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PubMed1997

Association of lip posture and the dimensions of the tonsils and sagittal airway with facial morphology.

The specific contribution of enlarged tonsils or adenoids to craniofacial growth remains unknown, and there is no agreement in the literature as to the significance of lip posture. This study assessed the separate associations of lip posture, sagittal airway size, and tonsil size with selected cephalometric measures. Clinical and cephalometric data of 207 children who presented for evaluation of tonsil and/or adenoid problems were evaluated. Multiple linear regression was used to assess the linear relationship between each of the three parameters and the cephalometric dependent variables. Open lip posture, reduced sagittal airway, and large tonsils were each associated statistically with a characteristic but different skeletal configuration. This association was proportional. Specifically, a more open lip posture was associated with a more backwardly rotated face and larger lower facial height. Reduced sagittal airway size was associated with en bloc backward relocation of the maxilla and mandible. Because the sella-nasion dimension shortened proportionally, the SNA and SNB angles were not affected. Larger tonsils were associated with more forward relocation and rotation of the maxilla and mandible and increased SNA and SNB angles. Because each of the three parameters was associated proportionally with a different craniofacial morphology, it is concluded that lip posture, sagittal airway size, and tonsil size represent three different and unrelated phenomena with respect to their effects on craniofacial growth and form.

Adolescent↗
PubMed2005

Effect of facial convexity on antero-posterior lip positions of the most favored Japanese facial profiles.

Soft tissue analyses are basic tools in planning orthodontic treatment. However, the perception of a well-balanced Japanese facial profile has not yet been established, particularly with respect to changes in facial convexity. The purpose of this study was to assess and determine the range of antero-posterior (A-P) lip positions of the top three most favored, well-balanced profiles from a series of various facial silhouettes with changing facial convexity. The average profile was constructed from the profiles of 30 Japanese males and females with Class I occlusions. Changes in facial convexity were established by altering the A-P chin position by protruding or retruding the chin in increments of 5 degrees and 10 degrees from the average profile. A series of 11 profiles were developed from each of the four changes in facial convexity. The lips were then protruded or retruded in one-mm increments from the average profile. Forty orthodontists were asked to rate the top three most favored, well-balanced profiles. We found that the raters tended to prefer more retruded lip positions as facial convexity decreased, for both males and females. The raters also tended to prefer slightly more protruded lip positions as the facial convexity increased. Because chin position is inherent in each patient, others may equate a retrusive or protrusive chin with certain personalities, thus, it is important for orthodontists to take into account the balance between the lips and the chin.

Adult↗
PubMed2006

Long-term stability of lip bumper therapy followed by fixed appliances.

Lip bumper treatment has been shown to successfully increase arch width, procline the incisors, and distalize molars. However, few studies have been performed showing the long-term stability of lip bumper treatment. In this study, mandibular casts taken by a single practitioner from 51 patients treated with lip bumpers without rapid palatal expansion were analyzed at pretreatment, post-lip bumper treatment, posttreatment, and long-term out of treatment. Measurements of arch width, arch depth, arch length, and anterior crowding were made. During treatment, there was a mean decrease in irregularity of 3.73 mm, with a posttreatment increase of 0.76 mm, for a net decrease of 2.97 mm. Despite posttreatment decreases, significant gains in arch width were maintained for extended periods of time. The intercanine width had a net increase of 1.78 mm (19% relapse), first premolars 3.39 mm (26% relapse), second premolars 2.58 mm (34% relapse), and first molars 2.17 mm (20% relapse). Lip bumper treatment along with fixed appliances is an effective means to obtain long-term increases in arch width and decreases in the irregularity index.

Adolescent↗
PubMed2002

Tongues and lips without jaws: a comparison of methods for decoupling speech movements.

Speech-related motions of small markers attached to the tongue, lower lip, and lower jaw of 44 normal young adult talkers of American English were analyzed to estimate the relative accuracy of selected methods for decoupling tongue and lip motions from ongoing jaw motion when all movements are originally measured relative to a common reference frame (such as the head). In general, results of the analysis show that a common "simple subtraction" method that ignores pitching rotation of the jaw yields larger errors in positions and speeds of decoupled tongue and lip markers than methods that do not ignore rotation. When the jaw is widely opened, is moving quickly, and/or when any decoupled marker is relatively far from the origin of a local coordinate system fixed to the jaw, positional and speed errors associated with the subtraction method can exceed 5 mm and 25 mm/s, respectively. We propose a simple procedure for estimating the pitching rotation of the jaw that can be applied when pitch cannot be measured. We then show that decoupled motions of tongue and lower lip markers based on estimated jaw rotation involve less error than those derived from any other decoupling method considered. Careful attention to processing methods should yield more accurate inferences about the nature and degree of coordination between speech-related movements of the tongue and lower lip that are decoupled from, and hence independent of, concurrent movements of the lower jaw.

