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The female upper lip is shorter than its male counterpart. We have recently described a precise direct surface measurement technique of the philtral height. In this study we aim to quantify the difference in philtral height using this same measuring technique between two groups of young male and female Lebanese subjects. The mean philtral height obtained in the young male group was 15.7 ± 1.7 mm. By comparing this result to the previously described mean philtral height of 14.3 ± 1.9 mm in the young female group, we obtained a mean difference of 1.3 ± 1.8 mm between the two groups. This result confirms and quantifies by direct surface measurement the gender difference in upper lip height and should be considered when planning a gender-affirming upper lip shortening surgery.

Upper lip lifting is a very popular procedure but there is no objective guidelines on how much skin has to be removed to obtain an optimal result. We have measured and compared the philtral height in two groups of young and old female Lebanese subjects. We have found a mean philtral height of 14.3 ± 1.9 mm in the young group and 19.8 ± 2.4 mm In the old group, with a mean philtral lengthening of 5.5 ± 2.9 mm. We suggest using these results to plan the amount of skin that has to be removed during a lip lift procedure. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to characterize the origin and course of the zygomaticus major muscle (Zmj) with its topographic relationships with the nasal ala, tragus, philtrum, and lateral canthus. Methods: The Zmj was examined in 50 specimens of 25 embalmed adult Korean cadavers. Facial muscles were dissected to expose the origin and course of the Zmj in 48 specimens of 24 cadavers. The 25th cadaver was sectioned to obtain images of the Zmj. Results: The positional relationships of the Zmj origin with the nasal ala and the tragus were classified into three categories. A horizontal line through the center of the Zmj origin and the nasal ala passed through the tragus in 20 of 48 specimens (41.7%), the intertragic notch in 18 specimens (37.5%), and above the tragus in 10 specimens (20.8%). In a horizontal section of the head, the Zmj origin was located near the level of the nasal ala and tragus. In a coronal section of the head, the fibers of the Zmj arising at its origin were located close to the zygomatic bone, lateral to the zygomaticus minor muscle. Conclusion: By combining dissection with the analysis of sectioned images and ultrasound images of the Zmj, this study has yielded positional information for easily predicting the location of the origin and the course of the Zmj and its related structures underlying the skin. [ABSTRACT FROM AUTHOR]

Elevated face temperature due to mask wearing can cause discomfort and skin irritation, making mask mandates challenging. When thermal discomfort becomes intolerable, individuals instinctively or unknowingly loosen or remove their facemasks, compromising the mask's protective efficacy. The objective of this study was to numerically quantify the microclimate under the mask and facial thermoregulation when wearing a surgical mask with different levels of misfit. An integrated ambient–mask–face–airway computational model was developed with gaps of varying sizes and locations and was validated against complementary experiments. The low Reynolds number (LRN) k-ω turbulence model with porous media was used to simulate transient respiratory flows. Both skin convective heat transfer and tissue heat generation were considered in thermoregulation under the facemask, besides the warm air exhaled from the body and the cool air inhaled from the ambient. The results of this study showed that when wearing a surgical mask with a perfect fit under normal breathing, the temperature at the philtrum increased by 4.3 °C compared to not wearing a mask. A small gap measuring 0.51 cm2 (gap A) at the nose top resulted in 5.6% leakage but reduced the warming effect by 28% compared to zero gap. Meanwhile, a gap of 4.3 cm2 (R1L1) caused 42% leakage and a 62% reduction in the warming effect. Unique temporospatial temperature profiles were observed at various sampling points and for different gap sizes, which correlated reasonably with the corresponding flow dynamics, particularly close to the gaps. The temperature change rate also exhibited patterns unique to the gap site and sampling point, with distinctive peaks occurring during the inspiratory–expiratory flow transitions. These results have the significant implications that by using the temporospatial temperature profiles at several landmark points, the gap location can potentially be pinpointed, and the gap size and leakage fractions can be quantified. [ABSTRACT FROM AUTHOR]

