• Archives of Craniofacial Surgery
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• v.19 no.1
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• pp.48-50
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• 2018

Bony anomaly caused by lip tie is not many reported yet. There was a case of upper lip tie wrapping into the anterior premaxilla. We represent a case of severe upper lip tie of limited lip motion, upper lips curling inside, and alveolar hypoplasia. Male patient was born on June 3, 2016. He had a deep philtral sulcus, low vermilion border and deep cupid's bow of upper lip due to tension of short, stout and very tight frenulum. His upper lip motion was severely restricted in particular lip eversion. There was anterior alveolar hypoplasia with deep sulcus in anterior maxilla. Resection of frenulum cord with Z-plasty was performed at anterior premaxilla and upper lip sulcus. Frenulum was tightly attached to gingiva through gum and into hard palate. Width of frenulum cord was about 1 cm, and length was about 3 cm. He gained upper lip contour including cupid's bow and normal vermilion border after the surgery. This case is severe upper lip tie showing the premaxillary hypoplasia, abnormal lip motion and contour for child. Although there is mild limitation of feeding with upper lip tie child, early detection and treatment are needed to correct bony growth.

• The korean journal of orthodontics
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• v.32 no.5 s.94
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• pp.355-360
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• 2002

After orthodontic treatment, there are several changes in soft tissue profile. Changes appear at lower anterior facial profile area, especially upper and lower lip. But there are many individual variations in the pattern of changes. So, this study was conducted to find out that the basic upper lip thickness could be one of the factors that could influence the treatment results. The samples were composed of 43 adult patients who had their 4 first premolars extracted. Groups were classified by their basic lip thickness. In group 1(thin upper lip group), there was negative relationship between mentolabial angle and lower lip change. In group 2(average lip thickness group), upper lip change was related to upper incisor change, lower incisor change, lower lip change and nasolabial angle change. And lower lip change was related to upper lip change, upper incisor change, lower incisor change. In group 3(thick upper lip group), there was no relation between both lip change and other variables.

• Phonetics and Speech Sciences
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• v.10 no.1
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• pp.23-31
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• 2018

In this study, we examined how the upper and lower lips articulate to produce labial /p/. Using electromagnetic midsagittal articulography, we collected flesh-point tracking movement data from eight native speakers of Seoul Korean (five females and three males). Individual articulatory movements in /p/ were examined in terms of minimum vertical upper lip position, maximum vertical lower lip position, and corresponding vertical upper lip position aligned with maximum vertical lower lip position. Using linear mixed-effect models, we tested two factors (word boundary [across-word vs. within-word] and speech rate [comfortable vs. fast]) and their interaction, considering subjects as random effects. The results are summarized as follows. First, maximum lower lip position varied with different word boundaries and speech rates, but no interaction was detected. In particular, maximum lower lip position was lower (e.g., less constricted or more reduced) in fast rate condition and across-word boundary condition. Second, minimum lower lip position, as well as lower lip position, measured at the time of maximum lower lip position only varied with different word boundaries, showing that they were consistently lower in across-word condition. We provide further empirical evidence of lower lip movement sensitive to both different word boundaries (e.g., linguistic factor) and speech rates (e.g., paralinguistic factor); this supports the traditional idea that the lower lip is an actively moving articulator. The sensitivity of upper lip movement is also observed with different word boundaries; this counters the traditional idea that the upper lip is the target area, which presupposes immobility. Taken together, the lip aperture gesture is a good indicator that takes into account upper and lower lip vertical movements, compared to the traditional approach that distinguishes a movable articulator from target place. Respective of different speech rates, the results of the present study patterned with cross-linguistic lenition-related allophonic variation, which is known to be more sensitive to fast rate.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.383-390
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• 2011