Adult↗
PubMed1977

Effects of auditory masking on lip movements during speech.

This study describes the effects of unpredictably presented masking noise on selected parameters of lip movement during speech. Four normal subjects produced a simple speech utterance while vertical displacements of the upper and lower lips were transduced and recorded. During selected productions a masking noise was presented dichotically at one of two distinct phases of lip movement. Analysis of the resulting data revealed the following for all subjects: (1) significant changes in the duration, displacement, and velocity of lip movement caused by masking and (2) significant reductions in the velocity of lip movement occurring approximately 50 msec after the onset of the masker. Possible explanations of these and certain speaker-dependent effects are discussed.

Acoustic Stimulation↗
PubMed1985

Variability of lip and jaw movements in children and adults: implications for the development of speech motor control.

The development of speech motor skill was studied by measuring the variability of lower lip and jaw movements. Groups of five adults, and children at ages 4, 7, and 10 years produced [mae] and [bae] 20 times each. The duration of lip-opening movements, jaw-opening movements, lip-open postures, jaw-open postures, and the timing between the onset of lower lip opening and jaw opening decreased in variability between the child and adult groups. No significant differences were observed in the variability of these measures across the child groups. The variability of lower lip displacement decreased significantly between the 4-year-old and 7-year-old groups, but not between any other age groups. Jaw displacement variability did not change significantly between any groups. No significant differences in variability were found between [bae] and [mae]. It is hypothesized that different developmental motor processes affect the variability of speech movements at early, intermediate, and older ages.

Age Factors↗
PubMed1985

Maximum voluntary closing forces in the upper and lower lips of humans.

Forces generated by facial muscles during speech production have previously been estimated to involve up to 20% of maximum voluntary closing force. The gross nature of this estimate is due, in part, to the complex relationship between muscle contraction and three-dimensional tissue conformation and to the lack of data concerning maximum force. The objective of the present study was to determine the maximum voluntary closing forces for the upper and lower lips in male and female adults. The results indicate the maximum force capabilities for the lower lip to be approximately three times greater than for the upper lip. Male subjects generated significantly greater lip closing forces than female subjects. The large difference between the upper and lower lips as force plants is discussed in relation to speech function and skilled motor behavior.

Adult↗
PubMed1986

Differential fine force control of the upper and lower lips.

From a review of the literature, it was hypothesized that the upper lip and lower lip are differentially controlled by separate, but interacting, neuronal connectivities. A normal data base was developed for select measures of fine force control occurring within physiologic levels presumably involved in speech production. Fine force control in the lower lip was found to be significantly more stable, and recruited at higher rates than the upper lip. Explanations are presented for the lower lip superiority on these measures and observations are made concerning the use of these rudimentary physiologic measures in studies of the dysarthrias.

Adolescent↗
PubMed1986

Visual feedback and lip-positioning skills of children with and without impaired hearing.

Interplay between visual feedback and lip-positioning skill was studied in 10 5- to 14-year-old children with normal hearing and 10 with severe to profound hearing impairment. With visual feedback, the subjects in both groups had similar response times and accuracy in matching six visually specified lip separation "targets." Special skill in processing visual information by the hearing-impaired subjects was suggested by higher velocities of lip movement toward the targets and shorter latencies in reaching the goal positions. In the responses of the hearing children, lip-closing movements were executed more accurately than opening movements both with and without visual feedback. In general, the findings showed that, given visually displayed lip-position targets and feedback from positioning actions, children can achieve the targets with high accuracy regardless of hearing status or prior speaking experience.

Adolescent↗
PubMed1986

EMG recording in human lip muscles: can single muscles be isolated?

Electromyography, recording the electrical activity of muscles, is an electrophysiological method that has been used widely in the study of movement performance by human subjects. Borrowing from the tradition of electromyographic studies of limb muscles, investigators interested in speech production have used the method to address many important experimental questions. Unfortunately, data recorded from craniofacial muscles generally have been discussed without reference to problems of interpretation that could arise due to the unique anatomical features of the muscles, particularly the lip muscles. Anatomical data show that the fibers of different muscles of the lips are interdigitated so that fibers with differing spatial orientation typically are found within a small section of lower lip tissue. The anatomical data are consistent with results of physiological studies of the lower lip muscles that have suggested that motor units with different physiological characteristics are found within a single recording site. Together, the anatomical and electrophysiological data suggest that, even with intramuscular electrodes, the probability of recording from a single muscle of the lip in isolation is extremely low. The fact that the activity of more than one muscle is likely to be sampled critically determines the nature of the conclusions that can be drawn from the data.

