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Background and Objective: Upper lip bite test (ULBT) is one of the various bedside tests used for prediction of difficult laryngoscopic intubation. However, its usefulness is not still very clear, and there is controversy regarding its accuracy. The aim of this systematic review was to determine the accuracy of the ULBT for predicting difficult airway including difficult laryngoscopy or difficult tracheal intubation.Methods: We searched the databases of PubMed, Scopus, and Google scholar for prospective studies published up until October 2016 assessing the accuracy of ULBT in comparison to Cormack-Lehane grading. The selected keywords were

PREMISE OF THE STUDY: Geographic differences in flower visitor assemblages might lead to among-population differences in the magnitude and pattern of floral integration. However, the role of current pollinator visitation in shaping the magnitude and pattern of floral trait correlations is still controversial. METHODS: We used individual-level data on floral morphology, flower visitation, and fitness to assess if floral integration (at flower and floral-module level) and the covariance structure of floral traits varied among three populations of Lonicera implexa differing in the importance of long-tongue (hawk moths) and short-tongue (bees and small beetles) pollinators; and to assess whether this variation was related to the selection pressures exerted by flower visitors. KEY RESULTS: Short-tongue pollinators preferentially visited plants with floral traits that enhanced flower accessibility; consequently, there was directional selection for accessibility (integration at floral-module level) in the populations where they dominated or codominated. In the population with both short- and long-tongue pollinators, disruptive selection on corolla width and directional selection against whole-flower integration was also found. Dominance by long-tongue pollinators (hawk moths) resulted in disruptive selection on whole-flower integration. Overall, the conflicting selection pressures that were found matched among-population differences in covariance structure: populations with short-tongue pollinators showed correlations between corolla-tube width and other floral traits that were absent in the population pollinated primarily by hawk moths. CONCLUSIONS: Conflicting selection on floral integration mediated by floral visitors can occur even in nearby populations of a species with restricted floral morphology.

Background Addressing the long upper lip has been a complex problem for some time. Methods such as the subnasal skin excision and the vermillion advancement technique have been described, but both leave a visible scar. A no-scar lip-lift technique is necessary for a subset of patients who have a long upper lip and will not accept a visible scar. Methods The upper lip is shortened via an intranasal incision and suspension suture that elevates the upper lip and anchors it to the anterior nasal spine. A retrospective review of 92 patients who had undergone upper lip-lift with the no-scar suspension technique was performed. Three plastic surgeons assessed the pre- and postoperative results and determined the presence of improvement in four categories: lip shortening, lip projection, incisor show, and vermillion show. Results The lip parameters improved, with 85% of the patients showing noticeable lip shortening, 79% showing increased sagittal projection, 74% exhibiting increased incisor show, and 25% exhibiting increased vermillion show. All the patients had improvement in at least one of the four categories. Complications were experienced by two patients with a suture abscess and one patient with an unraveled suture. Conclusion The overall lip contours improved after the lip suspension technique, most noticeably in terms of lip height and sagittal projection, and the scar was hidden intranasally.

Cleft lip and/or primary palate (CL/P) represent a prevalent congenital malformation, the aetiology of which is highly intricate. Although it is generally accepted that the condition arises from failed fusion between the upper lip and primary palate, the precise mechanism underlying this fusion process remains enigmatic. In this study, we utilized transposase‐accessible chromatin sequencing (scATAC‐seq) and single‐cell RNA sequencing (scRNA‐seq) to interrogate lambdoidal junction tissue derived from C57BL/6J mouse embryos at critical stages of embryogenesis (10.5, 11.5 and 12.5 embryonic days). We successfully identified distinct subgroups of mesenchymal and ectodermal cells involved in the fusion process and characterized their unique transcriptional profiles. Furthermore, we conducted cell differentiation trajectory analysis, revealing a dynamic repertoire of genes that are sequentially activated or repressed during pseudotime, facilitating the transition of relevant cell types. Additionally, we employed scATAC data to identify key genes associated with the fusion process and demonstrated differential chromatin accessibility across major cell types. Finally, we constructed a dynamic intercellular communication network and predicted upstream transcriptional regulators of critical genes involved in important signalling pathways. Our findings provide a valuable resource for future studies on upper lip and primary palate development, as well as congenital defects.