Purpose: To correct the upper lip depression after the correction of unilateral cleft lip, autologous grafts such as bone, dermal, fascial grafts and fat injections or alloplastic implants are used. Transplanted bones, dermis and fascia have a tendency to be absorbed and have donor morbidity. Fat injections are absorbed inconsistently and alloplastic implants have problems such as foreign body reactions, protrusions and infections. Authors corrected the upper lip depression using conchal cartilage graft in unilateral cleft lip deformity and the results was analysed with photos. Methods: 26-unilateral cleft lip and 2-microform cleft lip cases, totally 28 cases were performed. Their mean age was 21.89 years. The male and female cases were 12 and 16, respectively. Under anesthesia (general: 18 cases and local: 10 cases), cavum conchae (n=8), cymba conchae (n=16) and whole conchae (n=4) were harvested. Transversely cut the margin of the obtained cartilage, we cut out the most bent portion and put a partial-thickness incision on concave surface in cases of excessive convexity. Then, we performed the onlay graft of the conchal cartilage via scar revision site in unilateral cleft lip and via the reconstruction site of the cupid bow in microform cleft lip. The augmentation of the upper lip was evaluated with photos. Adapting the baseline connecting between the both cheilions as a horizontal standard line, we measured the highest point among the tangents between the upper lip and nose (point a), the lowest point (point c), the middle point between a and c (point b) and the vertical line from the alare (point d) to the horizontal standard line. To assess the postoperative symmetry, we compared cleft side upper lip contour index (%) A,B,C,D=(a,b,c,d)-ch ${\times}$ 100/(ch-ch) and non-cleft side upper lip contour index (%) A',B',C',D'= (a',b',c',d')-ch ${\times}$ 100 / (ch-ch).h) Results: After the surgery, no complication was found except in one case which double layers graft performed in the cleft lip deformity, the lateral portion was protruded. The upper lip contour index, the difference of A and A' were-0.83%, and thus the mild depression was persisted. Difference of B and B', C and C', D and D' were 0.83%, 1.07%, 0.90%. There were statistically significant difference, and thus the depression of upper lip were improved generally. Conclusion: Authors performed the onlay graft of the conchal cartilage in unilateral cleft lip deformity and found that the depression of the upper lip was well corrected except the uppermost part when photogrammetrically analyzed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.274-278
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• 2005

Purpose : Prediction for soft tissue change after orthognathic surgery is very important for the final esthetics. In this study, we have tried to get the amount of upper lip movement relative to bony segment movement after anterior segmental osteotomy by cephalmetric analysis to predict final upper lip position after surgery. Material and Methods : 20 patients was studied on whom anterior segmental osteotmy as performed by Cupar method during the years 2002 to 2003. Cephalometric radiograph were taken at 1month before surgery and 6 month after surgery. Change of upper lip was measured on landmark Ls and Sto relative to hard tissue (landmark Ia) setback on these X-rays and analyzed. Results : 1. Upper lip setback movement. Setback of upper lip showed proportional relation to the hard tissue setback and the ratio was about 84%(p=0.001). 2. Upper lip downward movement. Downward movement of upper lip showed no proportional relation to hard tissue setback And the amount was mean 1.38 mm and SD 1.21mm (p=0.922). Conclusion : The posterior movement of upper lip is affected by hard tissue movement and shows good proportional change whereas downward movement is not so much influenced by hard tissue movement. And we think slight downward movement shown in this study could be explained by the V-Y closure performed during surgery.

• The korean journal of orthodontics
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• v.14 no.1
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• pp.103-113
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• 1984

This work was undertaken to evaluate the integumental response in lower face to hard tissue changes, and to grope the prediction equation for expected integumental profile changes. Cephalometric headplates of 25 persons consisted of 8 Angle's class 1 maxillary protrusive and 17 Angle's class II division 1 patients whose mean age was 15.2 years were traced, diagramatized, and statistically analyzed. The results were as follows; 1. Upper incisor and lips were retracted and convexity of integumental profile decreased concurrently with decrease of hard tissue procumbency, however soft tissue point A', B', and Pog' did not undergo significant changes after orthodontic treatment. 2. Remarkable increment of upper lip thickness and upper lip height was shown and this was related to upper incisor retraction. The ratio between the amount of upper incisor retraction and the increment o f upper lip thickness was approximately 1.16:1. 3. Moderate correlation of upper lip retraction to upper incisor retraction, and of lower lip retraction to lower incisor movement were arranged, and yet comparatively wide variability from subject to subject was shown. 4. It was possible to predict statistically for horizontal alteration of lip position and change of upper lip angulation ground in orthodontic treatment.

• Archives of Craniofacial Surgery
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• v.21 no.2
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• pp.127-131
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• 2020

A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.

