palate (CL±P) were identified, yielding an overall incidence rate of 0.6 cases per 1000 live births. The majority of cases (50%) presented with both cleft lip and palate, followed by cleft palate only (40%) and cleft lip only (10%). Demographic analysis revealed a higher prevalence among females (60%), full-term neonates (80%), neonates from larger families of more than 6 children (50%), and those with birth weights between 2.5 and 4 kg (70%). Left-sided clefts were more common (90%) than right-sided clefts (10%). Potential risk factors included maternal history of abortion (20%), irregular pregnancy follow-up (90%), and gestational diabetes (10%). Conclusion. This study provides insights into the prevalence and associated risk factors of cleft lip ± palate (CL±P) among neonates in Derna, Libya. The findings underscore the importance of comprehensive prenatal care and public health interventions to address modifiable risk factors and reduce the incidence of cleft lip ± palate in affected populations. Further research is needed to explore additional factors contributing to cleft anomaly occurrence and outcomes.

Evaluation of pharyngeal airway space after orthodontic extraction treatment in class II malocclusion integrating with the subjective sleep quality assessment

Orthodontic treatment with premolar extractions is typically used to relieve dental crowding and retract anterior teeth for lip profile improvement. The aim of the study is to compare the changes in regional pharyngeal airway space (PAS) after orthodontic treatment with Class II malocclusion and to identify the correlations between questionnaire results and PAS dimensions after orthodontic treatment. In this retrospective cohort study, 79 consecutive patients were divided into normodivergent nonextraction, normodivergent extraction, and hyperdivergent extraction groups. Serial lateral cephalograms were used to evaluate the patients’ PASs and hyoid bone positions. The Pittsburgh Sleep Quality Index and STOP-Bang questionnaire were used for sleep quality evaluation and obstructive sleep apnea (OSA) risk assessment, respectively, after treatment. The greatest airway reduction was observed in hyperdivergent extraction group. However, the changes in PAS and hyoid positions did not differ significantly among three groups. According to questionnaire results, all three groups had high sleep quality and low risk of OSA, with no significant intergroup differences. Moreover, pretreatment-to-posttreatment changes in PAS were not correlated with sleep quality or risk of OSA. Orthodontic retraction with premolar extractions nither exhibit significant reduction in airway dimensions nor increase their risk of OSA.

Influence of social media on the esthetic perception of the lip profile of orthodontic patients

ObjectiveTo identify the use of social media as an influencing factor of the orthodontic patient’s preferences regarding the lip profile protrusion. MethodsA two-part cross-sectional questionnaire was distributed to orthodontic patients in Spain and The Netherlands. The first part collected general data and frequency of use of different social media. The second part consisted of a series of modified female and male silhouettes presenting different lip profile positions. Each participant was required to choose both the (male and female) most attractive silhouette and the least attractive one.Student t-test, one-way ANOVA and Chi-square test were performed. Effect sizes were calculated to express the magnitude of differences between samples. ResultsThe Spanish sample resulted in a moderate higher tendency (R2 = 0.060) to choose protrusive lips as the most attractive lip profile for females, on subjects with more frequent use of social media. A medium tendency (R2=0,26) was observed as result of low users of social media choosing and ideal lip profile for men.The Dutch sample showed that high users of social media tended to choose as attractive a more protrusive female lip profile versus low users (p < .01). This was also observed (p < .05) on male attractive lip profiles. ConclusionsResults suggest that frequent users of social media platforms tend to prefer more protruded lips than their less frequent counterparts. This information is valuable to be considered when formulating a treatment plan to satisfy the patient’s expectations.