Electromyography↗
PubMed2002

Down syndrome: lip lesions (angular stomatitis and fissures) and Candida albicans.

BACKGROUND: The incidence of angular cheilitis (angular stomatitis, perleche, commissural fissures) appears to be increased in people with Down syndrome (DS). Lip fissures are also (in our clinical impression) a fairly regular feature, yet this is scarcely mentioned in the literature. OBJECTIVES: To establish the incidence of angular cheilitis and lip fissures in a substantial group of patients with DS and to examine the relationship with Candida albicans. PATIENTS AND METHODS: The prevalence of orofacial soft tissue lesions was investigated in a group of 77 DS patients. Swabs were taken from lip lesions, palate and tongue and inoculated on Sabouraud's agar discs for the isolation of C. albicans, identified with commercially available kits. RESULTS: Lip fissures were seen in at least one-quarter of DS patients. Angular cheilitis was also found in a similar percentage. CONCLUSIONS: C. albicans was isolated from a substantial proportion of lesions tested, and was present more frequently than in those without lip lesions, but it is uncertain whether this represents cause or effect.

Adolescent↗
PubMed1998

EMG activity of the orbicularis oris and mentalis muscles in children with malocclusion, incompetent lips and atypical swallowing--part I.

The function and the level of activity of the orbicularis oris (upper and lower), and of the mentalis muscles were verified electromyographically in resting position and in several movements and carried out in 18 children aged 8-12 years, divided into three groups: one with normal occlusion, and two with Class II division 1, with atypical swallowing and/or incompetent lips, who had received no orthodontic treatment. It was observed that, in a resting position with the lips separated, there was no activity in any of the muscles. When there was a contact of the lips, action potentials were recorded in the muscles studied, in those individuals with incompetent lips. In the movements of sucking either through a straw or a pacifier and the thumb, there were no differences among the groups. The incompetent lips group presented very marked muscle activity of the lower orbicularis oris and mentalis in the movement of sucking a lollipop. In deglutition of saliva, the orbicularis oris presented slight activity, and the mentalis, moderate. In deglutition of water, the mentalis presented very marked activity, whereas, the upper and lower orbicularis oris presented moderate and marked activities, respectively.

Action Potentials↗
PubMed2001

Lip cancer: important management issues.

Lip cancer should be diagnosed and treated at an early stage. It most often presents on the lower lip of middle-aged to elderly males. The aetiology is similar to non-melanoma skin cancer, that is, chronic sun exposure. Despite treatment, a proportion of patients will experience delayed relapse and one in 10 will die from lip cancer. Clinicians need to be aware of the natural history of this disease. Two cases of squamous cell carcinoma of the lip treated by radiotherapy are presented and discussed to highlight important aspects in the management of lip cancer.

Aged↗
PubMed2002

Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate.

BACKGROUND: A retrospective survey of 339 infants who had undergone primary plastic surgery for cleft lip and palate was performed to evaluate the concomitant preoperative assessment based on severity grading of the common cold and the correlation of cleft type with the incidence of perioperative respiratory complications. METHODS: We assessed the severity of common cold symptoms in the preoperative period using the Common Cold Score, which comprises 10 symptoms and findings. We then determined the association of the incidence of perioperative respiratory complications with the increasing severity of common cold symptoms and also compared the complication incidence in the three cleft types in healthy infants without a common cold. RESULTS: The incidence of perioperative respiratory complications was greater in the group with a suspected presence of a common cold. Infants with severer cleft, who had bilateral cleft lip and palate, even without common cold symptoms, had a significantly higher incidence of perioperative respiratory complications (8.9%) than infants with simple cleft lip (1.7%, P < 0.05). CONCLUSIONS: Clinicians should consider postponing primary plastic surgery for cleft lip and palate in infants with a suspected presence of a common cold. Our results also suggest that the presence of a wide cleft is a risk factor for causing perioperative respiratory complications in infants with cleft lip and palate. We believe that a careful preoperative assessment of common cold symptoms in these infants can decrease the incidence of perioperative respiratory complications.

Anesthesia↗
PubMed2002

A new ePTFE soft tissue implant for natural-looking augmentation of lips and wrinkles.

