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Yang X, Justus R, Li B, Xue C, Lee ITD, Guo Y, Bai D, Han X, Xu H. Customized planning of the visible maxillary arch width in harmony with interparopia width and smile width for female facial aesthetics. Orthod Craniofac Res 2024; 27:139-150. [PMID: 37534780 DOI: 10.1111/ocr.12697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 05/09/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND The visible maxillary arch width (VAW) is an important aesthetic-determining feature. To date, there is no well-established methodology to determine the aesthetically optimal VAW in customized treatment planning. METHODS In this study, the common traits of the dentofacial configuration were investigated in most attractive Asian and Caucasian female smiles. The smiling photo of a subject was digitally modified based on combined variations of VAW, smile width (SW), transverse facial dimensions (TFD), and vertical facial dimensions. These modified photos were assessed for aesthetics. The aesthetically essential parameters were identified, and their mathematic correlations and reference ranges were determined for different vertical facial patterns. Using the obtained results, a mathematic guidance was constructed for customized smile designing. The applicability of this guidance was tested in Asian females. RESULTS The most attractive Asian and Caucasian female smiles have intraracial and interracial commonalities in the VAW-to-TFD ratios. The interparopia width (IPD) predominated over facial widths in determining well-matched VAW and SW. For optimal smile aesthetics, the VAW and SW were correlated as simulated by the formula 1.92 IPD ≤ VAW + 2.3 SW ≤ 2.17 IPD, plus the VAW-to-IPD ratio within 0.54 to 0.62 and the SW-to-IPD ratio within 0.61 to 0.71, ranges tailored to vertical facial patterns. This constitutes a mathematic guidance for customized planning of the aesthetically optimal VAW. This guidance was preliminarily validated to be applicable to Asian females. CONCLUSIONS The VAW-to-TFD ratios were essential for Caucasian and Asian female smile aesthetics. The mathematic guidance could serve as a reference for customized smile designs for Asian females.
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Affiliation(s)
- Xianrui Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Roberto Justus
- Department of Orthodontics, Intercontinental University, Mexico City, Mexico
| | - Bin Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chaoran Xue
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | | | - Yongwen Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xianglong Han
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hui Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Özsoy Ö, Özsoy U, Yıldırım Y, Alkan E, Yılmaz B, Güllü SE. Correlation of 3D Morphometric Changes, Kinematics, and Muscle Activity During Smile. Laryngoscope 2024. [PMID: 38226662 DOI: 10.1002/lary.31289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/06/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE Knowing the morphological, kinematic, and electrophysiological parameters of the smile in healthy individuals may contribute to evaluating, planning, and monitoring the smile reanimation. This study aimed to determine the correlation between 3D morphometric changes, movement kinematics, and muscle activity in the facial soft tissue of healthy individuals. METHOD In this cohort study, 20 volunteers were selected from healthy individuals with no facial disorders. During smiling, three-dimensional face scanning, facial motion capture, and surface electromyography (sEMG) were performed. The average displacement, velocity, and acceleration during facial movements were measured. The mean change in 3D surface morphometry and activation of the zygomaticus major were determined. RESULTS The volunteers, comprising 10 males and 10 females, had a mean age of 24 ± 10 years; for female, mean age was 23 ± 5 years and for men 26 ± 13 years. Significant correlations were found between kinematic and morphometric data (r = 0.51, p < 0.001), sEMG and morphometric (r = 0.50, p < 0.001) data, and sEMG and kinematic data (r = 0.49, p < 0.002). The maximum acceleration occurred during approximately 65% of the muscle activation time and 64% of the peak muscle activation value. Additionally, the maximum velocity was reached at around 73% of the muscle activation time and 67% of the peak muscle activation value. Furthermore, the maximum displacement values were observed at approximately 88% of the muscle activation time and 76% of the peak muscle activation value. CONCLUSION The findings may provide insights into the smile's functional parameters, contribute to understanding facial muscle-related disorders, and aid in improving the diagnosis and treatment of the smile. LEVEL OF EVIDENCE N/A Laryngoscope, 2024.
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Affiliation(s)
- Özlem Özsoy
- Faculty of Medicine, Department of Physiology, Akdeniz University, Antalya, Turkey
| | - Umut Özsoy
- Faculty of Medicine, Department of Anatomy, Akdeniz University, Antalya, Turkey
| | - Yılmaz Yıldırım
- Faculty of Medicine, Department of Anatomy, Akdeniz University, Antalya, Turkey
| | - Ege Alkan
- Faculty of Medicine, Department of Anatomy, Akdeniz University, Antalya, Turkey
| | - Beste Yılmaz
- Faculty of Medicine, Department of Anatomy, Akdeniz University, Antalya, Turkey
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Tatakis DN, Paramitha V, Lu WE, Guo X. Upper lip characteristics and associated excessive gingival display etiologies in adults: Race and sex differences. J Periodontol 2024; 95:74-83. [PMID: 37436716 DOI: 10.1002/jper.23-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND This cross-sectional study aimed to examine upper lip (UL) and smile characteristics and soft tissue excessive gingival display (EGD) etiologies (hypermobile upper lip [HUL], altered passive eruption [APE], and short upper lip [SUL]) in a nondental adult population and to analyze interracial (Black and White) and intersex differences. METHODS Community participants, non-Hispanic Blacks (NHB) and non-Hispanic Whites (NHW), were recruited and examined for UL vertical dimensions at rest and maximum smile and for HUL, APE, and SUL. Associations between gingival display (GD) or EGD and UL anatomical characteristics, HUL, APE, and SUL were analyzed. RESULTS Participants included 66 NHB and 65 NHW adults. Ergotrid height (greater among NHW; p = 0.019) averaged 14.0 mm. Upper lip vermilion length (ULVL), total UL length, internal lip length, total UL length during smile, and UL mobility averaged 8.6, 22.5, 23.1, 16.6, and 5.9 mm, respectively (all significantly greater in NHB; p ≤ 0.012). SUL prevalence was 4.6%, found only among NHW. Lip length change from rest to smile (LLC) averaged 26.2% (significantly greater in females; p = 0.003). HUL prevalence was 10.7% (NHB 13.1%, NHW 3.5%; p = 0.024). NHB had significantly greater GD (p ≤ 0.017). EGD and APE prevalence (6.9% for both) showed significant interracial and intersex differences (p ≤ 0.014). Multivariate logistic regression analyses indicated that LLC and HUL were the most consistently significant EGD determinants. CONCLUSIONS UL anatomical and functional characteristics and soft tissue-related EGD etiologies exhibit significant interracial and intersex differences, with UL mobility/hypermobility being the most consistently significant determinant of GD.
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Affiliation(s)
- Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Vanessa Paramitha
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
- Private Practice, Jakarta, Indonesia
| | - Wei-En Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Xiaohan Guo
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
- Global Biometric and Data Management, Pfizer, New Jersey, USA
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Abstract
Although still-face effects are well-studied, little is known about the degree to which the Face-to-Face/Still-Face (FFSF) is associated with the production of intense affective displays. Duchenne smiling expresses more intense positive affect than non-Duchenne smiling, while Duchenne cry-faces express more intense negative affect than non-Duchenne cry-faces. Forty 4-month-old infants and their mothers completed the FFSF, and key affect-indexing facial Action Units (AUs) were coded by expert Facial Action Coding System coders for the first 30 s of each FFSF episode. Computer vision software, automated facial affect recognition (AFAR), identified AUs for the entire 2-min episodes. Expert coding and AFAR produced similar infant and mother Duchenne and non-Duchenne FFSF effects, highlighting the convergent validity of automated measurement. Substantive AFAR analyses indicated that both infant Duchenne and non-Duchenne smiling declined from the FF to the SF, but only Duchenne smiling increased from the SF to the RE. In similar fashion, the magnitude of mother Duchenne smiling changes over the FFSF were 2-4 times greater than non-Duchenne smiling changes. Duchenne expressions appear to be a sensitive index of intense infant and mother affective valence that are accessible to automated measurement and may be a target for future FFSF research.
