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PubMedDate not supplied

Treatment of gingival pigmentation: a case series.

A smile expresses a feeling of joy, success, sensuality, affection and courtesy, and reveals self confidence and kindness. The harmony of the smile is determined not only by the shape, the position and the color of the teeth but also by the gingival tissues. Gingival health and appearance are essential components of an attractive smile. Gingival pigmentation results from melanin granules, which are produced by melanoblasts. The degree of pigmentation depends on melanoblastic activity. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of 'black gums' are common particularly in patients having a very high smile line (gummy smile). For depigmentation of gingiva different treatment modalities have been reported like- Bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery and laser. In the present case series bur abrasion, scraping, partial thickness flap (epithelial excision) cryotherapy and electrosurgery have been tried for depigmentation, which are simple, effective and yield good results, along with good patient satisfaction. The problems encountered with some of these techniques have also been discussed.

Adult↗
PubMed2005

[The effects of personal relationships on facial displays].

Previous studies have suggested that facial displays in the presence of others are influenced by the relationship with accompanying persons. In these studies, subjects participated with friends or strangers, without any focus on social interactions between partners. In the current study, pairs of friends or strangers viewed film clips expected to elicit positive and negative affects; the control group participated without partners. We measured synchronous smiles between partners as a social interactive display, in addition to the duration and the frequency of smiles and frowns. Subjective emotion and social motive were also measured. Smiles were facilitated by the presence of a friend than a stranger or the condition of lone participation, regardless of stimulus valence. Synchronous smiles and the communication motive were also enhanced with a friend than with a stranger. These results suggested that the expression of smiles was facilitated by the communication motive and social interactions between partners.

Adult↗
PubMed1995

A visual method of determining marginal placement of crowns: Part II. Marginal placement of posterior crowns.

In the second part of a two-part study on the necessity for subgingival crown placement, photographs of 527 Saudi citizens (285 men and 242 women) with natural and exaggerated smiles were made. The photographs revealed that a substantial percentage of the participants did not exhibit the gingival tissue of their posterior maxillary teeth (41.7% to 70.2%) and mandibular teeth (92.8% to 98.5%) during a natural smile. A comparison of the posterior tooth visibility of male and female subjects revealed statistically significant differences in the following situations: the gingival section of maxillary first molars, the occlusal section of the mandibular first molars, and the occlusal section of the second premolars during a natural smile, and the occlusal section of the mandibular first and second premolars during an exaggerated smile. Therefore, an analysis of each individual's smile should be included among the factors considered when placement of coronal margins is determined.

Bicuspid↗
PubMed2006

Bilateral conjugacy of movement initiation is retained at the eye but not at the mouth following long-term unilateral facial nerve palsy.

Voluntary eyelid closure and smiling were studied in 11 normal subjects and 11 patients with long-term unilateral facial nerve palsy (FNP). The conjugacy of eyelid movements shown previously for blinks was maintained for voluntary eye closures in normal subjects, with movement onset being synchronous in both eyes. Bilateral onset synchrony of the sides of the mouth was also observed in smiling movements in normal subjects. In FNP patients, initiation of movement of the paretic and non-paretic eyelids was also synchronous, but markedly delayed relative to normal (by 136 ms = 32%). The initiation of bilateral movements at the mouth was similarly delayed, but in contrast to the eyes, it was not synchronous. Central neural processing in the FNP subjects was normal, however, since unilateral movements at the mouth were not delayed. The delays therefore point to considerable additional information processing needed for initiating bilateral facial movements after FNP. The maintenance of bilateral onset synchrony in eyelid closure and its loss in smiling following FNP is an important difference in the neural control of these facial regions. Bilateral conjugacy of eyelid movements is probably crucial for coordinating visual input and was achieved apparently without conscious effort on the part of the patients. Bilateral conjugacy of movements at the sides of the mouth may be less critical for normal function, although patients would very much like to achieve it in order to improve the appearance of their smile. Since the everyday frequency of eyelid movements is considerably greater than that of smiling, it is possible that the preserved eyelid conjugacy in these patients with long-term FNP is merely a product of greater experience. However, if synchrony of movement onset is found to be preserved in patients with acute FNP, then it would suggest that eyelid conjugacy has a privileged status in the neural organisation of the face.

