• 대한구순구개열학회지
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• 제10권1호
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• pp.17-22
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• 2007

The vertebrate upper lip forms from initially freely projecting maxillary, medial nasal, and lateral nasal prominences at the rostral and lateral boundaries of the primitive oral cavity. These facial prominences arise during early embryogenesis from ventrally migrating neural crest cells in combination with the head ectoderm and mesoderm and undergo directed growth and expansion around the nasal pits to actively fuse with each other. Initial fusion is between lateral and medial nasal processes and is followed by fusion between maxillary and medial nasal processes. Fusion between these prominences involves active epithelial filopodial and adhering interactions as well as programmed cell death. Slight defects in growth and patterning of the facial mesenchyme or epithelial fusion result in cleft lip with or without cleft palate, the most common and disfiguring craniofacial birth defect. This review will summarize the current understanding of the basic morphogenetic processes and molecular mechanisms underlying upper lip development.

• 대한두경부종양학회지
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• 제40권1호
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• pp.33-36
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• 2024

Pleomorphic adenoma (PA) is a commonly occurring benign tumor originating in the salivary glands. The incidence is mostly in the parotid glands (85%) followed by minor salivary glands (10%). Pleomorphic adenoma from minor salivary glands of the lips is a rare neoplasm. Here, we present a case of a patient with PA in the upper lip, reporting a common neoplasm in a rare site. A 82-year-old male with a slowly progressing swelling that occurred 20years ago on the upper white lip. This tumor is not associated with pain and tenderness. The mass was about 1.5x1.5cm sized, circumscribed, sessile and firm on the external upper lip without oral side bulging (Fig. 1). The tumor was removed completely with a elliptical incision under local anesthesia. The encapsulated mass was measured 0.9x0.9x0.6cm. On histology, a well-circumscribed growth was seen comprising epithelial and stromal components. The epithelial component formed glandular structures lined by round-to oval cells having small nuclei, pink cytoplasm and myoepithelial basal cell layer while the stroma had a fibromyxoid appearance(Fig. 2). Postoperatively wound was well healed without recurrence after 6months. Pleomorphic adenoma of the upper lip is a rare neoplasm, especially not intraoral growth. For aesthetic good result, the mass was removed without hesitation. It is required a high index of suspicion and a long-term follow-up because it could recur and rarely be transformed into malignancy.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.702-706
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• 2009

Purpose: Analysis of lower nose and upper lip asymmetry in patients with unilateral cleft lip nose deformity has been proceeded through direct measurement and photo analysis. But there are limitation in presenting real image because of its 2 dimensional trait. The authors analyzed such an asymmetry using 3D VECTRA system (Canfield, NJ, USA) in quantitative way. Methods: In 25 Patients with unilateral cleft lip nose deformity(male 12, female 13, age ranging from 4 to 19), patients with right side deformity were 10 and left were 15. Analysis of asymmetry was proceeded through 3D VECTRA system. After taking 3 dimensional photo, alar area, upper lip area, nostril perimeter, nostril area, Cupid's bow length, nostril height and nostril width were measured. Correlation coefficient and inter data quotients were calculated. Results: In nostril perimeter, maximal difference of cleft side and non - cleft side was 39.3%, asymmetric quotient Qasy = Qcl/Qncl(Qcl, value of cleft side; Qncl, value of non - cleft side) was ranged from 0.84 to 1.85 and in seven cases the length of cleft side was smaller. In nostril area, maximal difference was 69.6% and in 13 cases cleft side was smaller. In lower nasal area, maximal difference was 37.2% asymmetric quotient Qasy = Qcl/Qncl was ranged from 0.47 to 2.03 and in 20 cases cleft side was smaller. The correlation coefficients of nostril perimeter and area were 0.8345. Conclusion: Using 3D VECTRA system, the authors can measure nostril perimeter and lower nasal area that could not been measured with previous methods. Asymmetry of midface was analyzed through area comparison in quantitative way. Futhermore, post operative change can be measured in quantitative method.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.470-476
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• 2012