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Affiliation(s)
- Yeojin Amy Ahn
- Department of Psychology, University of Miami, Coral
Gables, Florida, USA
| | - Itir Önal Ertuğrul
- Department of Information and Computing Sciences, Utrecht
University, Utrecht, Netherlands
| | - Sy-Miin Chow
- Department of Human Development and Family Studies,
Pennsylvania State University, State College, Pennsylvania, USA
| | - Jeffrey F. Cohn
- Department of Psychology, University of Pittsburgh,
Pittsburgh, Pennsylvania, USA
| | - Daniel S. Messinger
- Department of Psychology, University of Miami, Coral
Gables, Florida, USA
- Department of Electrical and Computer Engineering,
University of Miami, Coral Gables, Florida, USA
- Departments of Pediatrics and Music Engineering, University
of Miami, Coral Gables, Florida, USA
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Arrubla-Escobar D, Barbosa-Liz DM, Zapata-Noreña O, Carvajal-Flórez A, Correa-Mullet K, Gómez-Gómez SL, Ardila CM. Smile Aesthetics Assessment in Patients Undergoing the Finishing Phase of Orthodontic Treatment: An Observational Cross-Sectional Study. Cureus 2023; 15:e45644. [PMID: 37868569 PMCID: PMC10590081 DOI: 10.7759/cureus.45644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Objective To describe the smile characteristics of patients entering the finishing phase of orthodontic treatment. Methods This observational study involved a non-probabilistic sample of 48 patients. Clinical records served as the basis for determining the type of treatment (with or without extractions). Photographs were analyzed to obtain smile variables. Dental casts and panoramic radiographs were evaluated to ascertain the cast-radiograph evaluation (CRE) index. Univariate and bivariate analyses were conducted at a significance level of 0.05. Results The study evaluated 24 men and 24 women, with an average age of 20.10 ± 6.78 years. Fifty percent of the patients did not undergo extractions, and the average CRE index for the sample was 34.83 ± 9.01. Regarding the smile, a medium smile line was prevalent in 66.7% of cases, and a non-consonant smile arc was observed in 58.3%. Significant differences in the smile arc were found between patients with and without extractions (p=0.019). Right and left buccal corridors measured 2.52 mm ± 1.52 and 2.43 mm ± 1.37, respectively. The upper dental midline deviated by 0.80 ± 0.91 mm and had an angulation of 1.65 ± 2.05º. Both variables showed significant differences between Class I and Class II patients (p=0.020; p=0.027). Symmetrical smiles were also observed (1.05 ± 0.17). Conclusions Based on our findings, clinicians should focus on the smile arc in patients who have not undergone extractions and on the midline inclination in Class II patients. These appear to be the most common areas for improvement in patients who are in the finishing phase of treatment. Additionally, considerable variability exists in the smile characteristics of patients still undergoing orthodontic treatment, leaving room for further enhancement of results.
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Affiliation(s)
| | - Diana M Barbosa-Liz
- Basic Sciences, GIONORTO Research Group, Faculty of Dentistry, Universidad de Antioquia, Medellin, COL
| | - Oscar Zapata-Noreña
- Basic Sciences, GIONORTO Research Group, Faculty of Dentistry, Universidad de Antioquia, Medellin, COL
| | - Alvaro Carvajal-Flórez
- Basic Sciences, GIONORTO Research Group, Faculty of Dentistry, Universidad de Antioquia, Medellin, COL
| | | | | | - Carlos M Ardila
- Basic Sciences, Biomedical Stomatology Research Group, Universidad de Antioquia, Medellin, COL
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Montevecchi M, Desimini FP, Sforza N, Bagattoni S, Piana G. Role of dental training and distance of the observer on the perception of apically shifted gingival margin with increased vertical tooth size in the esthetic zone. Clin Exp Dent Res 2023; 9:171-176. [PMID: 36415147 PMCID: PMC9932252 DOI: 10.1002/cre2.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/21/2022] [Accepted: 11/05/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To evaluate the influence of the gingival contour on the smile esthetics. The influence of size, symmetry, teeth involved in apically shifted gingival margins, and the distance and clinical training of the observer were investigated. MATERIALS AND METHODS Two groups were identified: 33 first-year dental students (inexperienced) and 40 last-year students (trained). Each observer expressed four evaluations on four different images assigning a score from 0 to 10. Using a picture of an "ideal" female smile, 10 variants were virtually created by shifting (2 and 4 mm) the gingival contour apically at different sites of the upper incisors and canines. A total of 292 evaluations were collected. RESULTS Considering a score >6 for a "pleasant smile," only one 4 mm single alteration at the canine gingival contour obtained an insufficient score. "Observational distance" and "clinical training" did not influence the final score, while size and symmetry of alterations displayed a significant role. CONCLUSIONS The dental training of the observer and a close interpersonal distance seemed to be irrelevant in the esthetic perception of gingival margin alterations.
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Affiliation(s)
- Marco Montevecchi
- Dental Clinic, Department of Biomedical and Neuromotor SciencesAlma Mater Studiorum—University of BolognaBolognaItaly
| | | | - Nicola Sforza
- Private PracticeCOS Centro Odontoiatrico SforzaBolognaItaly
| | - Simone Bagattoni
- Dental Clinic, Department of Biomedical and Neuromotor SciencesAlma Mater Studiorum—University of BolognaBolognaItaly
| | - Gabriela Piana
- Dental Clinic, Department of Biomedical and Neuromotor SciencesAlma Mater Studiorum—University of BolognaBolognaItaly
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Prasad S, Arunachalam S, Boillat T, Ghoneima A, Gandedkar N, Diar-Bakirly S. Wearable Orofacial Technology and Orthodontics. Dent J (Basel) 2023; 11:dj11010024. [PMID: 36661561 PMCID: PMC9858298 DOI: 10.3390/dj11010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/19/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
Wearable technology to augment traditional approaches are increasingly being added to the arsenals of treatment providers. Wearable technology generally refers to electronic systems, devices, or sensors that are usually worn on or are in close proximity to the human body. Wearables may be stand-alone or integrated into materials that are worn on the body. What sets medical wearables apart from other systems is their ability to collect, store, and relay information regarding an individual's current body status to other devices operating on compatible networks in naturalistic settings. The last decade has witnessed a steady increase in the use of wearables specific to the orofacial region. Applications range from supplementing diagnosis, tracking treatment progress, monitoring patient compliance, and better understanding the jaw's functional and parafunctional activities. Orofacial wearable devices may be unimodal or incorporate multiple sensing modalities. The objective data collected continuously, in real time, in naturalistic settings using these orofacial wearables provide opportunities to formulate accurate and personalized treatment strategies. In the not-too-distant future, it is anticipated that information about an individual's current oral health status may provide patient-centric personalized care to prevent, diagnose, and treat oral diseases, with wearables playing a key role. In this review, we examine the progress achieved, summarize applications of orthodontic relevance and examine the future potential of orofacial wearables.
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Affiliation(s)
- Sabarinath Prasad
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
- Correspondence:
| | - Sivakumar Arunachalam
- Orthodontics and Dentofacial Orthopedics, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Thomas Boillat
- Design Lab, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
| | - Ahmed Ghoneima
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
| | - Narayan Gandedkar
- Discipline of Orthodontics & Paediatric Dentistry, School of Dentistry, University of Sydney, Sydney, NSW 2006, Australia
| | - Samira Diar-Bakirly
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
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Schutte H, Muradin MSM, Bielevelt F, ten Harkel TC, Speksnijder CM, Rosenberg AJWP. Creating Three-Dimensional Templates of Smiling and Pouting Faces for Different Sex- and Age Groups. J Clin Med 2022; 11:jcm11247257. [PMID: 36555875 PMCID: PMC9787849 DOI: 10.3390/jcm11247257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Smile appearance has a major psychological impact. Orthognathic surgery, which has harmonizing results on skeletal structures, can negatively influence the smile appearance due to soft tissue effects. To enhance the aesthetic effects of orthognathic surgery on soft tissues, reference models for large parts of the hospital’s adherent area are called for. This study aims to create average facial models for different sex and age groups in two facial exercises: maximum closed smile, and pouting. These models were created using coherent point drift and Procrustes algorithms in MATLAB. Principal component analysis was performed, and of 20 surgical landmarks, the in-group variation using standard deviation was calculated. Three distances were analyzed: nasal width, philtral width, and mouth width. To correct for facial size, these distances were analyzed as a ratio of intercanthal width. In total, 328 healthy subjects were included in the study. Subjects were grouped by sex, and in age categories spanning four years each, with an adult group with all ages >16 years. For both smiling and pouting faces, all ratios increased with ageing. These templates and data can benefit facial surgeons, to obtain an expected outcome according to the age of the patient.