The Lower Lip Profile Change During Total Distalization of the Mandibular Dentition

Objectives: This study aimed to determine the factors influencing the lower lip profile during Class III lower total arch distalization camouflage treatment. Methods: The cohort included 45 patients diagnosed with skeletal class III malocclusion. These patients underwent camouflage orthodontic treatment with lower arch total distalization. Lateral cephalograms were taken at the pretreatment and posttreatment stages. Cephalometric measurements were analyzed to unravel the influencing factors of the lower lip profile. This study defined new variables, i.e., CK and CKA, for detailed soft tissue analysis. Results: Novel soft tissue measurements presented in this study showed statistically significant changes after treatment. The CK angle and L1 to A Pog, L1 to NB, and IMPA were statistically correlated. Simple regression analysis was performed between variables. The formula was ΔCKA = 0.79(Δ L1 to NB) -1.6, and multiple regression resulted in ΔCKA = 0.5(Δ L1 to NB) – 0.42 (‘LL to Eline’, before treatment). Conclusion: The present study provided evidence that the lower lip evaluations, including the novel CKA and CKHA, were significantly related to the mandibular incisor position during total distalization of the mandibular dentition. The results demonstrated that clinically significant lip retraction could be obtained. Therefore, non-extraction with distalization must be suggested as the first treatment option in mild skeletal class III malocclusion patients.

A retrospective study on clinical and epidemiological profile of nonsyndromic cleft lip and palate patients admitted in a large Comprehensive Cleft Care Centre in West Bengal, India

Aim: The aim of this study is to observe the clinical and epidemiological profile of nonsyndromic cleft lip (CL) and/or palate patients admitted to a cleft care center in West Bengal from May 2021 to April 2022. Materials and Methods: A retrospective epidemiological study had been done by preparing a master data sheet to record the patient's data from a Comprehensive Cleft Care Centre in West Bengal. The study variables included were patient's age reporting at the hospital, type of cleft, sex distribution of patients, residential address of the parents, socioeconomic status through parents' education, occupation, and monthly income, and consanguineous marriage history of the family. Results: A total of 276 nonsyndromic cleft patients during the time period (May 2021 to April 2022) were considered. Among these, 164 were male and 112 were female patients. The mean age of patients reporting to this hospital on average was 13–18 months. CL with palate patients (62%) predominated than any other type and was mostly seen in male patients (69.59%); isolated CL (22%) cases were more in females (56.25%), whereas isolated cleft palate (16%) cases were seen more in males (62.79%); unilateral (77%) and left-sided cleft (67%) were found predominantly than bilateral cases (23%) and seen mostly in females, whereas bilateral cleft cases were more in males. Most of the patients belonged to North 24 Parganas District which is an adjacent district of Kolkata, and most of the families belonged to a low socioeconomic group, and interestingly, most of them had consanguineous marriage history (61%) with at least one generation. Conclusion: The results of this study provided that CL with palate type is more common among all types of clefts and predominantly found in males than females in West Bengal. The unilateral left-sided cleft is predominant among all other varieties. Most of the parents belonged to low socioeconomic status and are having consanguineous marriage history. We need to spread awareness among the public through ads and banners, social media, and medical free camps about the deformity of CL and/or palate and also possible preventive measures, make arrangements for free treatment among the CL and/or CL and palate population for better life of cleft patients and their parents.

The Evaluation of Hospital Social Responsibility Services in Gatot Soebroto Indonesia Central Army Hospital in 2015 – 2019 of Cleft Lip and Palate Patients

Background : Cleft lip and cleft palate are the most common congenital craniofacial anomalies treated by plastic surgeons. The incidence of cleft lip and palate is higher at lower socioeconomic levels. Hospital Social Responsibility (HSR) in Gatot Soebroto Central Army Hospital provides free cleft lip and palate surgeries to those who need it the most. The HSR services still need to be evaluated, to get an overview of epidemiologic profile of cleft lip and palate patients, and to improve the services itself. Materials and Method: The authors conducted a retrospective descriptive study based on online data of Smile Train HSR RSPAD Cleft Center from period of January 2015 to December 2019. All patients presented with cleft lip and/or palate were included. Results : Of all 713 patients in total; The gender distribution male 62.2% (444/713) was higher than female 37.7% (269/713). Most of the patients came from Java Island 77.5% (553/713). 685 were primary surgeries, 28 secondary surgeries. Among the primary surgeries, lip repair has the highest numbers 71.6% (491/685), followed by palate repair 27.2% (187/685), and alveolar bone grafting 1% (7/685). The most widely used surgical technique in lip surgery was the Millard 50% (345/685), while the most widely used surgical technique in palate surgery was the Bardach technique 22.9% (157/685). The median age for the primary lip repair patients was 1 year (range, 3 months to 60 years), and the median age for the primary palate repair patients was 4 year (range, 7 months to 26 years). Among secondary surgeries, lip revision with Millard technique was the highest (82.1%), followed by scar revision 3.57%, fistula repair (7.1%). The most common diagnosis was unilateral cleft lip (left 34.4%, right 13.2%) and followed by complete cleft palate (22.7%) Conclusion : Male patients were more dominant than females. The most common diagnosis was unilateral cleft lip. Incomplete diagnostic data and clinical photos of patients make it difficult to determine the complete diagnose of cleft lip and palate.