Background The whistle deformity is one of the common sequelae of secondary cleft lip deformities. Santos reported using a crossed-denuded flap for primary cleft lip repair to prevent a vermilion notching. The authors modified this technique to correct the whistle deformity, calling their version the cross-muscle flap. Methods From May 2005 to January 2011, 14 secondary unilateral cleft lip patients were treated. All suffered from a whistle deformity, which is characterized by the deficiency of the central tubercle, notching in the upper lip, and bulging on the lateral segment. The mean age of the patients was 13.8 years and the mean follow-up period was 21.8 weeks. After elevation from the lateral vermilion and medial tubercle, two muscle flaps were crossed and turned over. The authors measured the three vertical heights and compared the two height ratios before and after surgery for evaluation of the postoperative results. Results None of the patients had any notable complications and the whistle deformity was corrected in all cases. The vertical height ratios at the midline on the upper lip and the affected Cupid's bow point were increased (P<0.05). The motion of the upper lip was acceptable. Conclusions A cross muscle flap is simple and it leaves a minimal scar on the lip. We were able to reconstruct the whistle deformity in secondary unilateral cleft lip patients with a single state procedure using a cross-muscle flap.

• 대한치과교정학회지
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• 제48권1호
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• pp.23-29
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• 2018

Objective: In accordance with the changing demographics in the United States, orthodontists working on various ethnic populations should be more conscious when using the standardized profile analyses for the African American patient. The objective of this study was to examine whether the perception of lip protrusiveness in modern African American faces has changed. For this purpose, we investigated the most favorable African American lip profile using the opinions of 10 experienced and 10 newly trained younger orthodontists. Methods: Attractiveness was converted to a number on visualized analog scales. Comparative ranks on 16 African American profiles, with focus on lip protrusiveness and thickness, were made among the groups. Mixed-effects linear regression models were fit and group differences were estimated. Results: Younger orthodontists favored a more protrusive lip profile, and the variance in their perceptions was narrower than those of older orthodontists. Measurements related to upper lip protrusion showed the strongest correlation to attractiveness (r = -0.82). The association with attractiveness decreased linearly as the protrusiveness of the upper lip increased. Steiner's E-line was the most influential reference for determining the level of attractiveness for the older orthodontists, whereas upper lip protrusion was the most influential factor for the young orthodontists. Conclusions: An adequate level of lip protrusiveness and thickness should be essential for maintaining attractive esthetics in African American patients. Yet, a new set of standards for prominent lips in this population is necessary to reflect the current trend in the concept of a beautiful face in the modern world.

• 대한치과교정학회지
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• 제43권6호
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• pp.279-287
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• 2013

Objective: To investigate the dentoskeletal factors which may predict soft-tissue chin strain during lip closure. Methods: The pretreatment frontal and lateral facial photographs and lateral cephalograms of 209 women (aged 18-30 years) with Angle's Class I or II malocclusion were examined. The subjects were categorized by three examiners into the no-strain and strain groups according to the soft-tissue chin tension or deformation during lip closure. Relationships of the cephalometric measurements with the group classification were analyzed by logistic regression analysis, and a classification and regression tree (CART) model was used to define the predictive variables for the group classification. Results: The lower the value of the overbite depth indicator (ODI) and the higher the values of upper incisor to Nasion-Pogonion (U1-NPog, mm), overjet, and upper incisor to upper lip (U1-upper lip, mm), the more likely was the subject to be classified into the strain group. The CART showed that U1-NPog was the most prominent predictor of soft-tissue chin strain (cut-off value of 14.2 mm), followed by overjet. Conclusions: To minimize strain of the soft-tissue chin, orthodontic treatment should be oriented toward increasing the ODI value while decreasing the U1-NPog, overjet, and U1 upper lip values.

• Archives of Plastic Surgery
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• 제43권3호
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• pp.242-247
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• 2016

Background Median cleft lip is a rare anomaly consisting of a midline vertical cleft through the upper lip. It can also involve the premaxillary bone, the nasal septum, and the central nervous system. In our current report, we present the clinical features of 6 patients with a median cleft lip and their surgical management according to the accompanying anomalies. Methods From December 2010 to January 2014, 6 patients with a median cleft lip were reviewed. Five of these cases underwent surgical correction; alveolar bone grafting was performed in a patient with a median alveolar cleft. The surgical technique included inverted-U excision of the upper lip and repair of the orbicularis oris muscle. The mean follow-up period was 20.4 months (range, 7.4-44.0 months). Results The study patients presented various anomalous features. Five patients received surgical correction, 4 with repair of the median cleft lip, and one with iliac bone grafting for median alveolar cleft. A patient with basal sphenoethmoidal meningocele was managed with transoral endoscopic surgery for repair of the meningocele. Successful surgical repair was achieved in all cases with no postoperative complications. Conclusions Relatively mild forms of median cleft lip can be corrected with inverted-U excision with good aesthetic outcomes. In addition, there is a broad spectrum of clinical features and various anomalies, such as nasal deformity, alveolar cleft, and short upper frenulum, which require close evaluation. The timing of the operation should be decided considering the presence of other anomalies that can threaten patient survival.