Elevated face temperature due to mask wearing can cause discomfort and skin irritation, making mask mandates challenging. When thermal discomfort becomes intolerable, individuals instinctively or unknowingly loosen or remove their facemasks, compromising the mask’s protective efficacy. The objective of this study was to numerically quantify the microclimate under the mask and facial thermoregulation when wearing a surgical mask with different levels of misfit. An integrated ambient–mask–face–airway computational model was developed with gaps of varying sizes and locations and was validated against complementary experiments. The low Reynolds number (LRN) k-ω turbulence model with porous media was used to simulate transient respiratory flows. Both skin convective heat transfer and tissue heat generation were considered in thermoregulation under the facemask, besides the warm air exhaled from the body and the cool air inhaled from the ambient. The results of this study showed that when wearing a surgical mask with a perfect fit under normal breathing, the temperature at the philtrum increased by 4.3 °C compared to not wearing a mask. A small gap measuring 0.51 cm2 (gap A) at the nose top resulted in 5.6% leakage but reduced the warming effect by 28% compared to zero gap. Meanwhile, a gap of 4.3 cm2 (R1L1) caused 42% leakage and a 62% reduction in the warming effect. Unique temporospatial temperature profiles were observed at various sampling points and for different gap sizes, which correlated reasonably with the corresponding flow dynamics, particularly close to the gaps. The temperature change rate also exhibited patterns unique to the gap site and sampling point, with distinctive peaks occurring during the inspiratory–expiratory flow transitions. These results have the significant implications that by using the temporospatial temperature profiles at several landmark points, the gap location can potentially be pinpointed, and the gap size and leakage fractions can be quantified.

Rodents have received substantial attention in the study of olfaction. However, the rhinarium, the naked part of the nose, which plays an important role in chemical, tactile, and thermal perception, has been relatively overlooked. This study presents a comprehensive analysis of the rhinarium morphology and spatially associated structures (i.e., upper lip, and philtrum) in sigmodontines, a diverse group within the Cricetidae rodents. The research covers 483 specimens representing 145 species, accounting for 74% of genera in the clade, including all 13 recognized tribes, three incertae sedis genera, and the murid representatives Mus musculus and Rattus norvegicus. The inconsistent use of terminology in describing rhinarium traits across the literature poses a challenge for comparative analyzes. To address this issue, a standardized terminology was proposed to characterize the rhinarium. A paired complex protuberance typically with epidermal ridges (i.e., rhinoglyphics), termed here the tubercle of Hill, was identified as a distinctive feature in muroid rhinaria. Comparative assessments among tribes revealed unique sets of features defining each major clade, encompassing variations in hairiness, dorsum nasi complexity, size and positioning of the tubercle of Hill, and other key attributes. Two primary rhinarium configurations were discerned: one shared by Oryzomyalia and Sigmodontini and another specific to Ichthyomyini. The former groups display a ventrally positioned rhinarium prominently featuring the tubercle of Hill and sculptured areola circularis. In contrast, Ichthyomyini exhibit a frontally directed rhinarium characterized by an enlarged dorsum nasi fused to the tubercle of Hill, resulting in a distinctive "cherry" appearance. Convergent rhinarium structures observed in fossorial species, characterized by well-developed plica alaris and hair fringes, are presumed to mitigate potential damage during digging. Conversely, semiaquatic carnivorous sigmodontines showcase an integrated apical structure in their rhinarium, facilitating enhanced somatosensory capabilities crucial for predation activities during diving expeditions., (© 2024 Wiley Periodicals LLC.)

The female upper lip is shorter than its male counterpart. We have recently described a precise direct surface measurement technique of the philtral height. In this study we aim to quantify the difference in philtral height using this same measuring technique between two groups of young male and female Lebanese subjects. The mean philtral height obtained in the young male group was 15.7 ± 1.7 mm. By comparing this result to the previously described mean philtral height of 14.3 ± 1.9 mm in the young female group, we obtained a mean difference of 1.3 ± 1.8 mm between the two groups. This result confirms and quantifies by direct surface measurement the gender difference in upper lip height and should be considered when planning a gender-affirming upper lip shortening surgery., Competing Interests: None., (© 2024 The Author(s).)

Introduction The philtral ridges form a prominent visual landmark in the upper lip. An aesthetically pleasing cleft lip repair should restore this preferably without any scars cutting across it. Although there are several scientific publications on morphology of this structure and its variations, very few studies on the Indian population have been published. Aim To study the morphology of the philtral ridges and their relationship to the columellar base in normal Indian children and its significance in cleft lip repair. Methods 115 normal healthy children from southern India aged between one and 12 years were studied based on direct observation of the relationship of the superior end of the philtral ridge to the columellar base and nasal sill. In type A, the philtral ridge terminates at the nasal sill just lateral to the columellar base, and in type B, it either reaches or fades before reaching the columellar base. All observations were performed by the first author by examining standardized two-dimensional (2D) photographs of the upper lip-nose complex. Results In this study, 74% of the subjects had the philtral column extending lateral to the columellar base. Conclusion These finding assume a significance since, in a substantial proportion of the studied population, techniques of cleft lip repair such as the rotation advancement method, place a scar that crosses the upper third of the philtral ridge which may be undesirable.