Profile of cleft lip and palate patients at a dental hospital in Johannesburg, South Africa

Objectives: This study aimed to determine the clinical profile of patients with orofacial clefts (OFC) who presented at a dental hospital in Johannesburg, South Africa, from January 1, 2013, to December 31, 2019. The aim of the study is to use the data collected to conduct an epidemiological survey and create an electronic database of all patients with OFC who presented to the hospital. Materials and Methods: A cross-sectional, retrospective record review of all cases of OFC treated at Johannesburg Cleft clinic from January 1, 2013, to December 31, 2019, was conducted. A structured, pretested record review form was used to obtain demographic and clinical information of patients with OFC. STATA version 15 was used to analyze the data and statistical tests were conducted at a 5% significance level. Results: One hundred and thirty-three records were analyzed. The majority were males (n = 68, 51.13%), while 48.87% (n = 65) were females. Most patients were South Africans 91.73% (n = 122,), and the majority were African blacks (67.67%). A statistically significant difference (P &lt; 0.05) was found in gender and racial distribution of OFC. Majority of the sample presented with clefts of the lip and palate 55.64% (n = 74,), followed by isolated CP 24.81% (n = 33), CL 17.29% (n = 23), and 2.26% (n = 3) presented with a facial cleft. Majority of the clefts were described as unilateral (n = 50, 37.59%) and 30.83% (n = 41) of the clefts were described as bilateral. Isolated cleft of the palate accounted for 24.81% (n = 33), while 4.51% (n = 6) were midline clefts. Facial clefts accounted for 2.26% (n = 3). Of all unilateral clefts (n = 50), those who presented on the left side account for 68% (n = 34), while those who presented on the right side accounted for 32% (n = 16). Conclusions: The dental hospital is providing services to a large number of patients with OFC. The study findings should assist in planning services for these patients.

Plane strain wedge indentation revisited

For a plane strain wedge indentation problem, detailed comparisons between slip-line field theory (SLFT) solutions, experimental observations and finite-element analysis results are carried out. Several past remaining questions on this problem are explored. The finite-element computations appear to account for the nature of a modified slip-line field solution (Petryk H. 1980 Journal de Mécanique Appliquée 4 , 255–282) that assumes the existence of an additional fan-shaped slip-line field just above the boundary between yielding and unyielding regions. For obtuse-angled wedges, finite-element computations show that the indentation load could be smaller for a rough wedge than for a smooth wedge. The question that was raised in the literature with respect to the reversed order of required loads for smooth and rough wedges is not necessarily a paradox. It is revealed that with increasing friction coefficient, a distinct deformation mode resembling the dead metal cap solution in the SLFT is established immediately after passing the critical friction coefficient value at which the contact mode theoretically changes from frictional sliding to perfect sticking. The profiles of the bulged-out lip material remain straight in all the finite-element computations for non-hardening materials. Nonlinearity of the lip profiles frequently observed in experiments appears in the presence of strain hardening or strain-rate sensitivity.

Influence of Maxillary Anterior Tooth Restoration Labial Thickness on Labial Soft Tissue in Young Asian People.