BACKGROUND: Expanded polytetrafluoroethylene (ePTFE) implants have been used for augmentation of thinning lips and wrinkles due to aging for more than 10 years. The aesthetic results have often been excellent, but complications such as infection, extrusion, migration, shrinkage, and hardening have occurred in some patients. OBJECTIVE: To assess short-term results and complications in patients undergoing augmentation of the lips, nasolabial folds, and marionette lines with a newly designed ePTFE implant. METHODS: Thirty patients received 60 Advanta ePTFE implants for augmentation of the lips, nasolabial folds, or marionette lines. RESULTS: All patients received a natural-looking augmentation following 3-4 days of noticeable swelling. The only significant complications involved two upper lip implants that were removed for suspected infection. CONCLUSION: In a preliminary series, Advanta ePTFE implants provided effective, natural-looking augmentation of the lips and nasolabial folds with minimal complications.

Adult↗
PubMed2003

Venous lake of the lip treated with a sclerosing agent: report of two cases.

BACKGROUND: A venous lake is a venous ectasia that appears mostly on the lower lip and other sun-exposed areas of an older person. Treatment of lip venous lake includes surgical excision, laser therapy, infrared coagulation, and cryotherapy. Although the use of sclerotherapy on varicose veins, leg telangiectasia, hemorrhoids, and hemangiomas is well established, the use of sclerotherapy for lip venous lake has not been reported. OBJECTIVE: We present two cases of lip venous lake treated with intralesional injection of 1% polidocanol. METHOD: Two cases are reported, and literature is reviewed. RESULT: The lesions virtually disappeared, leaving an inconspicuous scar, with two sessions of sclerotherapy. Side effects were not observed. CONCLUSION: Sclerotherapy with polidocanol is effective in the treatment of lip venous lake and offers an alternative to conventional methods.

Aged↗
PubMed2000

Reconstruction of lower lip defects after tumor excision: an aesthetic and functional evaluation.

We are presenting a new questionnaire to evaluate the functional and aesthetic aspects after reconstruction of defects of the lower lip resulting from tumor excision. The questionnaire is based on objective parameters with numerical values. The application of the questionnaire is carried out based on 2 different surgical techniques, which have been used in the Department of Oral and Maxillofacial Surgery of La Princesa University Hospital in Madrid. These techniques are used in the reconstruction of surgical defects and concern the location and percentage of the lip resection. These techniques are the rotation-advancement flap by Yu and the rotation-advancement in island flap by Colmenero et al. The defects are located laterally and they include 40% to 60% of the length of the lip, avoiding the commissure. There is also one case with a defect that is almost 100% of the length of the lip. According to the questionnaire, we conclude that in unilateral defects that exceed 50% (up to 70%), Yu's technique provides better results from an aesthetic and functional point of view than Colmenero's technique. In subtotal defects, bilateral Yu flaps provide optimum function, with good position of the scars. This is a technique to be considered when confronted with extensive defects of the lip that do not include the commissures.

Adult↗
PubMedDate not supplied

Lip lead as an alternative measure for lead exposure assessment of lead battery assembly workers.

This study investigated lead exposures of lead battery assembly workers in Taiwan. A special attempt was made to evaluate the use of lip lead as an alternative index for occupational lead exposure. Ninety-six of 113 workers from a lead battery plant were recruited as study subjects. Air lead; lead loadings on workers' sleeves, gloves, hands, cheeks, and lips; and blood lead were determined for exposure assessment. A questionnaire also was administered to collect information on work history, suspected exogenous lead sources, and personal behavior and activities. Geometric means of total air lead at different subareas ranged from 0.070 (2.5 geometric standard deviation [GSD]) to 0.159 (1.8 GSD) mg/m3. Geometric means of respirable air lead level for different subgroups of workers varied from 0.009 (2.0 GSD) to 0.032 (1.9 GSD) mg/m3, whereas those of the blood lead level ranged from 22.4 (1.3 GSD) to 44.5 (1.3 GSD) microg/dL. The heaviest lead loadings were found for plate-processing workers (e.g., 66.4 [1.5 GSD] on gloves, 0.80 [3.7 GSD] on cheeks, and 0.79 [3.2 GSD] microg/cm2) on bare-hands after washing. Blood lead level was significantly correlated with lead levels in air, lead loadings on lips, and bare hands after washing (r=0.24-0.30). Results of multiple regression analysis showed that only lip lead had a significant effect on the blood lead, whereas respirable air lead and personal behavior had only mild effects in this model. It was concluded that lip lead level may be used as an alternative index of lead exposure to facilitate the estimation of lead uptake through ingestion.

Cheek↗