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Affiliation(s)
- Hilde Schutte
- Department of Maxillofacial Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Correspondence:
| | - Marvick S. M. Muradin
- Department of Maxillofacial Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Freek Bielevelt
- Department of Maxillofacial Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- 3D Lab Radboudumc, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Timen C. ten Harkel
- Department of Maxillofacial Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- 3D Lab Radboudumc, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Caroline M. Speksnijder
- Department of Maxillofacial Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Antoine J. W. P. Rosenberg
- Department of Maxillofacial Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
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Mohammed H, Kumar R, Bennani H, Halberstadt JB, Farella M. Automated detection of smiles as discrete episodes. J Oral Rehabil 2022; 49:1173-1180. [PMID: 36205621 PMCID: PMC9828522 DOI: 10.1111/joor.13378] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 07/25/2022] [Accepted: 08/22/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Patients seeking restorative and orthodontic treatment expect an improvement in their smiles and oral health-related quality of life. Nonetheless, the qualitative and quantitative characteristics of dynamic smiles are yet to be understood. OBJECTIVE To develop, validate, and introduce open-access software for automated analysis of smiles in terms of their frequency, genuineness, duration, and intensity. MATERIALS AND METHODS A software script was developed using the Facial Action Coding System (FACS) and artificial intelligence to assess activations of (1) cheek raiser, a marker of smile genuineness; (2) lip corner puller, a marker of smile intensity; and (3) perioral lip muscles, a marker of lips apart. Thirty study participants were asked to view a series of amusing videos. A full-face video was recorded using a webcam. The onset and cessation of smile episodes were identified by two examiners trained with FACS coding. A Receiver Operating Characteristic (ROC) curve was then used to assess detection accuracy and optimise thresholding. The videos of participants were then analysed off-line to automatedly assess the features of smiles. RESULTS The area under the ROC curve for smile detection was 0.94, with a sensitivity of 82.9% and a specificity of 89.7%. The software correctly identified 90.0% of smile episodes. While watching the amusing videos, study participants smiled 1.6 (±0.8) times per minute. CONCLUSIONS Features of smiles such as frequency, duration, genuineness, and intensity can be automatedly assessed with an acceptable level of accuracy. The software can be used to investigate the impact of oral conditions and their rehabilitation on smiles.
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Affiliation(s)
- Hisham Mohammed
- Discipline of Orthodontics, Faculty of DentistryUniversity of OtagoDunedinNew Zealand
| | - Reginald Kumar
- Discipline of Orthodontics, Faculty of DentistryUniversity of OtagoDunedinNew Zealand
| | - Hamza Bennani
- School of Information Technology, Otago PolytechnicDunedinNew Zealand
| | | | - Mauro Farella
- Discipline of Orthodontics, Faculty of DentistryUniversity of OtagoDunedinNew Zealand,Discipline of Orthodontics, Department of Surgical SciencesUniversity of CagliariCagliariItaly
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Abstract
Smiling has been a topic of interest to psychologists for decades, with a myriad of studies tying this behavior to well-being. Despite this, we know surprisingly little about the nature of the connections between smiling and physical health. We review the literature connecting both naturally occurring smiles and experimentally manipulated smiles to physical health and health-relevant outcomes. This work is discussed in the context of existing affect and health-relevant theoretical models that help explain the connection between smiling and physical health including the facial feedback hypothesis, the undoing hypothesis, the generalized unsafety theory of stress, and polyvagal theory. We also describe a number of plausible pathways, some new and relatively untested, through which smiling may influence physical health such as trait or state positive affect, social relationships, stress buffering, and the oculocardiac reflex. Finally, we provide a discussion of possible future directions, including the importance of cultural variation and replication. Although this field is still in its infancy, the findings from both naturally occurring smile studies and experimentally manipulated smile studies consistently suggest that smiling may have a number of health-relevant benefits including beneficially impacting our physiology during acute stress, improved stress recovery, and reduced illness over time.
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Affiliation(s)
- Marie P Cross
- Department of Biobehavioral Health, Pennsylvania State University, University Park, University Park, PA, USA
| | - Amanda M Acevedo
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Kate A Leger
- Department of Psychology, University of Kentucky, Lexington, Lexington, KY, USA
| | - Sarah D Pressman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
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Babeer WA, Bakhsh ZT, Natto ZS. The perception of smile attractiveness to altered vertical position of maxillary anteriors by various groups. Medicine (Baltimore) 2022; 101:e28660. [PMID: 35244035 PMCID: PMC8896490 DOI: 10.1097/md.0000000000028660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 01/05/2022] [Indexed: 01/04/2023] Open
Abstract
There is a gap in research about the differences in smile attractiveness. The problem the study addresses is how the vertical canine and incisor position affect smile attractiveness. The aim of this study was to assess the perception of the smile attractiveness between Saudi laypersons, orthodontists, non-orthodontist, and various dental students levels, and to determine how the canine and incisor vertical positions affect the attractiveness of smile. The study is a cross-sectional survey and was conducted at King Abdulaziz University, Jeddah, Saudi Arabia. Six groups of subjects participated in the study: Orthodontic residents (n = 31), prosthodontic, restorative, periodontics specialties residents specialties residents (n = 30), interns (n = 31), fifth year students (n = 41), 6th year students (n = 39), and laypeople (n = 39). Participants were asked to rate the attractiveness of a smile of a female subject photographed using a Minolta DiMage 7i digital camera. The image had been manipulated to produce 2 sets of images; 1 to modify the incisors and 1 to change the canines. The subjects were asked to choose the most and least attractive picture. For the best incisor positions, only the laypeople and prosthodontics liked the original picture, the rest liked +0.5 mm which accentuate the smile curve and make it follow the lower lip line. For the worst incisor position, all groups did not prefer the minus 1.5 reversed smile. For the best canine vertical position, all groups preferred the original position where canine was at the level of the incisal plane. For the worst canine position, they all disliked the minus 1.5 reversed smile. Results confirmed past findings that orthodontists are in general more critical about smile attractiveness than laypersons, but just like other dental specialists. The findings can be used in the esthetic dentistry field, but further research on the study population based on other dental design parameters remain necessary.
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Affiliation(s)
- Walaa A. Babeer
- Department of Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Zuhair S. Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Mossaad AM, Abdelrahman MA, Kotb AM, Alolayan AB, Elsayed SAH. Gummy Smile Management Using Diode Laser Gingivectomy Versus Botulinum Toxin Injection - A Prospective Study. Ann Maxillofac Surg 2021; 11:70-74. [PMID: 34522657 PMCID: PMC8407640 DOI: 10.4103/ams.ams_458_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/13/2021] [Accepted: 02/22/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Gummy smile (GS) is a nonesthetic condition that affects the confidence of many young people. The present study aimed to compare the results of two approaches used in the management of GS in a group of Egyptian females. Materials and Methods: This comparative cohort study included 24 female patients aged 25–35 years, divided into two groups. Group A included patients treated with diode dental laser gingivectomy, while Group B included patients who were treated with Botox injection. The clinical assessment of the pre-and post-operative measurements of exposed gums in millimetres on an active full smile was analyzed and compared for both groups. The paired t-test was used to compare pre and post measurements in each group, and the mean difference between the groups was compared using the independent t-test. Results: Group A showed instant improvement, while Group B results appeared 1 week later. The variation between preoperative and postoperative GS measurements in both groups was statistically significant. The preoperative and postoperative mean ± standard deviation was (5.17 ± 0.9 and 1.89 ± 0.5) in Group A and (4.27 ± 1.0 and 1.79 ± 1.0) in Group B. Comparison between the two groups revealed a highly significant greater mean difference of 3.27 ± 0.5 mm in Group A than Group B (P < 0.001). The findings were satisfactory in all cases of both approaches, and there were no complications. Discussion: Using a diode laser to treat gummy smiles for oro-dental genetics case with gingival hypertrophy saves time and effort compared to conventional surgical techniques. Diode dental laser is a safe fast and effective method of treatment giving more superior results than Botox injection which showed a less invasive alternative temporary GS therapy that is easily guaranteed and more patient-favored.
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Affiliation(s)
- Aida M Mossaad
- Department of Orodental Genetics, National Research Centre, Faculty of Dental Medicine for Girls, Al-Azhar University, and Taibah University, Cairo, Egypt
| | - Mostapha A Abdelrahman
- Department of Orodental Genetics, National Research Centre, Faculty of Dental Medicine for Girls, Al-Azhar University, and Taibah University, Cairo, Egypt
| | - Amr M Kotb
- Department of Dermatology, National Research Centre, Faculty of Dental Medicine for Girls, Al-Azhar University, and Taibah University, Cairo, Egypt
| | - Albraa B Alolayan
- Department of Orodental Genetics, National Research Centre, Faculty of Dental Medicine for Girls, Al-Azhar University, and Taibah University, Cairo, Egypt
| | - Shadia Abdel-Hameed Elsayed
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al-Azhar University, and Taibah University, Cairo, Egypt
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13
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Rotundo R, Nieri M, Lamberti E, Covani U, Peñarrocha-Oltra D, Peñarrocha-Diago M. Factors influencing the aesthetics of smile: An observational study on clinical assessment and patient's perception. J Clin Periodontol 2021; 48:1449-1457. [PMID: 34409619 DOI: 10.1111/jcpe.13531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/28/2021] [Indexed: 11/27/2022]
Abstract
AIM To clinically assess the aesthetics of smile and the possible influencing factors. MATERIALS AND METHODS In this explorative study, an initial questionnaire on demographic variables and perception of own quality of smile (Visual Analogue Scale) was administered by a first examiner. A second blinded assessor examined all patients and recorded clinical data. In addition, for each patient, the Smile Aesthetic Index (SEI) was calculated. Descriptive statistics and multilevel logistic models were performed. RESULTS One hundred consecutive subjects were enrolled. The mean SEI was 8.4 ± 1.2, while the mean patient's perception of smile was 7.1 ± 2.0. However, they did not correlate (r = 0.16 from -0.04 to 0.34; p = .12). Gingival recessions were perceived by 21.9% of subjects, tooth alignment by 38.6%, tooth dyschromia by 34.3%, and missing papilla/diastema by 26.7%. In particular, gingival recessions were perceived when they were deeper (p = .0342), located in the upper jaw (p = .0223), and corresponding to incisors (p < .0001) and canines (p = .0159) with respect to molars. CONCLUSIONS Clinical assessment and patient perception represent two important diagnostic phases. However, there is no correlation between them. Attention should be given to specific variables to provide the most comprehensive aesthetic analysis of smile.