To determine whether a significant dimensional difference in labial soft tissue could be produced by maxillary anterior tooth restorations with diverse labial thicknesses. Changes in the contour of the lips in each participant produced by provisional restorations with different labial thicknesses (1-4 mm) compared to baseline (0 mm) were assessed using 3D software and using a visual analog scale by a group of prosthodontists and a group of laypeople. Significant enhancements in 3D deviation compared to baseline were present when the participants were wearing the labial provisional restorations. Negative correlations for labial thickness with nasolabial angle and distance from upper lip to E-plane measurements were found. However, the changes were most pronounced for the prosthodontist and laypeople groups when the labial veneer thickness was 2 mm or more. Prosthodontists and laypeople hardly recognized the lip profile changes when labial provisional restorations were below 2 mm. Therefore, restorations with limited labial thickness had a weak esthetic impact on lip morphology.

Soft Tissue Lip Profile with Steiner(S) and Ricketts (E) Lip Analysis in Patient’s with Skeletal and Dental Class I Occlusion

Objective: To determine the soft tissue lip profile with Steiner (S) and Ricketts (E) lip analysis in patients with skeletal and dental class i occlusion at LUMHS Methodology: This descriptive study was done at department of Orthodontic, Liaquat University of medical and health sciences Jamshoro/Hyderabad, from august 2014 to august 2015. Individuals having age range of 18–30 years with dental and skeletal occlusion class I, competent lips involving facial profile, without history of preceding orthodontic treatment, mal and crowded aligned teeth and either of gender were included. To evaluate hard soft and tissue lip profile, the cephalometric analysis was done using radiographs, traced manually on matte acetate sheets with thicknesses of 0.003, measurements of 8x10 under direct inspection on an illuminator. SPSS version 26 was used for data analyzed. Results: A total of 100 patients were enrolled in the study their average age was 22±1.2 years. Males were 41% and females were 59%. The overall average of SNA angle was 81.866±1.199 and average of SNB angle was 80.667 ±1.27. Average of ANB angle, S line to upper lip, S line to the lower lip and E line to upper lip were 1.167 ±1.028, 1.067 ±1.006 mm, 1.917±1.369 mm, and 3.2±1.96 mm, respectively, while average of lower lip was 2.80+2.83. Conclusion: In terms of soft tissue lip profile with Ricketts (E) and Steiner (S) lip analysis among patients with dental and skeletal occlusion class I, the Antero-posterior position of lower and upper lip regarding E-line was 2.80 +2.83mm and 3.2+1.96 mm, respectively, and Antero-posterior position of lower and upper lip regarding S-line was 2.16+1.34mm and 1.30+1.019 mm, respectively. According to gender, there was statistically no significant variance. Keywords: Lip profile, skeletal, dental, occlusion class I

Heritability of facial soft tissue growth in mono- and dizygotic twins at 12 and 17 years of age: A retrospective cohort study.

The purpose of this investigation of untreated monozygotic and dizygotic twins was to identify the genetic and environmental components to the facial soft tissue growth. The sample consisted of 52 untreated monozygotic twins (36 male and 16 female) and 46 untreated dizygotic twins (23 male and 23 female) from the Forsyth Moorrees Twin Study (1959-1975). Lateral cephalograms were taken at 12 and 17years of age and traced to analyse facial convexity, nasolabial angle, upper and lower lip thickness, upper and lower lip profile and nose prominence. The genetic and environmental components of variance were analysed with structural equation modelling for multilevel mixed-effects model. At 12years of age, strong additive genetic influence was seen for facial convexity (70%), upper lip profile (66%) and nose prominence (65%), whereas strong dominant genetic components were found for upper lip thickness (56%). Nevertheless, under unique environment influence were nasolabial angle (58%), lower lip profile (51%) and lower lip thickness (64%). At 17years of age, only upper lip thickness (55%) and nose prominence (84%) were under strong additive genetic control, while the rest of the variables were under strong dominant genetic control. The only exception was lower lip thickness (61%), which is still influenced by the unique environment. Although monozygotic/dizygotic twins share at least part of their genome, at both times either additive, dominant or environmental components were found. Nevertheless, at 17years of age most of the variables are either under additive or dominant genetic influence.

Epidemiology and survival outcomes of lip, oral cavity, and oropharyngeal squamous cell carcinoma in a southeast Brazilian population.

