Esthetic Composition of Smile in Individuals with Cleft Lip, Alveolus, and Palate: Visibility of the Periodontium and the Esthetics of Smile

Abstract

Objective. To evaluate characteristics of smile related to visibility in individuals with cleft lip, alveolus, and palate. Design. Cross-sectional. Setting. HRAC/USP, Brazil. Patients. Individuals with repaired complete unilateral cleft lip and palate (n = 45), aged 15–30 years. Interventions. Frontal facial photographs were obtained in natural and forced smiles (n = 135). Six specialists in periodontics evaluated the photographs as to the smile line, thickness, and curve of the upper lip. Main Outcome Measures. The cleft area was compared with the contralateral region. Results were expressed as percentages and means. The findings were compared between groups of periodontists. Results. Statistically significant relationship was observed in the smile line between examiners and between natural and forced smiles, regardless of the association with the cleft side. The lip was thicker at rest and thinner in the forced smile, as also evaluated by the group not experienced with cleft care. The curve of the upper lip in natural and forced smiles was considered as close to straight by both groups, regardless of the cleft. Conclusion. The smile in individuals with clefts was regarded as average for both cleft and noncleft sides. The thickness was characterized as average to thin, being thinner in forced smile and when analyzed by the group not experienced with cleft care. In the average, the curve of the upper lip was considered as straight. The present study elucidates some characteristics related to the smile in individuals with repaired unilateral cleft lip, alveolus, and palate.

Esthetic management of a patient with cleft lip and palate

“…FDP provides a more natural tooth replacement. If the abutment teeth need no other restoration, a resin bonded FDP can be used [8]. This is a conservative restoration requiring very little tooth preparation with excellent appearance and function.…”

Aesthetic Concepts and Interdisciplinary Approach in a Patient With Bilateral Cleft Lip and Palate and Missing Premaxilla: A Case Report

“…Facial appearance plays an essential role in the psychosocial development of patients with CLP, who usually are shy and quiet (Peter et al, 1975;Kapp-Simon et al, 1997). The smile is one of the most important facial expressions, communicating different emotions and ideas of human beings (Esper et al, 2012).…”

Evaluation of micro esthetics characteristics of maxillary anterior teeth after orthodontic treatment in UCLP: a digital dental model study

“…The smile line in UCLP is usually classified as average and is represented by small gingival exposure. 23 The search for symmetry between central incisors edges is based on the clinical opinion that, when closer to the midline there is a greater need for symmetry while, slight asymmetries are acceptable to teeth distant to the midline. 40 Considering this aspect, even though U1 and U3 had statistical significant differences in UCLP and U2 had significant difference in the NO group the specific values are bellow 0.5mm therefore, the homologous teeth were considered symmetric.…”

“…Few studies have been conducted in order to assess the anterior dental esthetics of CLP individuals. [21][22][23] In the evaluation of the smile soft tissue features in individuals with unilateral cleft lip and palate (UCLP) and the degree of satisfaction after complete rehabilitation only 13.3% of individuals considered their smile as esthetically unpleasant. The most common reasons for the dissatisfaction included the shape of teeth, tooth positioning, contour and color of teeth, lip shape or height.…”

“…21 When evaluating the visibility of the periodontum (smile line) and the esthetics of smile (thickness of upper lip and curve of upper lip) in UCLP the authors concluded that the simile line varied according to the type of smile (natural or forced), being scored as average at the cleft and noncleft sides, with a low prevalence of high and very high smile line. 23 No previous research has evaluated the micro esthetics characteristics of anterior maxillary teeth in UCLP individuals, after orthodontic treatment with canine substitution of missing lateral incisors. Therefore, the purposes of this study were to compare the micro esthetics in cleft and noncleft sides.…”