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Affiliation(s)
- Roberto Rotundo
- Periodontology Unit, UCL Eastman Dental Institute, London, UK
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | - Ugo Covani
- Istituto Stomatologico Toscano, Camaiore, Italy
| | - David Peñarrocha-Oltra
- Department of Oral Surgery, Valencia University Medical and Dental School, Valencia, Spain
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14
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Silva CO, Rezende RI, Mazuquini AC, Leal VC, Amaral GSA, Guo X, Tatakis DN. Aesthetic crown lengthening and lip repositioning surgery: Pre- and post-operative assessment of smile attractiveness. J Clin Periodontol 2021; 48:826-833. [PMID: 33745186 DOI: 10.1111/jcpe.13461] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/04/2021] [Accepted: 03/09/2021] [Indexed: 12/20/2022]
Abstract
AIM To assess the effect of aesthetic crown lengthening (ACL) and lip repositioning surgery (LRS) on perception of smile attractiveness. MATERIALS AND METHODS Preoperative and 6-month postoperative smile photographs of ACL- or LRS-treated patients were evaluated by 100 raters (five gender-balanced groups of ten per procedure) of diverse background (dental students, general dentists, periodontists and laypersons with and without any aesthetic concerns about their own smile). Smile attractiveness was rated by visual analogue scale (VAS). Multivariate mixed-effect models were applied to determine the effect of procedure, rater (age, gender and group) and case (gingival display and GD) on smile attractiveness rating. RESULTS Average preoperative and postoperative VAS scores for ACL patients were 3.8 ± 2.0 and 6.2 ± 1.9, respectively. Corresponding LRS patient values were 4.8 ± 2.0 and 6.4 ± 1.9. Treatment, baseline GD and rater age were significant determinants (p < .001) of smile attractiveness for both procedures. Rater gender was not significant. Rater group was significant (p < .032) only for ACL. Procedure (p < .001), baseline VAS (p < .001), change in GD (p ≤ .002) and rater age (p ≤ .017) were significant determinants of smile attractiveness change from preoperative to postoperative. CONCLUSIONS ACL and LRS are two periodontal plastic surgery procedures that deliver significant smile attractiveness improvements, in the eyes of both laypersons and dental professionals.
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Affiliation(s)
- Cléverson O Silva
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | - Robson I Rezende
- School of Dentistry, State University of Maringá (UEM), Maringá, Brazil
| | | | - Vinicius C Leal
- School of Dentistry, Ingá University (UNINGÁ), Maringá, Brazil
| | | | - Xiaohan Guo
- Department of Statistics, College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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15
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Girard JM, Cohn JF, Yin L, Morency LP. Reconsidering the Duchenne Smile: Formalizing and Testing Hypotheses about Eye Constriction and Positive Emotion. ACTA ACUST UNITED AC 2021; 2:32-47. [PMID: 34337430 DOI: 10.1007/s42761-020-00030-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The common view of emotional expressions is that certain configurations of facial-muscle movements reliably reveal certain categories of emotion. The principal exemplar of this view is the Duchenne smile, a configuration of facial-muscle movements (i.e., smiling with eye constriction) that has been argued to reliably reveal genuine positive emotion. In this paper, we formalized a list of hypotheses that have been proposed regarding the Duchenne smile, briefly reviewed the literature weighing on these hypotheses, identified limitations and unanswered questions, and conducted two empirical studies to begin addressing these limitations and answering these questions. Both studies analyzed a database of 751 smiles observed while 136 participants completed experimental tasks designed to elicit amusement, embarrassment, fear, and physical pain. Study 1 focused on participants' self-reported positive emotion and Study 2 focused on how third-party observers would perceive videos of these smiles. Most of the hypotheses that have been proposed about the Duchenne smile were either contradicted by or only weakly supported by our data. Eye constriction did provide some information about experienced positive emotion, but this information was lacking in specificity, already provided by other smile characteristics, and highly dependent on context. Eye constriction provided more information about perceived positive emotion, including some unique information over other smile characteristics, but context was also important here as well. Overall, our results suggest that accurately inferring positive emotion from a smile requires more sophisticated methods than simply looking for the presence/absence (or even the intensity) of eye constriction.
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Affiliation(s)
| | | | - Lijun Yin
- Binghamton University, Binghamton, NY, USA
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16
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Dos Santos-Pereira SA, Cicareli ÁJ, Idalgo FA, Nunes AG, Kassis EN, Castanha Henriques JF, Bellini-Pereira SA. Effectiveness of lip repositioning surgeries in the treatment of excessive gingival display: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2020; 33:446-457. [PMID: 33325589 DOI: 10.1111/jerd.12695] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/25/2020] [Accepted: 12/03/2020] [Indexed: 11/27/2022]
Abstract
To synthesize the available evidence regarding lip repositioning surgery (LRS) and quantify the short- and long-term reduction in excessive gingival display (EGD) with the procedure. Additionally, evaluate the effect of myotomy on the results. Seven electronic databases were searched up to May 2020 by two independent reviewers. Studies evaluating the exclusive use of LRS to treat EGD were included. After risk of bias assessment, the data were quantitatively evaluated with random-effects meta-analysis. The initial database search yielded 368 studies, of which 16 were selected for full-text review. Finally, eight studies were included. The random effects model exhibited an EGD reduction of 2.87 mm (95% CI: 1.91-3.82) after 3 months of LRS. These results decreased after 6 months (2.71 mm; 95% CI: 1.95-3.47) and 12 months (2.10 mm; 95% CI: 1.48-2.72). Meta-analysis comparing the performance of myotomy showed greater EGD reduction at 6 months than without myotomy (P < 0.02). LRS is an effective approach for treating EGD, and it has satisfactory results up to 6 months. After this period, the effectiveness appears to progressively decrease over time indicating substantial relapse at 12 months. Myotomy seems a suitable alternative to increase the stability of LRS. Lip repositioning surgery is an effective procedure to improve smile esthetics in the short-term (up to 6 months). After this period, the efficacy of LRS seems to decrease progressively, and an approximately 25% relapse may be expected after 12 months. Clinicians should combine the procedure with other approaches, such as plastic periodontal surgeries, restorative procedures, or botulin toxin injections for more predictable and stable outcomes.
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Affiliation(s)
| | - Álvaro José Cicareli
- Department of Periodontics and Implantology, University Center North Paulista, São Paulo, Brazil
| | - Fábio Alarcon Idalgo
- Department of Periodontics and Implantology, University Center North Paulista, São Paulo, Brazil
| | - Alexandre Gomes Nunes
- Department of Periodontics and Implantology, University Center North Paulista, São Paulo, Brazil
| | - Elias Naim Kassis
- Department of Oral and Maxillofacial Surgery, University Center North Paulista, São Paulo, Brazil
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17
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Janu A, Azam A, Tandon R, Chandra P, Kulshrestha R, Umale V. Photographic Evaluation, Analysis and Comparison of Aesthetically Pleasing Smiles: A Prospective Study. Turk J Orthod 2020; 33:177-182. [PMID: 32974064 DOI: 10.5152/turkjorthod.2020.19060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 03/30/2020] [Indexed: 11/22/2022]
Abstract
Objective To evaluate the differences in aesthetically pleasing smiles and compare the smile arc parameters in males and females by dental specialists using photographs. Methods The study was conducted on 500 North Indian subjects (Indo-Aryan race; 212 males and 288 females) aged 17-25 years (mean age, males=21.1 years; females=23.4 years), with reasonably pleasing smiles. The facial photographs were taken using a DSLR camera. The standardized photographs were shown to 30 judges for evaluation and rated using the visual analog scale. The smiles were categorized into attractive, fair, and average. The quantification of the smile characteristics was done by using an objective method that involved identifying consonant and non-consonant smiles. Results The association between smile arc and smile attractiveness was significant (p=0.018) in females. The buccal corridor width was higher among those with fair to attractive smiles as compared with those with an average smile (p=0.018). Most subjects with an attractive smile had a smile arc parallel to the upper lip as compared with most subjects with a fair or average smile who did not have the smile arc in parallel (p=0.006). Conclusion Most females were in the fair to attractive category whereas most males were in the average to fair category. The buccal corridor width was found to be higher among those with a fair to attractive smile as compared with those with an average smile. There was an association between smile arc and smile attractiveness in females.