Case-Control Studies↗
PubMed1988

Perceptual asymmetries in left- and right-handers for cartoon and real faces.

We examined 40 left-handers and 40 right-handers on two free-vision tests of face processing. A chimeric face composed of a smiling half-face joined to either a neutral half-face (real faces) or a sad half-face (cartoon faces) and its mirror image were presented on each trial. Subjects judged which chimeric face looked happier, the one with the smile to the left or the one with the smile to the right. Right-handers, but not left-handers, had a highly significant leftward attentional bias, since chimeras with the smile to the left were judged happier than those with the smile to the right. The cartoon- and real-face tasks did not differ in the mean perceptual asymmetries they elicited. However, correlations between attentional-asymmetry scores for the two tasks, although high for both left- and right-handers, were significantly smaller than task reliabilities. Thus, the cartoon- and real-face tasks overlap to a major extent in the lateralized processes they measure, but to a lesser extent, they also index different lateralized processes.

Adult↗
PubMed2003

Relationship between facial asymmetry and judging trustworthiness in faces.

Nonverbal facial signals provide valuable information for successful social interactions. Previous findings showed left-right facial asymmetry in attractiveness, smiling, and health in faces, and here we investigated the asymmetrical status of trustworthiness. Pairs of left-left and right-right faces from 38 photographs were viewed by participants who judged which member of the pair looked the most trustworthy. The results were compared to attractiveness and smiling judgements (Zaidel, Chen, & German, 1995). We found that trustworthiness was more related to attractiveness than to smiling in the women's faces, but no significant asymmetry for trustworthiness was found; in the men's faces, trustworthiness was neither related to attractiveness nor to smiling, nor was there a significant asymmetry. Taken together, trustworthiness as a facial display is complex; even when it appears to confirm the "halo effect", its expression is not strongly left-right asymmetrical in contrast to attractiveness or smiling.

Journal Article↗
PubMed1989

[Mothers and infants as initiators of interaction in several mother/child pairs (2-4 months].

The aim of this research is to show the main social patterns in five mother-infant dyads (3 males and 2 females), observed in their families (48 sessions-8/16 weeks). The maternal patterns Speaking to, Smiling at, Touching directed to infants present significant correlations in our Ss (rs Spearman less than 0.01 p less than 0.001). Infants are active initiators in Looking at/ Smiling by mother, Vocalizing/ Smiling by mother. Moreover maternal initiatives differ significantly in Smiling at/ Looking at by infant, Smiling at/ Vocalizing by infant (t Student less than 0.01 p less than 0.001).

Child Behavior↗
PubMed1994

Physiological responses to child stimuli in mothers with and without a childhood history of physical abuse.

The present study investigated changes in heart rate, skin conductance, and self-reported affect in response to child stimuli in mothers with and without a childhood history of physical abuse. The stimuli were videotape presentations of a smiling and crying infant. During baseline periods (prior to videotape presentations), mothers without a childhood history of abuse displayed a significant reduction in skin conductance, which was not observed in mothers with a childhood history of abuse, suggesting that mothers without a history of abuse habituated to the experimental setting. Although the two groups of mothers did not differ in self-reported affect or in heart rates in response to the crying and smiling infant, mothers with a childhood history of abuse showed increases in skin conductance while viewing the smiling infant, but not while viewing the crying infant. In contrast, mothers without a childhood history of abuse showed increases in skin conductance during the presentation of the crying infant, but not while viewing the smiling infant. Similarities between the skin conductance results for mothers with and without a childhood history of abuse and skin conductance data reported for physically abusive and at-risk mothers are discussed.

Adult↗
PubMed2005

A common neural basis for receptive and expressive communication of pleasant facial affect.