Background: The esthetics of the face and teeth help in the prognosis of the outcome of orthognathic surgery, implant surgery, operative dentistry, anterior aesthetic surgery, and fixed or removable prosthetic procedure. Objective: To compare the amount of maxillary incisal exposure between patients with normal and short upper lip lengths. Methods: This cross-sectional study was conducted at the Orthodontics Department of Peshawar Dental College and Hospital, Pakistan, and involved clinical measurements of upper lip length and incisal exposure using a digital vernier caliper. A total of 235 adult patients were assessed according to their upper lip length and their classification was done under short upper lip, normal upper lip or enhanced upper lip length. A digital vernier caliper was used to measure the amount of incisal exposure during the resting position as well as during the smiling phase. Results: Out of total 235 participants, 112 (47.7%) were males and 123 (52.3%) females, with a mean age of 32.4±SD years and an age range of 20-45 years.  Normal lip length participants had the largest exposure with a mean of 8.19 mm±1.87 SD (p value <0.001) as shown by the outcome whereby different lip length groups presented significant differences in incisal exposures. The angular depth of the incisal edges was less exposed than that analyzed by the observers with increased or decreased labial lip lengths. Conclusion: The study shows that upper lip length significantly affects maxillary anterior tooth visibility at rest and during smiling, with optimal esthetic incisal display observed in individuals ...

Background: The esthetics of the face and teeth help in the prognosis of the outcome of orthognathic surgery, implant surgery, operative dentistry, anterior aesthetic surgery, and fixed or removable prosthetic procedure. Objective: To compare the amount of maxillary incisal exposure between patients with normal and short upper lip lengths. Methods: This cross-sectional study was conducted at the Orthodontics Department of Peshawar Dental College and Hospital, Pakistan, and involved clinical measurements of upper lip length and incisal exposure using a digital vernier caliper. A total of 235 adult patients were assessed according to their upper lip length and their classification was done under short upper lip, normal upper lip or enhanced upper lip length. A digital vernier caliper was used to measure the amount of incisal exposure during the resting position as well as during the smiling phase. Results: Out of total 235 participants, 112 (47.7%) were males and 123 (52.3%) females, with a mean age of 32.4±SD years and an age range of 20-45 years.  Normal lip length participants had the largest exposure with a mean of 8.19 mm±1.87 SD (p value <0.001) as shown by the outcome whereby different lip length groups presented significant differences in incisal exposures. The angular depth of the incisal edges was less exposed than that analyzed by the observers with increased or decreased labial lip lengths. Conclusion: The study shows that upper lip length significantly affects maxillary anterior tooth visibility at rest and during smiling, with optimal esthetic incisal display observed in individuals ...

Polymorphous low grade adenocarcinoma (PLGA) is a malignant neoplasm that frequently occurs in the minor salivary glands in palate and oral cavity. We present a case of upper lip swelling with ulceroproliferative growth, clinically mimicking squamous cell carcinoma (SCC). Fine-needle aspiration cytology smears suggested PLGA, which was later confirmed on histopathology. Clinical presentation of PLGA may simulate SCC.