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Affiliation(s)
- Anisha Janu
- Department of Dentistry, JLN Medical College and Hospital, Ajmer, Rajasthan, India
| | - Aftab Azam
- Department of Orthodontics and Dentofacial Orthopedics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Ragni Tandon
- Department of Orthodontics and Dentofacial Orthopedics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Pratik Chandra
- Department of Orthodontics and Dentofacial Orthopedics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Rohit Kulshrestha
- Department of Orthodontics and Dentofacial Orthopedics, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Vinay Umale
- Department of Orthodontics and Dentofacial Orthopedics, Yogita Dental College, Khed, Maharashtra, India
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18
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Abstract
Some tools can be used as an aid to the surgical planning for gummy smile correction, such as digital smile design (DSD), which allows to determine patterns of harmony and eventual asymmetries between teeth and gums. This work aims to report a gummy smile correction using DSD as reverse planning. The clinical examination revealed the presence of gummy smile and extensive bone exostosis in the premolar region. DSD was performed in the upper arch, determining the amount of gingiva to be removed, thus providing more safety and precision to the procedure. The surgery was performed by performing using an internal bevel incisions, detachment of a full thickness flap, and osteotomy and osteoplasty. After 6 months of preservation, there was an increase in the clinical crown of the teeth, with smile harmony, less exposure of the gingiva in the smile and a high level of patient aesthetic satisfaction.
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Affiliation(s)
| | | | - Luciana P Maia
- Dental School, University of Western São Paulo - UNOESTE, Presidente Prudente, Brazil
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19
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Tawfik OK, Naiem SN, Tawfik LK, Yussif N, Meghil MM, Cutler CW, Darhous M, El-Nahass HE. Lip repositioning with or without myotomy: A randomized clinical trial. J Periodontol 2019; 89:815-823. [PMID: 30006937 DOI: 10.1002/jper.17-0598] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/22/2017] [Accepted: 11/24/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Lip repositioning is a conservative surgical method for the correction of excess gingival display (EGD) by limiting the upward retraction of the lips. Lip repositioning presents a simple method for the treatment of gummy smile. The aim of this randomized clinical trial (RCT) was to assess lip repositioning, compared to lip repositioning with muscle severance for efficacy in treatment of EGD and resultant stability. METHODS A single-blinded, controlled, parallel-group RCT was performed. Twenty patients with EGD were enrolled in the study, treated with lip repositioning with and without muscle severance. Participants were assessed for EGD reduction, changes in lip length and result stability at 3, 6 and 12 months. Additionally, pain, swelling and satisfaction, were assessed. RESULTS Classic lip repositioning was found capable of reducing EGD by 2.73 mm (SD ± 1.281), while lip repositioning with muscle severance offered an improved reduction in EGD with a mean reduction of 3.57mm (SD ± 1.62). Lip length, swelling and pain scores were found comparable between the two techniques. CONCLUSION Lip repositioning is an effective method for treating EGD, however, muscle severance provides a more stable result at 12 months when compared to the classical technique. More studies are necessary to fully assess this procedure.
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Affiliation(s)
- Omnia K Tawfik
- Department of Oral medicine and Periodontology, Faculty of Oral and Dental Medicine-Cairo University, Manial, Cairo, Egypt.,Department of Periodontics, Dental College of Georgia-Augusta University, Augusta, Georgia
| | - Suzi N Naiem
- Department of Oral medicine and Periodontology, Faculty of Oral and Dental Medicine-Cairo University, Manial, Cairo, Egypt
| | | | - Nermin Yussif
- October University of Modern Sciences and Arts (MSA university), Cairo, Egypt
| | - Mohamed M Meghil
- Department of Periodontics, Dental College of Georgia-Augusta University, Augusta, Georgia
| | - Christopher W Cutler
- Department of Periodontics, Dental College of Georgia-Augusta University, Augusta, Georgia
| | - Mona Darhous
- Department of Oral medicine and Periodontology, Faculty of Oral and Dental Medicine-Cairo University, Manial, Cairo, Egypt
| | - Hani E El-Nahass
- Department of Oral medicine and Periodontology, Faculty of Oral and Dental Medicine-Cairo University, Manial, Cairo, Egypt
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20
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Rotundo R, Genzano L, Patel D, D'Aiuto F, Nieri M. Adjunctive benefit of a xenogenic collagen matrix associated with coronally advanced flap for the treatment of multiple gingival recessions: A superiority, assessor-blind, randomized clinical trial. J Clin Periodontol 2019; 46:1013-1023. [PMID: 31292987 DOI: 10.1111/jcpe.13168] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 07/01/2019] [Accepted: 07/06/2019] [Indexed: 10/26/2022]
Abstract
AIM To evaluate the superiority of coronally advanced flaps (CAFs) when used in combination with a xenogeneic collagen matrix (CMX) for root coverage of multiple adjacent gingival recessions. MATERIALS AND METHODS Participants with at least 2 upper adjacent teeth exhibiting gingival recession depth ≥2 mm were recruited and randomized to CAF with (test) or without (control) CMX, respectively. Mean and complete root coverage, amount of keratinized tissue (KTw), gingival thickness (GThick) and patient-reported outcomes (PROMs) were recorded at baseline, 3, 6 and 12 months. RESULTS Twenty-four patients providing 61 gingival recessions were analysed. After 1 year, gingival recession depth decreased from 2.3 ± 0.7 to 0.3 ± 0.4 mm in the CAF + CMX group (2.0 ± 0.8 mm meanRC) and from 2.6 ± 1.0 to 0.6 ± 0.3 mm in the control group (2.0 ± 1.1 mm meanRC). No difference was observed between the two groups (p = 0.2023). Nineteen (63%) of the test and 16 (52%) of control defects showed complete root coverage (p = 0.4919). GThick greatly increased in the test group (0.5 mm; 0.2-0.8 mm, 95% CI; p = 0.0057). No difference between the two groups was observed for KTw (p = 0.5668) and PROMs. CONCLUSION At 1 year, CAF + CMX provided similar root coverage to CAF alone, but a significant increase in gingival thickness.
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Affiliation(s)
- Roberto Rotundo
- Honorary Associate Professor in Periodontology, UCL Eastman Dental Institute, London, UK
| | | | - Divya Patel
- Specialist Trainee, UCL Eastman Dental Institute, London, UK
| | - Francesco D'Aiuto
- Chair and Honorary Consultant in Periodontology, UCL Eastman Dental Institute, London, UK
| | - Michele Nieri
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
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21
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Antonarakis GS, Kiliaridis S. Class II functional appliance treatment and dynamic three-dimensional mimic muscle evaluation. J Oral Rehabil 2019; 46:813-819. [PMID: 31081283 DOI: 10.1111/joor.12819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/25/2019] [Accepted: 05/09/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Functional appliances have skeletal and dentoalveolar treatment effects, but knowledge on their effect on facial expressions is limited. OBJECTIVE To analyse changes in facial expressions, using three-dimensional (3D) mimic muscle evaluation, in growing children with Class II malocclusion and large overjet, undergoing functional appliance treatment. METHODS Fifteen growing children with Class II division 1 malocclusion, selected prospectively, had dynamic 3D recordings of facial expressions prior to and 12 months after commencing functional appliance treatment. Facial expressions recorded were smile and lip pucker, and the movements of the oral commissures were analysed, as well as mouth width and its symmetry. A control group of fifteen age- and sex-matched growing children without immediate need for orthodontic treatment had similar recordings prior to and after a 12-month observation period. RESULTS In the treatment group, the Class II malocclusion in all children improved after 12 months of functional appliance wear. With regard to movements of the oral commissures, the initial recordings of the treatment group did not show any significant differences to the control group for neither smile nor lip pucker. Differences were noted however when looking at mouth width asymmetry, where this tended to become more symmetrical in the functional appliance treatment group, during rest and during smiling, while it became more asymmetrical in the untreated control group. CONCLUSION The use of removable functional appliances in children with Class II division 1 malocclusion may have a positive effect on mouth width symmetry when smiling, making it more symmetrical.