There is accumulating evidence suggesting that the visual representation of facial affect is closely linked to its motor representation. To examine whether perception of pleasant facial affect involves neural circuitries associated with its production, we performed an fMRI experiment with 'compressed image acquisition' where subjects smiled and observed movies depicting other people smiling within scan-free time intervals between the acquisition of each image volume. Overlaps between the brain activation during observation and execution of smile expressions were located in the right premotor cortex and pars opercularis of the inferior frontal gyrus, right parietal operculum (SII) and left anterior insula. Observation of smile expressions further yielded signal increases within the posterior superior temporal sulcus (STS), fusiform gyrus and ventral amygdala. The results show that perceiving and expressing pleasant facial affect share a common neural basis in areas concerned with motor as well as somato- and limbic-sensory processing. In concert with temporal regions serving the visual analysis of facial expressive features, a mapping of the observed expressions onto neural circuitries associated with the production of these expressions and its somatosensory consequences could provide a description of what the expression would feel like if produced in the observer. Such a mechanism is suggested to be important for empathic understanding of others' feelings.

Adult↗
PubMed1997

Changes in facial movement after maxillary osteotomies.

PURPOSE: Determine changes in facial movement while smiling after maxillary Le Fort I osteotomies. MATERIALS AND METHODS: Twenty patients (ages 15 to 38) treatment-planned for maxillary Le Fort I osteotomies were divided into two groups. Group A consisted of 10 patients who underwent superior and/or posterior positioning of the maxilla. Group B consisted of 10 patients who underwent anterior and/ or inferior repositioning of the maxilla. All patients underwent preoperative and postoperative (3 to 8 months) videographic analysis of a maximal closed mouth smile by the Johnson Maximal Static Response Assay, evaluating four landmarks around the mouth and nose (alar base--A, cheilion--C, labrale superioris--Ls, and intermediate between cheilion and labrale superioris--Im). RESULTS: Group A was noted to have a statistically significant decrease in movement of the face at points C and Im. No significant change was seen for points Ls and A. Group B was noted to have a statistically significant increase in movement of the face at point A, C, and Im. Point Ls was also found to increase, however not significantly. CONCLUSION: Surgical repositioning of the maxilla anteriorly and/or inferiorly lengthens the facial musculature resulting in an increase in facial movement while smiling. Likewise surgically repositioning the maxilla superiorly and/or posteriorly reduces the length of the facial musculature, resulting in a decrease in facial movement while smiling.

Adolescent↗
PubMed1992

Rhinoplasty and facial expression.

Based on the philosophical concept that facial beauty is not merely harmony of static anatomical structures but also the dynamic expression of the face (especially when one smiles), I propose that plastic surgeons approach the problem of aesthetic improvement of the human face not only in response but also when the face moves. I call this "surgery of the facial expression." I describe here the use of a new surgical procedure to correct a certain condition with which plastic surgeons are frequently confronted when patients consult and request rhinoplasty. Many patients have added defects that are exposed only when they begin to make facial movements and gestures; moreover, these added defects become even more manifest when they smile. I call this phenomenon "rhino-gingivolabial syndrome of the smile," and describe the technique I have used not only to improve the form of the nose but also to enhance the patient's smile.

Facial Expression↗
PubMed2001

Cross-facial nerve grafting as an adjunct to hypoglossal-facial nerve crossover in reanimation of early facial paralysis: clinical and electrophysiological evaluation.

Reanimation of a spontaneous and synchronous smile, and sufficient depressor mechanism of the lower lip presents a surgical challenge in facial paralysis. Hypoglossal-facial nerve crossover and cross-facial nerve grafting are the best options if the mimetic muscles around the mouth are still viable in patients in whom the facial nerve was sacrificed at the brainstem. Although good muscle tone and facial motion have been obtained by hypoglossal-facial nerve crossover, smile is dependent on conscious tongue movement. Cross-facial nerve grafting provides a voluntary and emotion-driven smile, but requires two coaptation sites, which leads to substantial axonal loss and a long regeneration time. This method was not successful in activating the depressor mechanism. The first stage is the classic "baby-sitting" procedure, in which the bulk of the mimetic muscles was maintained by the rapid reinnervation of the hypoglossal-facial nerve crossover during the regeneration period of the cross-facial nerve graft, and temporalis muscle transfer to the eyelids is performed. During the second stage, the cross-facial nerve graft that used the thickest zygomaticobuccal branch on the healthy side was coapted with the corresponding branches on the paralyzed side. The hypoglossal-facial nerve crossover continued to innervate the depressor muscles. Good spontaneous smile and sufficient depressor mechanism were achieved by cross-facial nerve grafting and hypoglossal-facial nerve crossover respectively, and these techniques are demonstrated by the authors clinically and electrophysiologically.