• 대한치과교정학회지
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• 제24권1호
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• pp.199-220
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• 1994

This study was conducted to determine the electromyographic features in the perioral muscles of class II division 1 malocclusion with incompetent lips, and to grope the correlation between its activities and craniofacial morphology. Tn this study, 14 subjects with class II division 1 malocclusion with incompetent lips(mean age of 20.5 years) and 20 subjects with normal occlusion(mean age of 23.9 years) were investigated. Electromyographic data were recorded from orbicularis oris, mentalis, buccinator and suprahyoid muscles durig rest lip posture, lip position at sealing, maximum sealing, maximal blowing, maximal biting, sipping milk, sipping and swallowing milk, chewing gum, masticating almond, swallowing almond and phonation utilizing the Medelec MS-25 electromyographic apparatus. Lateral cephalometric radiographs were taken with the mandible in intercuspal position on all subjects. All data were recorded statistically processed. The findings of this study can be summerized as follows : 1. In class II division 1 malocclusion with incompetent lips, the overall augmentations of perioral muscle activities during various functionel movements set for lip sealing were manifested and particular swelling in mentalis activity at rest was detected. 2. On the other hand remarkable diminution of upper lip acitivities at lip sealing movements was drawn. 3. In Class II division 1 malocclusion with incompetent lips, negative correlations existed between the diversity of upper lip activities and upper incisor position and overjet as well in contrast to positive correlations in the lower lip. 4. It was suggested that the abnormal function of lower lip and mentalis muscle contributed somewhat the revelation of the characteristics of Class II division 1 malocclusion.

• 대한치과보철학회지
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• 제42권5호
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• pp.524-534
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• 2004

Statement of problem: The meaning of the beauty has a little different nature according to a time, culture, and nation. Purpose : This study was undertaken to estimate the geometric esthetic criteria for Korean woman by analysis of facial photograph in a smiling. Material and methods: The facial photographs of 678 Korean beautiful woman were collected from Miss Korea candidates(from 1971 to 2003 year). The dento-facial composition was measured and analyzed geometrically on computer monitor using $Adobe^{(R)}$ $Photoshop^{(R)}$ 7.0. The statistical significance of the differences among the 4 decade groups was estimated by a $x^2$ test. Result : The Korean beautiful woman skewed the geometric characteristics such as the 'coincidence' (83.0%) between facial midline and dental midline, the 'normal' (96.9%) alignment and arrangement of upper anterior teeth. the 'average' (79.1%) position and 'upward' (53.4%) curvature of upper lip, the 'parallel' (85.7%) relationship between the lower lip and upper anterior incisal curvature, the 'touching' (49.9%) and 'not-touching' (44.8%) relationship between upper anterior incisor and towel lip, the 'first premolar' (54.1%) and 'second premolar' (38.9%) displayed in a smile, and the 'symmetry' (89.4%) of smile. There was statistical significance among the 4 decades in the respect of the upper lip curvature, the relationship between upper anterior incisor and lower lip, and the most posterior teeth displayed in a smile (p<0.05). Conclusion : The Korean beautiful woman showed similar results to the western esthetic criteria in the some respects and the tendency that the Korean woman had more active smiling recently.

• 대한치과보철학회지
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• 제30권4호
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• pp.575-581
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• 1992

It is a very important procedure to establish the occlusal plane in the construction of complete denture. So many methods have been utilized to establish the occlusal plane in complete denture prosthodontics. However, no single method seems to fully accepted. This study was aimed to review the literature on establishing the occlusal plane in complete denture prosthodontics, to measure the distance from the lower border of the upper lip to the upper incisal edge and to investigate the correlation between the ala-tragus line and the occlusal plane. The results ware as follows ; 1. The average distance between the lower border of the upper lip and the upper incisal edge was $1.45{\pm}1.28mm$. 2. The distance between the lower border of the upper lip and the upper incisal edge had a tendency to decrease with age. 3. A angle of the ala-tragus line to the occlusal plane measured with Fox plane was $-1.41{\pm}2.33^{\circ}$. 4. The ala-tragus line to occlusal plane was nearly parallel, cosidering curve of spee in the upper natural teeth.