Background Lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC) represent a major health problem in the global scenario. In South America, the highest incidence rates are seen in Brazil. Therefore, the epidemiological and clinical profile and survival outcomes of lip, oral cavity, and oropharyngeal SCC was studied in São Paulo State, Brazil.Material and Methods The clinicopathological data of 12,099 patients with lip, oral cavity, and oropharyngeal SCC were obtained from hospital cancer registries of the Fundação Oncocentro de São Paulo, Brazil (2010–2015). Survival rates and other analyses were performed using SPSS software.Results A clear male predominance was observed, particularly for patients with oropharyngeal SCC (88.3%). The average age of patients was higher for lip cases (65 ± 13.5 years) compared to other sites. The schooling level was low for most patients, especially in lip cases (87.9%). Most of the patients with oral cavity (71.8%) and oropharyngeal (86.3%) SCC had advanced-stage (III–IV) disease. However, the majority of lip cases (83.3%) were at an early stage (I–II). Surgical excision was the main treatment for lip (72%) and oral cavity SCC (23.5%), and chemoradiotherapy was the main treatment for oropharyngeal SCC (40.2%). The 5-year overall survival (OS) for patients with lip, oral cavity, and oropharyngeal SCC were 66.3, 30.9, and 22.6%, respectively. Multivariate analysis revealed that the determinants of OS were different for lip, oral cavity, and oropharyngeal SCC, except for those at the clinical stage, which was an independent predictor for all sites.Conclusions OS-independent determinants varied according to the affected site. Oral cavity and oropharyngeal SCC presented worse survival rates than those for lip SCC. Key words:Squamous cell carcinoma of head and neck, lip neoplasms, mouth neoplasms, oropharyngeal neoplasms, survival analysis.

Correlation of lip profile preferences in Pakistani population; and its comparison with orthodontic norms.

To determine the most desired lip profile and compare the subjective sense of aesthetics among orthodontists, general dentists and the general population. The cross-sectional study was conducted at the Orthodontic Department of the Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January 1 to February 25, 2020, and comprised different silhouettes for each gender with increasing lip procumbence from -6mm to +6mm with respect to Rickett's E-line which were created using Photoshop CS 8.0 after cephalometric analysis of 20 cephalograms. The sample comprised an equal number of orthodontists in group A, general dentists in group B and orthodontic treatment-seekers in group C with equal representation of the two genders. Data was analysed using SPSS 24. Of the 180 subjects, there were 60(33.3%) in each of the three groups, with 30(50%) males and as many females in all the groups. All the three groups preferred the average lip profile for males (p=0.018) and 2mm procumbent lips for females (p=0.008). There was significant difference of opinion between groups A and C (p=0.034) and between groups B and C (p=0.022). There was found to be a marked difference of opinion among the orthodontists, the general dentists and the orthodontic treatment-seekers regarding the desired lip profile.

Rare case of skeletal third class in a subject suffering from Solitary Median Maxillary Central Incisor syndrome (SMMCI) associated to panhypopituitarism

BackgroundThe median solitary maxillary central incisor syndrome (SMMCI) is a rare malformative syndrome consisting of multiple defects, mainly found on the body midline. It can be correlated to the etiopathological and phenotypic pattern of panhypopituitarism. This case-report describes the rare case of a patient suffering from SMMCI and panhypopituitarism, showing an unusual craniofacial morphology.Case presentationFrom the cephalometric analysis, a skeletal class III was identified (despite the other cases described in literature described as skeletal class II), derived from hypomaxillia and mandibular protrusion. A convex lip profile, with tendency to mandibular hyper-divergency, airway patency, anterior and posterior cross-bite were observed. At the clinical examination, a maxillary cant was evident on the frontal plane that appeared asymmetric, with the prevalence of the third lower part of the face. There were some dysmorphic signs such as: small nose, rectilinear eyelid line and reduced interocular distance.ConclusionsThe present clinical case shows how, despite the literature, SMMCI can be associated with a III skeletal class, with maxillary hypoplasia and mandibular protrusion. The interdisciplinary collaboration between dentist and pediatrician is therefore important for the early interception of the malocclusions associated with these syndromes.