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      The influence of age on lip-line cant in adults: a cross-sectional study

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          The aims of this study were to assess the direction and degree of lip-line cant in Korean adult orthodontic patients and to identify the effects of sex and age on changes in the cant severity.


          In this cross-sectional retrospective study, lip-line cant was measured in the frontal photographs of 585 Korean patients (92 men and 493 women) aged 18-48 years. The outcome variables (direction and degree of lip-line cant) were assessed in terms of predictor variables (sex, age, sagittal skeletal relationship, and menton deviation angle).


          The direction of lip-line cant did not differ according to sex, age, or skeletal classification. Patients had 1.6° of lip-line cant on average before orthodontic treatment. Middle-aged adults displayed a significant trend toward a lower degree of lip-line cant compared to younger adults ( p < 0.01). Multiple linear regression analysis showed that the degree of lip-line cant was weakly negatively correlated with age ( p < 0.001).


          While the direction of lip-line cant did not differ according to the parameters explored here, the degree of cant was correlated with age in adults, independent of menton deviation. Specifically, middle-aged adults tended to display significantly lower degrees of lip-line cant than did younger adults.

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          Most cited references 30

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          Long-term survival of fat transplants: controlled demonstrations.

           S R Coleman (2015)
          To document the amount and rate of re-absorption of fatty tissue transplanted using the author's technique, the author initiated controlled studies in 1987. A selected crease was infiltrated with autologous fatty tissue using a nearby crease as control. At specific time intervals the infiltrated crease was compared to the nearby control crease to evaluate percentage of recurrence. Photographs were taken in the first week, then at least yearly over six years. All views, all positions of the mouth, and all lighting situations demonstrated the continued absence of any crease in the area of infiltration. In contrast, the nearby control crease remained unchanged or deepened from its preoperative condition, giving every indication of a permanent correction. This experiment demonstrates the potential lasting nature of corrections performed with the transplantation of fatty tissue and is supported by over 400 infiltrations into the nasolabial folds in the author's practice.
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            The anatomy of the aging face: volume loss and changes in 3-dimensional topography.

            Facial aging reflects the dynamic, cumulative effects of time on the skin, soft tissues, and deep structural components of the face, and is a complex synergy of skin textural changes and loss of facial volume. Many of the facial manifestations of aging reflect the combined effects of gravity, progressive bone resorption, decreased tissue elasticity, and redistribution of subcutaneous fullness. A convenient method for assessing the morphological effects of aging is to divide the face into the upper third (forehead and brows), middle third (midface and nose), and lower third (chin, jawline, and neck). The midface is an important factor in facial aesthetics because perceptions of facial attractiveness are largely founded on the synergy of the eyes, nose, lips, and cheek bones (central facial triangle). For aesthetic purposes, this area should be considered from a 3-dimensional rather than a 2-dimensional perspective, and restoration of a youthful 3-dimensional facial topography should be regarded as the primary goal in facial rejuvenation. Recent years have seen a significant increase in the number of nonsurgical procedures performed for facial rejuvenation. Patients seeking alternatives to surgical procedures include those who require restoration of lost facial volume, those who wish to enhance normal facial features, and those who want to correct facial asymmetry. Important factors in selecting a nonsurgical treatment option include the advantages of an immediate cosmetic result and a short recovery time.
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              Dental and facial asymmetries: a review.

              Asymmetry in the face and dentition is a naturally occurring phenomenon. In most cases facial asymmetry can only be detected by comparing homologous parts of the face. The etiology of asymmetry includes: a) Genetic or congenital malformations e.g. hemifacial microsomia and unilateral clefts of the lip and palate; b) Environmental factors, e.g. habits and trauma; c) Functional deviations, e.g. mandibular shifts as a result of tooth interferences. Dental asymmetries and a variety of functional deviations can be treated orthodontically. On the other hand, significant structural facial asymmetries are not easily amenable to orthodontic treatment. These problems may require orthopedic correction during the growth period and/or surgical management at a later point. Patient complaints and desires need to be addressed since they may vary from unrealistic expectations to a lack of concern even in the presence of large deviations. With mild dental, skeletal and soft tissue deviations the advisability of treatment should be carefully considered.

                Author and article information

                [a ]Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentisrty, Yonsei University, Seoul, Korea.
                [b ]Private Practice, Seongnam, Korea.
                Author notes
                Corresponding author: Chung Ju Hwang. Professor, Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel +82-2-2228-3106, hwang@
                Korean J Orthod
                Korean J Orthod
                Korean Journal of Orthodontics
                Korean Association of Orthodontists
                March 2016
                18 March 2016
                : 46
                : 2
                : 81-86
                © 2016 The Korean Association of Orthodontists.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Original Article


                menton deviation, lip-line cant, age, adults


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