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Affiliation(s)
- Gregory S Antonarakis
- Division of Orthodontics, University clinics of dental medicine, University of Geneva, Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics, University clinics of dental medicine, University of Geneva, Geneva, Switzerland
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Tan JR, Coulson S, Keep M. Face-to-Face Versus Video Assessment of Facial Paralysis: Implications for Telemedicine. J Med Internet Res 2019; 21:e11109. [PMID: 30977734 PMCID: PMC6484264 DOI: 10.2196/11109] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/13/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients with facial nerve paralysis (FNP) experience challenges in accessing health care that could potentially be overcome by telemedicine. However, the reliability of telemedicine has yet to be established in this field. OBJECTIVE This study aimed to investigate the consistency between face-to-face and video assessments of patients with FNP by experienced clinicians. METHODS A repeated-measures design was used. A total of 7 clinicians assessed the FNP of 28 patients in a face-to-face clinic using standardized grading systems (the House-Brackmann, Sydney, and Sunnybrook facial grading systems). After 3 months, the same grading systems were used to assess facial palsy in video recordings of the same patients. RESULTS The House-Brackmann system in video assessment had excellent reliability and agreement (intraclass correlation coefficient [ICC]=0.780; principal component analysis [PCA]=87.5%), similar to face-to-face assessment (ICC=0.686; PCA=79.2%). Reliability of the Sydney system was good to excellent, with excellent agreement face-to-face (ICC=0.633 to 0.834; PCA=81.0%-95.2%). However, video assessment of the cervical branch and synkinesis had fair reliability and good agreement (ICC=0.437 to 0.597; PCA=71.4%), whereas that of other branches had good to excellent reliability and excellent agreement (ICC=0.625 to 0.862; PCA=85.7%-100.0%). Reliability of the Sunnybrook system was poor to fair for resting symmetry (ICC=0.195 to 0.498; PCA=91.3%-100.0%) and synkinesis (ICC=-0.037 to 0.637; PCA=69.6%-87.0%) but was good to excellent for voluntary movement (ICC=0.601 to 0.906; PCA=56.5%-91.3%) in face-to-face and video assessments. Bland-Altman plots indicated normal limits of agreement within ±1 between face-to-face and video-assessed scores only for the temporal and buccal branches of the Sydney system and for resting symmetry in the Sunnybrook system. CONCLUSIONS Video assessment of FNP with the House-Brackmann and Sunnybrook systems was as reliable as face-to-face but with insufficient agreement, especially in the assessment of synkinesis. However, video assessment does not account for the impact of real-time interactions that occur during tele-assessment sessions.
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Affiliation(s)
- Jian Rong Tan
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, Australia
| | - Susan Coulson
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, Australia
| | - Melanie Keep
- Faculty of Health Sciences, University of Sydney, Lidcombe, Australia
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23
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Abstract
Objective The aim of this study was to use three-dimensional images to determine the presence of upper lip asymmetry at rest and during smiling in a group of individuals with no history of orthodontics or facial cosmetic surgery. Methods Standardized three-dimensional frontal resting and smiling images of 54 volunteers were analyzed using the 3dMDvultus software (3dMD, Atlanta, GA). Measurements were made from the soft tissue nasion, ipsilateral ala, subnasale, and menton to the right and left commissures of the lip. A 2.5 mm or greater difference between the right and left sides was defined as an asymmetry. The agreement on the presence or absence of asymmetry between the subjects' states of rest and smiling was determined by the McNemar's chi-squared test. Statistical significance was defined as p<0.05. Results Menton was the most stable facial landmark to evaluate the upper lip symmetry at rest and during smiling (p=0.002). Using menton as a landmark, only one of the 54 subjects showed asymmetry while resting, but 12 (22%) showed asymmetry when smiling. Conclusion As part of treatment planning for orthodontics or orthognathic surgery, patients should be evaluated for the upper lip symmetry during resting and smiling. The presence of asymmetry during smiling is a significant clinical problem that needs to be recognized so that patients can be informed about the effect it can have on the final esthetic result.
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Affiliation(s)
- Andrew Mathis
- Virginia Commonwealth University School of Dentistry, Richmond, Virginia, USA
| | - Daniel M Laskin
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University School of Dentistry, Richmond, Virginia, USA
| | - Eser Tüfekçi
- Deparment of Orthodontics, Virginia Commonwealth University School of Dentistry, Richmond, Virginia, USA
| | - Caroline Caricco
- Department of Periodontics, Virginia Commonwealth University School of Dentistry, Richmond, Virginia, USA
| | - Steven J Lindauer
- Deparment of Orthodontics, Virginia Commonwealth University School of Dentistry, Richmond, Virginia, USA
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Cross MP, Pressman SD. Say cheese? The connections between positive facial expressions in student identification photographs and health care seeking behavior. J Health Psychol 2018; 25:2511-2519. [PMID: 30052098 DOI: 10.1177/1359105318790066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined whether positive facial expressions in student identification photographs were connected with a health-relevant behavior: visits to a health care center in the last year for preventive and non-preventive (e.g. illness, injury) purposes. Identification photographs were coded for degree of smile. Smiling participants were more likely to have sought preventive care versus those not smiling in their photographs, but there was no difference in non-preventive (i.e. ill health) visits. This study shows for the first time that smiling in photographs may be related to healthy behavior and complements past work connecting smiling to positive psychosocial and health outcomes.
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He Z, Liu J, Rao Z, Wan L. Fairness and Smiling Mediate the Effects of Openness on Perceived Fairness: Beside Perceived Intention. Front Psychol 2018; 9:772. [PMID: 29875721 PMCID: PMC5974586 DOI: 10.3389/fpsyg.2018.00772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 05/01/2018] [Indexed: 11/23/2022] Open
Abstract
Previous studies have shown that smiling, fairness, intention, and the results being openness to the proposer can influence the responses in ultimatum games, respectively. But it is not clear that how the four factors might interact with each other in twos or in threes or in fours. This study examined the way that how the four factors work in resource distribution games by testing the differences between average rejection rates in different treatments. Two hundred and twenty healthy volunteers participated in an intentional version of the ultimatum game (UG). The experiment used a 2 × 2 × 2 × 2 mixed design with "openness" as a between subjects factor and the other three as within subjects factors, and the participants were assigned as recipients. The results revealed that fairness or perceived good intention reduced the subject's average rejection rates. There was a significant interaction between facial expressions and openness. With fair offers, the average rejection rate for informed was lower than that of uninformed; but when unfair, no difference between the corresponding average rejection rates was found. The interaction effect of smiling and openness was also significant, the average rejection rate for informed offers was lower when the proposer was smiling and no rejection rate difference between uninformed offers and informed offers when no smiling. No other interaction effect was found.
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Affiliation(s)
- Zhifang He
- School of Psychology, Jiangxi Normal University, Nanchang, China
- School of Humanities, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jianping Liu
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Zhiming Rao
- School of Physics and Communication Electronics, Jiangxi Normal University, Nanchang, China
| | - Lili Wan
- School of Humanities, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Wang Y, Wang WW, Hua XY, Liu HQ, Ding W. Patterns of cortical reorganization in facial synkinesis: a task functional magnetic resonance imaging study. Neural Regen Res 2018; 13:1637-1642. [PMID: 30127126 PMCID: PMC6126138 DOI: 10.4103/1673-5374.235304] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Facial synkinesis, a sequela of peripheral facial nerve palsy, is characterized by simultaneous involuntary facial movement during a voluntary desired one. Maladaptive cortical plasticity might be involved in the dysfunction of facial muscles. This cohort study investigated the cortical functional alterations in patients with unilateral facial synkinesis, using the task functional magnetic resonance imaging. Facial motor tasks, including blinking and smiling, were performed by 16 patients (aged 30.6 ± 4.5 years, 14 females/2 males) and 24 age- and sex-matched healthy controls (aged 29.1 ± 4.2 years, 19 females/5 males). Results demonstrated that activation in the cortico-facial motor representation area was lower during tasks in patients with facial synkinesis compared with healthy controls. Facial movements on either side performed by patients caused more intensive activation of the supplementary motor area on the contralateral side of the affected face, than those on the unaffected side. Our results revealed that there was cortical reorganization in the primary sensorimotor area and the supplementary motor area. This study was registered in Chinese Clinical Trial Registry (registration number: ChiCTR1800014630).
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Affiliation(s)
- Yin Wang
- Department of Radiology, Huashan Hospital; Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei-Wei Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu-Yun Hua
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Han-Qiu Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei Ding
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abstract
People with Parkinson’s disease (PD) often experience a decrease in their facial expressivity, but little is known about how the coordinated movements across regions of the face are impaired in PD. The face has neurologically independent regions that coordinate to articulate distinct social meanings that others perceive as gestalt expressions, and so understanding how different regions of the face are affected is important. Using the Facial Action Coding System, this study comprehensively measured spontaneous facial expression across 600 frames for a multiple case study of people with PD who were rated as having varying degrees of facial expression deficits, and created correlation matrices for frequency and intensity of produced muscle activations across different areas of the face. Data visualization techniques were used to create temporal and correlational mappings of muscle action in the face at different degrees of facial expressivity. Results showed that as severity of facial expression deficit increased, there was a decrease in number, duration, intensity, and coactivation of facial muscle action. This understanding of how regions of the parkinsonian face move independently and in conjunction with other regions will provide a new focus for future research aiming to model how facial expression in PD relates to disease progression, stigma, and quality of life.