• Archives of Plastic Surgery
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• v.46 no.3
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• pp.248-254
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• 2019

Background No head to head comparison is available between surgical lip lifting and upper lip filler injections to decide which technique yields the best results in patients. Despite the growing popularity of upper lip augmentation, its effect on societal perceptions of attractiveness, successfulness and overall health in woman is unknown. Methods Blinded casual observers viewed three versions of independent images of 15 unique patient lower faces for a total of 45 images. Observers rated the attractiveness, perceived success, and perceived overall health for each patient image. Facial perception questions were answered on a visual analog scale from 0 to 100, where higher scores corresponded to more positive responses. Results Two hundred and seventeen random observers with an average age of 47 years (standard deviation, 15.9) rated the images. The majority of observers were females (n=183, 84%) of white race (n=174, 80%) and had at least some college education (n=202, 93%). The marginal mean score for perceived attractiveness from the natural condition was 1.5 points (95% confidence interval [CI], 0.9-2.18) higher than perceived attractiveness from the simulated upper lip filler injection condition, and 2.6 points higher (95% CI, 1.95-3.24) than the simulated upper lip lift condition. There was a moderate to strong correlation between the scores of the same observer. Conclusions Simulated upper lip augmentation is amenable to social perception analysis. Scores of the same observer for attractiveness, successfulness, and overall health are strongly correlated. Overall, the natural condition had the highest scores in all categories, followed by simulated upper lip filler, and lastly simulated upper lip lift.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.253-271
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• 1992

The purpose of this study was to investigate the difference of EMG activity of the Orbicularis oris and Mentalis muscle between normal occlusion and class III malocclusion group during various lip position and to find out whether any correlations exist between the muscular activity and craniofacial morphology. In this study, 50 subjects with a mean age of 22.9 Years (range 20.0-26.0) were investigated (25 subjects were normal occlusion, and 25 subjects were class III malocclusion). EMG data were recorded from the Orbicularis oris and Mentalis muscle during rest lip posture, lip position at maximum biting, lip position at maximum sealing effort, lip position at chewing, swallowing and phonation with the Medelec MS-25 electromyographic machine. Lateral cephalometric radiographs was taken with the mandible in intercuspal position on all subjects. All data were recorded and statistically processed. The findings of this study can be summerized as follows: 1. In normal occlusion, the maximal mean amplitude of upper lip during the lip position at chewing was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 2. In Class III malocclusion, the maximal mean amplitude of upper lip during the lip position at chewing, swallowing and phonation was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 3. Compare to normal occlusion, the Class III malocclusion was showed low maximal mean amplitude of upper lip during rest lip posture and the lip position at swallowing of saliva, and showed great maximal mean amplitude of lower lip and meantalis muscle during the lip position at chewing and phonation. 4. In normal occlusion, the maximal mean amplitude of upper lip during various lip position was not correlated with the length and thickness of upper lip, but the maximal mean amplitude of lower lip during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip. 5. In Class III malocclusion, the maximal mean amplitude of upper lip during rest lip posture was negatively correlated with the thickness of upper lip, and the maximal mean amplitude of lower lip and mentalis muscle during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not correlated with the cephalometric measurements of soft tissue. 6. The correlation between the maximal mean amplitude of orbicularis oris and mentalis muscle and cephalometric measurements of incisors was not nearly present. 7. In normal occlusion, the maximal mean amplitude of lower lip and mentalis muscle during the lip position at maximum biting was negatively correlated with the angle between palatal plane and mandibular plane. In Class III malocclusion, the maximal mean amplitude of upper lip, lower lip and mentalis muscle during function was negatively correlated with the length of maxilla, the maximal mean amplitude of upper lip and lower lip during function was negatively correlated with the SNA and SNPo, and the maximal mean amplitude of lower lip during the lip position at chewing was negatively correlated with the ANB.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.310-318
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• 2000

The purpose of this study was to assess the soft tissue changes of upper lip & nose using 38 patients who treated with Le Fort I osteotomy for the correction of dentofacial deformities. Patients were devided into three groups. One was advancement group of maxilla(Group I, N=14), another was impaction group of maxilla(Group II, N=12) and the other was combination group(advancement & impaction)(Group III, N=12). Preop. and 1 month postop. (T1), preop. and 6 months postop.(T2) were analyzed and compared. The results obtained were as follows : 1. The upper lip thickness(UL-VP) moved anteriorly approximately 62% of the horizontal maxillary change and this was significant in the advancement group(Group I) 2. The upper lip length(Stm-Sn) and the lower border of upper lip(Stm) moved superiorly 25%, 40% of the maxillary impaction group(Group II) (P<0.05) 3. There was significancy in the upper lip thicness(UL-VP) approximately 56% of the combination group(Group III) (P<0.05) 4. The nasolabial angle decreased in all groups, but there were no significancy.