BackgroundThe recent rise in popularity of minimally invasive facial aesthetic procedures has resulted in the overall heightened patient interest in lip rejuvenation. There is a variety of techniques and modifications for surgical upper lip enhancement described in the literature but no single method is considered optimal. The aim of this literature review is to provide a comprehensive analysis of the studies dealing with surgical upper lip enhancement and evaluate their short- and long-term outcomes, as well as complication profiles.MethodsA comprehensive review of the published literature through July of 2019 was performed. The PUBMED and Cochrane databases were searched for all English language articles on aesthetic surgical enhancement of the upper lip. Only articles dealing with the aesthetic aspect of the upper lip subunit were included. Preoperative assessment, patient selection and technique execution were assessed. Data were abstracted on all postoperative complications and outcomes.ResultsOverall, 52 articles were screened for inclusion, of which 17 met the inclusion criteria. The total number of patients treated in these studies was 2265. The average follow-up period was 30 months. The most commonly used surgical method across the studies was the subnasal lip lift (93.6%). The bull’s horn excision pattern was utilized to perform the subnasal lip lift in 71.7% of the cases, and the wavy ellipse excision was used in 18.1% of patients. Lip advancement by vermillion border excision pattern was the technique of choice for 49 patients (2.2%). Across all patients the most common complication was a non-aesthetically appealing result or adverse scarring with a mean incidence of 7.23%. Overall, the studies reported improvement in the aesthetic appearance of the upper lip after surgical enhancement, along with few but promising reports of high patient satisfaction. There is a relative paucity of high-quality data regarding complication profiles, patient selection, indications and contraindications.ConclusionsThis review provides an overview of several techniques and modifications for upper lip enhancement. It highlights the paucity of high-quality data on their application and optimizing patient selection. Promising satisfaction rates and relatively low complication rates suggest a more prominent role for surgical cheiloplasty in facial rejuvenation.Level of evidence IIIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background Clinical observations suggest that upper lip injuries often exhibit prolonged healing and reduced healing efficacy. The unique anatomical and physiological characteristics of the lips make them particularly susceptible to infection and delayed recovery, posing significant challenges for postoperative management. The aim of this research, grounded in the anatomical and physiological subtleties of the upper lip, was to contrast the wound management outcomes between patients treated with a conventional wound management approach and those treated with a customized wound management model. Additionally, it aimed to explore the efficacy of a dynamic model in the assessment and treatment of upper lip wounds. Method It is a retrospective cohort study. Patients with maxillofacial injuries who attended the Emergency Department of West China Hospital of Stomatology of Sichuan University were selected for retrospective analysis. Between February and August 2023, 89 out of 783 patients with maxillofacial injuries who had upper lip injuries formed the control group. From February to August 2024, 84 patients with upper lip injuries, selected from 643 patients with maxillofacial injuries, constituted the experimental group. The control group applied the traditional wound management method, while the experimental group implemented the customized wound management model, which involved optimizing the team, devising a wound-healing model, improving dressings, innovating in both the timing and method of dressing changes, and providing customized care for complex wounds. The outcomes of upper lip wound management between the two groups were compared, including the wound infection rate, the Vancouver Scar Scale (VSS) score 30 days after surgery, and patients’ satisfaction. Data analysis was conducted using SPSS 23.0 software. Results There were no statistically significant differences in the demographic variables between the two groups ( P  > 0.05). The upper lip infection rates were 18% (16 out of 89) in the control group and 1.2% (1 out of 84) in the experimental group, respectively. Notably, the incidence of wound complications and wound infection rates differed significantly between the control and experimental groups, with the experimental group showing lower figures for both ( P  < 0.001). Compared to the control group, the experimental group had a lower VSS score and a higher patients’ satisfaction score, with these differences being statistically significant ( P  < 0.001). Conclusion The customized wound management model demonstrated superior clinical efficacy in treating upper lip injuries. Patients gain advantages from a customized postoperative wound management model designed according to the upper lip healing kinetics. By aligning postoperative care with the unique healing kinetics of the upper lip, this approach significantly reduces infection rates and enhances patient satisfaction. These findings advocate for wider adoption of this personalized wound management model in the clinical treatment of upper lip injuries. Trial registration Clinical Trial Registration No. ChiCTR2300079287, Registration Date 29 December 2023.

Excessive gingival display (EGD) is most commonly attributed to vertical upper lip elevation, short lip length, or dentoalveolar disproportion. However, some patients exhibit gingival or mucosal visibility during smiling despite minimal vertical upper lip displacement, suggesting the presence of alternative dynamic patterns. This exploratory case series examined an inversion-dominant smile presentation and its documented modulation in association with conservative intraoral chemodenervation directed toward the marginal region of the orbicularis oris. Ninety-four patients with dynamic inversion during smiling were assessed using a qualitative rating aid (Armenti Inversion Scale, AIS) and a quantitative composite proportional measure of vermilion loss (ΔLv%). All patients received low-dose intraoral Onabotulinum toxin A (4–6 U) as part of routine aesthetic care. At Day 15 follow-up, a shift toward lower inversion grades was observed across the cohort, with a large proportion of patients showing minimal residual inversion. Quantitative ΔLv% values showed proportional changes that were directionally consistent with shifts in AIS grade. The functional alterations were mild, transient, and self-resolving. Preliminary inter-rater agreement for AIS and measurement repeatability for ΔLv% suggested acceptable internal consistency for exploratory reporting tools. These findings suggest that inward vermilion inversion may represent a potentially distinct dynamic contributor to gingival or mucosal exposure in selected individuals, and that conservative marginal chemodenervation was associated with transient modulation of this pattern with generally preserved oral competence. AIS and ΔLv% are preliminary documentation tools. Further studies incorporating objective neuromuscular assessment, three-dimensional imaging, and comparative designs are required to refine phenotypic characterization.