Adult↗
PubMed2005

Evaluation of a new measurement tool for facial paralysis reconstruction.

Evaluation of facial movement, including distance and direction, is essential for anyone interested in facial paralysis reconstruction. The authors' goal was to develop a measurement system that is simple, uses commercially available equipment, takes little time, and provides meaningful and accurate measurements. This technique is called the facial reanimation measurement system. It involves placing dots around the patient's mouth and video recording the patient performing maximal effort smiles. Using a video editing program, one frame showing the patient at rest is overlaid with a second frame showing the patient's smile. This overlaid image is imported into Adobe PhotoShop, where measurements are obtained using tools available in the program. Twenty patients were used to test interrater and intrarater reliability of the facial reanimation measurement system. The accuracy of the measurement process was tested by comparing 10 known distances and angles with those obtained using the facial reanimation measurement system. Both intrarater and interrater reliability of the distance and angle measurements are highly accurate, with intraclass correlations greater than 0.9. The facial reanimation measurement system is accurate to within 0.6 mm and 2.0 degrees when compared with a "known" distance and angle. The facial reanimation measurement system has been used to measure smile movements of more than 200 patients and has been demonstrated to be valuable for detecting changes of facial movements over time. This system is simple and economical and only requires 20 minutes to perform. Although the authors demonstrated evaluation of smile movement, the system may be used to evaluate other movements, such as mouth puckering, eye closure, and forehead elevation.

Adult↗
PubMed2006

Functional upgrading of partially recovered facial palsy by cross-face nerve grafting with distal end-to-side neurorrhaphy.

BACKGROUND: Cross-face nerve grafting combined with functional muscle transplantation has become the standard in reconstructing an emotionally controlled smile in complete irreversible facial palsy. A special problem exists in incomplete or partially recovered facial palsies, when the little existing function should be preserved but the existing function alone is clinically insufficient. METHODS: In this situation, cross-face nerve grafting performed by means of end-to-end coaptation to a zygomatic branch of the healthy side and by end-to-side neurorrhaphy to a corresponding branch of the incompletely paralyzed side is proposed to upgrade smile function on the latter side and contribute to more static and dynamic overall symmetry. The interposition nerve graft is set in overlength to preserve the possibility of a later muscle transplantation in case of unsatisfying functional result through the additional neuronal input. The authors have used this concept in seven patients with irreversible partial facial palsy. Three cases have a sufficiently long follow-up to be presented here. Outcome was objectively quantified with three-dimensional video analysis of facial movements. RESULTS: In all three cases, functional improvement and a positive effect on the static and dynamic symmetry of the face could be measured. None of the patients was disappointed by the smile function achieved or wanted to undergo additional muscle transplantation. CONCLUSION: On the basis of these first clinical experiences, the authors recommend cross-face nerve grafting with overlength and a distal end-to-side neurorrhaphy in patients with irreversible incomplete facial palsy affecting the smile.

Adult↗
PubMed2003

Organization of the central control of muscles of facial expression in man.

