Lip Asymmetry and Smile Aesthetics

Batwa, Waeil; McDonald, Fraser; Cash, Alexander C

doi:10.1597/12-122

Cited by 8 publications

(8 citation statements)

References 15 publications

(17 reference statements)

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“…Clarifying the main problem of the patient is crucial to determining the appropriate treatment. Batwa et al 29 reported that lip asymmetry of .2.5 mm had a relative impact on smile esthetics. However, there are limited studies on the extent to which the asymmetry can be visually perceived in which planes in clinical terms.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional evaluation of social smile symmetry

Duran

Di̇ndaroğlu

Görgülü

2016

The Angle Orthodontist

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Objective: To evaluate the social smile symmetry using three-dimensional (3D) stereophotogrammetric images. Materials and Methods: The study was conducted with 3D facial images of 30 individuals (age range 13-25 years). The rest position was considered as the reference image and the social smile image was aligned on this image using the best-fit alignment method. The spatial differences between the same points established on both images using 3D analyses were determined for right and left points in X, Y, and Z planes. Results: The highest difference related to spatial distance in right and left points was À0.56 mm (95% confidence interval [CI], À1.19, 0.06 mm) between right and left commissure (Com) points. The difference was not significant, and the Bland-Altman upper and lower limits were À3.85 mm and 2.71 mm, respectively. The highest difference for the transversal plane was found in Com points, similarly to the spatial distance (mean: 0.50 mm, 95% CI, À2.62, 1.02 mm). The differences between the changes in the left and right points in the Y and Z plane were not significant (P . .05). Conclusions: The social smile was observed to show asymmetry in varying amounts in the different directions. Asymmetry increases in some cases, specifically for the corners of the mouth.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional evaluation of social smile symmetry

Duran

Di̇ndaroğlu

Görgülü

2016

The Angle Orthodontist

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“…In the literature, asymmetries of the cheeks, nose, lips, condyles, chin, and the dentoalveolar regions in individuals with UCLP have been studied frequently (Kraus et al, 1966;Kyrkanides et al, 2000;Kurt et al, 2010;Kuijpers et al, 2015). Also, dental symmetries, relationships of teeth with the curvature of the lips, arch widths, tooth dimensions, and gingival levels influence aesthetic perceptions during smiling (Batwa et al, 2013). On the other hand, achieving ideal positioning of the teeth (crown and root) and obtaining a stable and functional occlusion are other important goals during orthodontic treatment (Lee et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Mesiodistal Angulation of Each Whole Tooth in Patients With Nonsyndromic Unilateral Cleft Lip and Palate: Is it Symmetrical?

Sezici¹,

Di̇ndaroğlu

Isik³

et al. 2020

The Cleft Palate-Craniofacial Journal

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Objective: To assess the symmetry of the mesiodistal angulations of maxillary and mandibular teeth in patients with unilateral cleft lip and palate (UCLP) and compare with the class I control group without cleft lip and palate (CLP). Design: A retrospective study. Setting: University department. Patients, Participants: The panoramic radiographs of 45 orthodontically untreated individuals with nonsyndromic UCLP (mean age 14.13 ± 0.75 years) and 45 skeletal class I individuals without CLP (mean age 14.01 ± 0.74 years). Interventions: The line passing through the most superior points of the condyles was taken as the reference. The angle between the long axes of the maxillary and mandibular teeth and reference line was measured digitally. With the purpose of determining condylar symmetry, mandibular asymmetry index measurements were utilized. Independent samples t test and paired samples t test were used for the statistical analyses. Main Outcome Measure(s): The mesiodistal angulation of the maxillary and mandibular teeth in patients with UCLP was measured. The differences between the contralateral sides were determined and compared to class I individuals without CLP. Results: No statistically significant difference was found among the condylar asymmetry in both groups ( P > .05).The significant differences between the cleft and noncleft sides in the UCLP group was observed in the maxillary central, canine, first premolar and second molar teeth ( P < .001, P = .002, P = .013, P = .012, respectively). The mean differences were found to be higher in the central and lateral incisors, canines and first premolars in the UCLP group ( P < .001, P = .006, P = .001, respectively). Conclusions: Although the cleft-side maxillary central incisors tipped in a distal direction in patients with UCLP, the canine and first premolar showed more inclinations toward the mesial direction.

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“…A difference in the position of the commissures of ≥2.5 mm was chosen as an indicator of the upper lip asymmetry based on studies involving the recognition of a maxillary cant and the study of Batwa et al (11) who showed that such a lip asymmetry had a relative impact on smile esthetics (20). Although clinically soft tissue menton is generally not considered to be a reliable reference point to determine facial skeletal asymmetry, in this 3dMD study, it proved to be most reliable for measuring the upper lip symmetry because the subjects had no bony facial asymmetry, and soft tissue menton is not subject to simultaneous movement when the facial muscles activate during smiling.…”

Section: Discussionmentioning

confidence: 99%

“…One important component of facial attractiveness is smile esthetics (6)(7)(8). Although, teeth color has been reported to be the most important factor in smile attractiveness, the vertical thickness and the symmetry of the lips have been also ranked as important variables (6,(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Upper Lip Asymmetry During Smiling: An Analysis Using Three-Dimensional Images

Mathis¹,

Laskin²,

Tüfekçi³

et al. 2018

Turk J Orthod

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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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Lip Asymmetry and Smile Aesthetics

Cited by 8 publications

References 15 publications

Three-dimensional evaluation of social smile symmetry

Three-dimensional evaluation of social smile symmetry

Mesiodistal Angulation of Each Whole Tooth in Patients With Nonsyndromic Unilateral Cleft Lip and Palate: Is it Symmetrical?

Upper Lip Asymmetry During Smiling: An Analysis Using Three-Dimensional Images

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