The role of orthodontics as an auxiliary tool to lip augmentation

Changes in vermilion lip morphology following orthodontic treatment with premolar extraction for Angle Class II maxillary protrusion

Objectives:

The objective of the study was to clarify the changes in vermilion lip morphology following orthodontic treatment in Japanese patients with Class II maxillary protrusion.

Materials and Methods:

The subjects were 15 adult women diagnosed as having Angle Class II maxillary protrusion who had undergone orthodontic treatment with premolar extraction. For analysis, profile photographs taken at the first examination and at completion of active treatment were used for linear and angular measurements. For linear measurements on the lateral facial photographs, an X–Y coordinate system was established using a lateral cephalogram superimposed along the line of the profile. Measurement points relating to the vermilion lip morphology were measured on the facial photographs by digital processing, with the Frankfort horizontal (FH) plane as the X-axis, and the line perpendicular to the X-axis passing through the alar curvature point (Ac) as the Y-axis.

Results:

The results of linear measurements showed significant retraction of approximately 3.0 mm in the upper vermilion lip, and mean retraction of the upper incisors after treatment was approximately 6.0 mm. However, whereas mean retraction of the lower incisors was approximately 1.0 mm, there was significant retraction of the lower vermilion lip of over 3.0 mm. Significant reduction in vermilion height was also found in the upper vermilion lip. With regard to angular measurements, the upper lip and total vermilion showed significant reductions that indicated inversion.

Conclusion:

Adequate retraction of the upper incisors in the maxillary protrusion with excessive overjet may retract not only the upper vermilion lip but also the lower one, suggesting that morphological changes in the lower lip are affected by the positioning of the upper incisors. In addition, the patterns of morphological changes differed between the upper and lower vermilion lips, with a large proportion of rotational change toward the mucous membrane in the upper vermilion lip and with a pattern of change resembling horizontal displacement in the lower vermilion lip. Total vermilion showed a significant reduction in vermilion height due to the reduction in height of the upper vermilion lip.

Does the presence of unilateral gingival recession on maxillary canines influence smile esthetics?

OBJECTIVE

The objective of this study was to determine orthodontists', periodontists', and laypersons' perception of smile esthetics, regarding the presence of different levels of gingival recession on the maxillary left canine.

MATERIAL AND METHODS

Two close-up smile images (frontal and oblique) of a white female were selected for this study. The images were digitally altered to create different levels of gingival recession on maxillary left canine, in 0.5-mm increments. They were randomly arranged into a photo album that was shown to 135 evaluators: 45 orthodontists, 45 periodontists, and 45 laypersons. Each evaluator was asked to rate the smile attractiveness, using to a visual analog scale. Data were analyzed statistically using ANOVA, Tukey's post-hoc test, and Student t-test.

RESULTS

According to the orthodontists and periodontists, all levels of recession were considered as unesthetic in both types of images. According to the laypersons, gingival recession > 1.5 mm in the frontal image and > 1.0 mm in the oblique image were considered unesthetic.

CONCLUSION

The results showed that the presence of unilateral gingival recession on maxillary canines may negatively influence smile attractiveness, depending on the evaluator type and the level of the recession.

10 commandments of smile esthetics

The search for esthetic treatment has persisted in the routine of dental professionals. Following this trend, dental patients have sought treatment with the primary aim of improving smile esthetics. The aim of this article is to present a protocol to assess patient's smile: The 10 Commandments of smile esthetics.