Surface EMGs were recorded simultaneously from ipsilateral pairs of facial muscles while subjects made three different common facial expressions: the smile, a sad expression and an expression of horror, and three contrived facial expressions. Central peaks were found in the cross-correlograms of EMG activity recorded from the orbicularis oculi and zygomaticus major during smiling, the corrugator and depressor anguli oris during the sad look and the frontalis and mentalis during the horror look. The size of the central peak was significantly greater between the orbicularis oculi and zygomaticus major during smiling. It is concluded that co-contraction of facial muscles during some facial expressions are accompanied by the presence of common synaptic drive to the motoneurones supplying the muscles involved. Central peaks were found in the cross-correlograms of EMG activity recorded from the frontalis and depressor anguli oris during a contrived expression. However, no central peaks were found in the cross-correlograms of EMG activity recorded from the frontalis and orbicularis oculi or from the frontalis and zygomaticus major during the other two contrived expressions. It is concluded that a common synaptic drive is not present between all possible facial muscle pairs and suggests a functional role for the synergy. The origin of the common drive is discussed. It is concluded that activity in branches of common stem last-order presynaptic input fibres to motoneurones innervating the different facial muscles and presynaptic synchronization of input activity to the different motoneurone pools is involved. The former probably contributes more to the drive to the orbicularis oculi and zygomaticus major during smiling, while the latter is probably more prevalent in the corrugator and depressor anguli oris during the sad look, the frontalis and mentalis during the horror look and the frontalis and depressor anguli oris during one of the contrived expressions. The strength of common synaptic drive is inversely related to the degree of separate control that can be exhibited by the facial muscles involved.

Electrodes↗
PubMed1988

A study of facial expression in Parkinson's disease using a novel microcomputer-based method.

The aim of this study was to compare the smiling behaviour of a group of Parkinson's disease sufferers with a control group of a similar age using a novel microcomputer-based approach, which utilises a mathematical model of the face to quantify facial expression. The findings indicate that the Parkinson's group differed from the control group in the frequency of smiling while watching a series of cartoons and in the degree of mouth opening during smiling. Both groups completed the Levine-Pilowsky Depression questionnaire, and patients with Parkinson's disease had significantly higher depression scores than those of the control group. Significant negative correlations between depression score and frequency of smiling, and depression score and inner eyebrow separation were also found.

Aged↗
PubMed2004

Frontal cephalometrics: practical applications, part 2.

AIMS: To (1) demonstrate the needs and benefits of three-dimensional diagnostic and treatment applications; (2) illustrate practical clinical applications of anteroposterior images and frontal analysis; and (3) enhance utilization of the Ricketts and Grummons frontal analyses. METHODS: Frontal analysis methods and applications are specified and integrated into facial, smile, jaw, and occlusal therapies. Asymmetry conditions must be differentially diagnosed and effectively treated. Frontal and related image analysis and tracing steps are detailed. RESULTS: Asymmetry of facial parts is the rule, rather than the exception. Dental and facial midlines, occlusal plane, chin location, and smile esthetics are primarily emphasized. Beautiful facial proportions and smile harmony can be developed despite initial facial dysmorphosis and disproportions. CONCLUSIONS: Patients view themselves from the frontal perspective, so this carries priority when assessing problems. It is important to know the etiology of asymmetry to assist others with genetic counseling. Facial harmony and smile beauty are optimal when facial and maxillary dental midlines are aligned. The maxillary dentition width should be sufficiently wide to be in harmony with the individual patient facial morphology. The occlusal plane should be level and the chin centered as much as possible. Best facial development and proportionality exist when the skeletal and dental components are optimized transversely and are symmetric.

Adolescent↗
PubMed1985

Do infants see emotional expressions in static faces?

To determine whether young infants discriminate photographs of different emotions on an affect-relevant basis or on the basis of isolated features unrelated to emotion, groups of 17-, 23-, and 29-week-olds were habituated to slides of 8 women posing either Toothy Angry, Nontoothy Angry, or Nontoothy Smiling facial expressions and were then shown 2 new women in the familiarized expression and in a novel Toothy Smiling expression. At all 3 ages, recovery to the novel Toothy Smiling faces occurred only after habituation to Nontoothy faces (whether smiling or angry), not after habituation to Toothy Angry faces, indicating that infants had been responsive to nonspecific features of the photographs (presence or absence of bared teeth) rather than to affectively relevant configurations of features. In a second experiment, 2 older age groups (35 and 41 weeks) also proved to be insensitive to affect-related aspects of still faces, though more so for angry than for happy expressions. It is suggested that the young infant's difficulty in extracting emotional information from static stimuli may be attributable to the absence of the critical invariants (dynamic, multimodally specified) that characterize naturalistic expressions of emotion.

Anger↗