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Affiliation(s)
- Sarah D Gunnery
- Department of Occupational Therapy, Tufts University, 574 Boston Ave, Medford, MA 02155, USA
| | - Elena N Naumova
- The Gerald J. and Dorothy H Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA
| | - Marie Saint-Hilaire
- Department of Neurology, Parkinson's Disease and Movement Disorders Center, Boston University Medical Center, 725 Albany St, Boston, MA 02118, USA
| | - Linda Tickle-Degnen
- Department of Occupational Therapy, Tufts University, 574 Boston Ave, Medford, MA 02155, USA
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Singh H, Maurya RK, Kapoor P, Sharma P, Srivastava D. Subjective and objective evaluation of frontal smile esthetics in patients with facial asymmetry-a comparative cross-sectional study. Orthod Craniofac Res 2016; 20:8-20. [PMID: 27862935 DOI: 10.1111/ocr.12135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2016] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES To analyze the relationship between subjective and objective evaluations of pre-treatment posed smiles in patients with facial asymmetry and to assess the influence of dentofacial structures involved in asymmetry on the perception of smile attractiveness. SAMPLE Thirty-five patients (25 males and 10 females) between 18 and 25 years of age with facial asymmetry were selected. MATERIALS AND METHODS Pre-treatment clinical photographs of posed smiles were subjectively evaluated by a panel of 20 orthodontists, 20 oral surgeons, and 20 laypersons. A customized Smile Mesh program was used for objective evaluation of the same smiles. Direct comparison among three smile groups (unattractive, slightly attractive, and attractive) for different Smile Mesh measurements was carried out using two-way anova test. Additionally, linear regression was performed to evaluate whether these measurements could predict the attractiveness of captured smiles. RESULTS Patients with 'slightly attractive' smiles had a significantly greater distance between the incisal margin of the maxillary central incisor and the lower lip during smiling. The Smile Index was significantly greater in attractive smiles. However, based on the coefficients of linear regression, no objectively gathered measurement could predict smile attractiveness. CONCLUSIONS Attractiveness or unattractiveness of smiles in patients with facial asymmetry could not be predicted by any measurement of Smile Mesh. The presence of facial asymmetry did not significantly influence the perception of smile esthetics.
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Affiliation(s)
- H Singh
- Department of Orthodontics and Craniofacial Orthopedics, ESIC Dental College and Hospital, Delhi, India
| | - R K Maurya
- Sultania Infantry Line, Bhopal Military Station, Bhopal, India
| | - P Kapoor
- Department of Orthodontics and Craniofacial Orthopedics, ESIC Dental College and Hospital, Delhi, India
| | - P Sharma
- Department of Orthodontics and Craniofacial Orthopedics, ESIC Dental College and Hospital, Delhi, India
| | - D Srivastava
- Department of Oral and Cranio-Maxillofacial Surgery, ESIC Dental College and Hospital, Delhi, India
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Chou JC, Nelson A, Katwal D, Elathamna EN, Durski MT. Effect of smile index and incisal edge position on perception of attractiveness in different age groups. J Oral Rehabil 2016; 43:855-862. [PMID: 27612023 DOI: 10.1111/joor.12439] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/29/2022]
Abstract
Changes in occlusal vertical dimension (OVD) and age have been found to affect Smile Index (SI, width/height of smile). Limited information is available regarding the aesthetic effects of these changes. The objective of this study was to evaluate the attractiveness of digitally manipulated smile images with differences in SI and incisal edge position (IEP) judged by respondents in different age groups. A total of 12 smile images were generated with varying SI (3·5, 5·3, 7·2, 9·0) and IEP (High, Medium, Low). Fifty respondents each in four age groups (15-24, 25-39, 40-54, 55+) evaluated the attractiveness of the 12 images using a 0-10 visual analog scale (VAS, 10 being most attractive). A repeated-measures three-factorial mixed model assessed differences. SI, IEP and age of respondents were found to significantly influence attractiveness score (P < 0·01 for all). With all age groups combined, SI = 7·2/IEP = Medium was most attractive (VAS = 7·22), followed by SI = 9·0/IEP = Medium, and SI = 5·3/IEP = Medium (VAS = 6·53 and 6·48, respectively). SI = 3·5/IEP = High and SI = 3·5/IEP = Low were least attractive (VAS = 1·99 and VAS = 2·58, respectively). Age group significantly influenced aesthetic perception, with younger respondents more critical in differences in SI and IEP. SI and IEP significantly influenced attractiveness of the smile in all respondent age groups. Low SI (i.e. 3·5) combined with high or low IEP was unattractive. Medium SI to high SI (i.e. 5·3-9·0) combined with medium IEP were considered attractive.
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Affiliation(s)
- J-C Chou
- Department of Oral Health and Rehabilitation, University of Louisville School of Dentistry, Louisville, KY, USA.
| | - A Nelson
- University of Louisville School of Dentistry, Louisville, KY, USA
| | - D Katwal
- Department of Oral Health and Rehabilitation, University of Louisville School of Dentistry, Louisville, KY, USA
| | - E N Elathamna
- Department of Oral Health and Rehabilitation, University of Louisville School of Dentistry, Louisville, KY, USA
| | - M T Durski
- Department of General Dentistry and Oral Medicine, University of Louisville School of Dentistry, Louisville, KY, USA
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Aly LA, Hammouda NI. Botox as an adjunct to lip repositioning for the management of excessive gingival display in the presence of hypermobility of upper lip and vertical maxillary excess. Dent Res J (Isfahan) 2016; 13:478-483. [PMID: 28182056 PMCID: PMC5256010 DOI: 10.4103/1735-3327.197039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Excessive gingival display (GD) is a frequent finding that can occur because of various intraoral or extraoral etiologies. This work describes the use of a mucosal repositioned flap for the management of a gummy smile associated with vertical maxillary excess (VME) and hypermobility of the upper lip followed by injection of Botox. MATERIALS AND METHODS Seven female patients in the age range of 17-25 years presented with a gummy smile. At full smile, the average GD ranged from 6 to 8 mm. A clinical examination revealed hypermobility of the upper lip. A cephalometric analysis pointed to the presence of VME. The mucosal repositioned flap surgery was conducted followed by injection with botulinum toxin type A (Botox) 2 weeks postsurgically. RESULTS After 4 weeks, results were definitely observed with a decrease from 8 mm gingival exposure to 3 mm, which was considered as normal GD for an adult during smiling. CONCLUSION For patients desiring a less invasive alternative to orthognathic surgery, the mucosal repositioned flap is a viable alternative. Moreover, Botox is a useful adjunct to enhance the esthetics and improve patient satisfaction where surgery alone may prove inadequately in moderate VME.
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Affiliation(s)
- Lobna Abdel Aly
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Future University, Cairo, Egypt
| | - Nelly Ibrahim Hammouda
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Brian JA, Smith IM, Zwaigenbaum L, Roberts W, Bryson SE. The Social ABCs caregiver-mediated intervention for toddlers with autism spectrum disorder: Feasibility, acceptability, and evidence of promise from a multisite study. Autism Res 2015; 9:899-912. [PMID: 26688077 PMCID: PMC5064621 DOI: 10.1002/aur.1582] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/29/2015] [Indexed: 11/08/2022]
Abstract
The Social ABCs is a parent-mediated intervention for toddlers with suspected or confirmed autism spectrum disorder (ASD). We undertook a multi-site pilot study to evaluate feasibility and acceptability, and to identify trends in child and parent behavior to inform future research using a larger sample and a rigorous research design. The program involved 12 weeks of parent coaching, followed by 12 weeks' implementation, and 3-month follow-up assessment for 20 parent-toddler dyads (age range: 12-32 months). Parents successfully learned the techniques and rated the intervention as highly acceptable. Paired samples t-tests revealed significant gains in children's functional communication (responsivity, initiations), and language gains (age-equivalents on standardized measures) commensurate with typical developmental rates. Significant increases in shared smiling and social orienting also emerged, but were attenuated at follow-up. Parents' fidelity was positively associated with child responsivity. Training parents as mediators is a feasible and highly acceptable approach that provides a potentially cost-effective opportunity for intensive intervention at a very young age at the first signs of ASD risk. Child and parent gains in several key variables demonstrate the promise of this intervention. Autism Res 2016, 9: 899-912. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.
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Affiliation(s)
- Jessica A Brian
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Isabel M Smith
- Departments of Pediatrics and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Wendy Roberts
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.,Integrated Services for Autism and Neurodevelopmental Disorders, Toronto, Ontario, Canada
| | - Susan E Bryson
- Departments of Pediatrics and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
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Abstract
Positive emotional engagement develops in the context of face-to-face interactions during the first 6 months of life. Deficits in emotional engagement are characteristic of autism spectrum disorder (ASD) and may characterize the younger siblings of children with ASD (high-risk siblings). High-risk siblings are likely to exhibit a broad range of positive emotional engagement that may or may not be associated with ASD outcomes. We examined positive emotional engagement (i.e., smiling rate and contingent responsiveness to the partner's smile) during the infant-parent interaction episodes of the face-to-face/still face protocol at 6 months of age. The sample included 43 high-risk infant siblings, 11 of whom went on to an ASD diagnosis, and 25 low-risk siblings with no family history of ASD. Low-risk siblings and high-risk siblings without ASD showed the typical still-face effect (i.e., decreases in smiling rate after period of parental nonresponsiveness), but high-risk siblings with later ASD outcomes did not show this decrease. Although high-risk siblings without an ASD diagnosis were less likely to respond to their parents' smiles than were low-risk siblings, the children with eventual ASD did not differ from the other groups in contingent responsiveness. Findings suggest that subtle differences in positive emotional engagement are present in the early development of high-risk siblings but are not consistently associated with ASD outcomes.
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Pinho T, Bellot-Arcís C, Montiel-Company JM, Neves M. Esthetic Assessment of the Effect of Gingival Exposure in the Smile of Patients with Unilateral and Bilateral Maxillary Incisor Agenesis. J Prosthodont 2014; 24:366-72. [PMID: 25220205 DOI: 10.1111/jopr.12216] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2014] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of this study was to determine the dental esthetic perception of the smile of patients with maxillary lateral incisor agenesis (MLIA); the perceptions were examined pre- and post-treatment. Esthetic determinations were made with regard to the gingival exposure in the patients' smile by orthodontists, general dentists, and laypersons. MATERIALS AND METHODS Three hundred eighty one people (80 orthodontists, 181 general dentists, 120 laypersons) rated the attractiveness of the smile in four cases before and after treatment, comprising two cases with unilateral MLIA and contralateral microdontia and two with bilateral MLIA. For each case, the buccal photograph was adjusted using a computer to apply standard lips to create high, medium, and low smiles. A numeric scale was used to measure the esthetic rating perceived by the judges. The resulting arithmetic means were compared using an ANOVA test, a linear trend, and a Student's t-test, applying a significance level of p < 0.05. The predictive capability of the variables, unilateral, or bilateral MLIA, symmetry of the treatment, gingival exposure of the smile, group, and gender were assessed using a multivariable linear regression model. RESULTS In the pre- and post-treatment cases, medium smile photographs received higher scores than the same cases with high or low smiles, with significant differences between them. In all cases, orthodontists were the least-tolerant evaluation group (assigning lowest scores), followed by general dentists. In a predictive linear regression model, bilateral MLIA was the more predictive variable in pretreatment cases. The gingival exposure of the smile was a predictive variable in post-treatment cases only. CONCLUSION The medium-height smile was considered to be more attractive. In all cases, orthodontists gave the lowest scores, followed by general dentists. Laypersons and male evaluators gave the highest scores. Symmetrical treatments scored higher than asymmetrical treatments. The gingival exposure had a significant influence on the esthetic perception of smiles in post-treatment cases.
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Affiliation(s)
- Teresa Pinho
- Instituto Superior de Ciências da Saúde-Norte, CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), Gandra PRD, Portugal
| | - Carlos Bellot-Arcís
- Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Leavens DA, Sansone J, Burfield A, Lightfoot S, O’Hara S, Todd BK. Putting the "Joy" in joint attention: affective-gestural synchrony by parents who point for their babies. Front Psychol 2014; 5:879. [PMID: 25161640 PMCID: PMC4129495 DOI: 10.3389/fpsyg.2014.00879] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/23/2014] [Indexed: 11/21/2022] Open
Abstract
Despite a growing body of work examining the expression of infants' positive emotion in joint attention contexts, few studies have examined the moment-by-moment dynamics of emotional signaling by adults interacting with babies in these contexts. We invited 73 parents of infants (three fathers) to our laboratory, comprising parent-infant dyads with babies at 6 (n = 15), 9 (n = 15), 12 (n = 15), 15 (n = 14), and 18 (n = 14) months of age. Parents were asked to sit in a chair centered on the long axis of a room and to point to distant dolls (2.5 m) when the dolls were animated, while holding their children in their laps. We found that parents displayed the highest levels of smiling at the same time that they pointed, thus demonstrating affective/referential synchrony in their infant-directed communication. There were no discernable differences in this pattern among parents with children of different ages. Thus, parents spontaneously encapsulated episodes of joint attention with positive emotion.
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Affiliation(s)
| | - Jo Sansone
- School of Psychology, University of Sussex, East SussexUK
| | - Anna Burfield
- School of Psychology, University of Sussex, East SussexUK
| | - Sian Lightfoot
- School of Psychology, University of Sussex, East SussexUK
| | | | - Brenda K. Todd
- School of Psychology, University of Sussex, East SussexUK
- Department of Psychology, City University LondonLondon, UK
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35
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Tessarollo FR, Feldens CA, Closs LQ. The impact of malocclusion on adolescents' dissatisfaction with dental appearance and oral functions. Angle Orthod 2012; 82:403-409. [PMID: 21942720 PMCID: PMC8865825 DOI: 10.2319/031911-195.1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 06/01/2011] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE To investigate the impact of malocclusion on adolescents' dissatisfaction with dental appearance and oral functions and to identify components of malocclusion that may contribute to these outcomes. MATERIALS AND METHODS The sample comprised 704 secondary school adolescents aged 12 to 13 years from Balneário Camboriú, Brazil. A trained and calibrated orthodontist examined the severity of malocclusion using the Dental Aesthetic Index (DAI). A pretested questionnaire was used to assess reported dental appearance, self-perception of speech, and self-perception of masticatory function using a 5-point scale of oral health status. The outcomes of the present study were dissatisfaction with dental appearance and dissatisfaction with oral functions. Simple and multivariate logistic regression analysis was performed to explore the association between DAI and outcomes and to quantify the effect of DAI components on dissatisfaction with dental appearance. RESULTS Each DAI unit increase led to a significant increase of 5% in the likelihood of dissatisfaction with dental appearance (OR: 1.05; 95% CI 1.01-1.08). DAI components that exerted influence on dissatisfaction with dental appearance were: missing teeth (P = .010), largest maxillary anterior irregularity ≥3 mm (P = .013), and largest mandibular anterior irregularity ≥2 mm (P = .008). There was no association between severity of malocclusion and dissatisfaction with oral functions. CONCLUSIONS Severity of malocclusion interfered with satisfaction of dental appearance in this population. Missing teeth and anterior irregularity were identified as factors influencing this outcome.
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Affiliation(s)
- Fábio Rafael Tessarollo
- Department of Orthodontics, School of Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
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Manera V, Del Giudice M, Grandi E, Colle L. Individual differences in the recognition of enjoyment smiles: no role for perceptual-attentional factors and autistic-like traits. Front Psychol 2011; 2:143. [PMID: 21779265 PMCID: PMC3134888 DOI: 10.3389/fpsyg.2011.00143] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 06/14/2011] [Indexed: 11/18/2022] Open
Abstract
Adults show remarkable individual variation in the ability to detect felt enjoyment in smiles based on the Duchenne marker (Action Unit 6). It has been hypothesized that perceptual and attentional factors (possibly correlated to autistic-like personality traits in the normative range) play a major role in determining individual differences in recognition performance. Here, this hypothesis was tested in a sample of 100 young adults. Eye-tracking methodology was employed to assess patterns of visual attention during a smile recognition task. Results indicate that neither perceptual–attentional factors nor autistic-like personality traits contribute appreciably to individual differences in smile recognition.
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Affiliation(s)
- Valeria Manera
- Laboratory of Experimental Psychology, Department of Psychology, Katholieke Universiteit Leuven Leuven, Belgium
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Burton L, Bolt N, Hadjikyriacou D, Silton N, Kilgallen C, Allimant J. Relationships of smiling and flirtation to aggression and 2D:4D, a prenatal androgen index. Evol Psychol 2011; 9:28-37. [PMID: 22947951 PMCID: PMC10426893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 12/23/2010] [Indexed: 06/01/2023] Open
Abstract
Smiling has been reported to be a signal of submission/lower status, or a sign of cooperation. In the present study, use of smiling and flirtation to "make people receptive to my ideas" was conceptualized as mild aggression, since it is mildly manipulative of the perception of others as to one's internal emotional status. For 91 participants (55 female, 36 male), use of smiling and flirtation to make others receptive to one's ideas were associated with relational aggression and a more male-typical (smaller) right 2D:4D finger length ratio. The only significant relationship in the male sample alone was the relationship between smiling and relational aggression. In the female sample alone, use of smiling and flirtation to "make people receptive to my ideas" was associated with a more male-typical 2D:4D finger length ratio pattern, and there was a trend for flirtation to be associated with greater physical aggression. Both 2D:4D and physical aggression have been associated with higher prenatal androgen level. It is concluded that deliberate smiling and flirtation are mild forms of relational aggression, and are related to prenatal androgenic activity in a manner similar to physical aggression. These findings are discussed in terms of the different evolutionary strategies of men and women to control their social environments.
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Affiliation(s)
- Leslie Burton
- Psychology Department, University of Connecticut, Stamford, CT, USA.
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