Introduction: One of the most common maxillofacial malformations is mandibular advancement, a class II malformation or malocclusion. One treatment is mandibular advancement surgery. This research aimed to investigate the effect of mandibular advancement surgery on upper lip length in class II patients. Methods: This retrospective study was conducted with 16 patients having class II malformations who underwent mandibular advancement surgery. Data analysis was conducted using SPSS 19. Results: Results showed that although height of philtrum increased after surgery, there was no significant difference in the height of the philtrum from before to after the mandibular advancement surgery (p > 0.05). Evaluation of the patients showed that although commissure height and vermilion height decreased after surgery, this difference was not statistically different(p > 0.05). However, there was a statistically significant difference between before and after commissure height (p

Background: The position of the dental midline is significant to enhance dentofacial esthetics. This study aimed to assess the closest anatomical landmark to the facial and mouth's midline applicable to dentate male and female Indian youths. Materials and Methods: A full-face photo of 100 males and 100 females with a broad smile showing visible anterior dentition was taken. An esthetic facial frame was developed digitally on the photographs taking the reference of facial anatomical landmarks. Relative facial midline values for nasion, the nose tip, the philtrum tip, and dental midline were obtained. The relative commissural midline value was obtained by dividing the variables by the constant. Statistical analysis: Data were statistically analyzed using the t-test. Results and Conclusions: Anatomic landmarks correlated with facial midline and with the inter-commissural midline (P < 0.01). The nasion is nearest to the facial midline, followed by dental midline, commissure, tip of the philtrum, and nose tip in that order. The anatomic landmarks nearest to the inter-commissural midline are the tip of the philtrum, followed by the dental midline, nasion, and nose tip. The nose tip was the farthest landmark from the face's midline and the inter-commissural midline. In gender-wise comparison, landmarks did not differ significantly (P > 0.05). All the measurements were almost equal in males and females.

Abstract Background Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p

Introduction The philtral ridges form a prominent visual landmark in the upper lip. An aesthetically pleasing cleft lip repair should restore this preferably without any scars cutting across it. Although there are several scientific publications on morphology of this structure and its variations, very few studies on the Indian population have been published. Aim To study the morphology of the philtral ridges and their relationship to the columellar base in normal Indian children and its significance in cleft lip repair. Methods 115 normal healthy children from southern India aged between one and 12 years were studied based on direct observation of the relationship of the superior end of the philtral ridge to the columellar base and nasal sill. In type A, the philtral ridge terminates at the nasal sill just lateral to the columellar base, and in type B, it either reaches or fades before reaching the columellar base. All observations were performed by the first author by examining standardized two-dimensional (2D) photographs of the upper lip-nose complex. Results In this study, 74% of the subjects had the philtral column extending lateral to the columellar base. Conclusion These finding assume a significance since, in a substantial proportion of the studied population, techniques of cleft lip repair such as the rotation advancement method, place a scar that crosses the upper third of the philtral ridge which may be undesirable. [ABSTRACT FROM AUTHOR]

Background: The position of the dental midline is significant to enhance dentofacial esthetics. This study aimed to assess the closest anatomical landmark to the facial and mouth's midline applicable to dentate male and female Indian youths. Materials and Methods: A full-face photo of 100 males and 100 females with a broad smile showing visible anterior dentition was taken. An esthetic facial frame was developed digitally on the photographs taking the reference of facial anatomical landmarks. Relative facial midline values for nasion, the nose tip, the philtrum tip, and dental midline were obtained. The relative commissural midline value was obtained by dividing the variables by the constant. Statistical analysis: Data were statistically analyzed using the t-test. Results and Conclusions: Anatomic landmarks correlated with facial midline and with the inter-commissural midline (P < 0.01). The nasion is nearest to the facial midline, followed by dental midline, commissure, tip of the philtrum, and nose tip in that order. The anatomic landmarks nearest to the inter-commissural midline are the tip of the philtrum, followed by the dental midline, nasion, and nose tip. The nose tip was the farthest landmark from the face's midline and the inter-commissural midline. In gender-wise comparison, landmarks did not differ significantly (P > 0.05). All the measurements were almost equal in males and females. [ABSTRACT FROM AUTHOR]

Introduction: One of the most common maxillofacial malformations is mandibular advancement, a class II malformation or malocclusion. One treatment is mandibular advancement surgery. This research aimed to investigate the effect of mandibular advancement surgery on upper lip length in class II patients. Methods: This retrospective study was conducted with 16 patients having class II malformations who underwent mandibular advancement surgery. Data analysis was conducted using SPSS 19. Results: Results showed that although height of philtrum increased after surgery, there was no significant difference in the height of the philtrum from before to after the mandibular advancement surgery (p> 0.05). Evaluation of the patients showed that although commissure height and vermilion height decreased after surgery, this difference was not statistically different(P> 0.05). However, there was a statistically significant difference between before and after commissure height (P<0.05) at camouflage in patients. There was also a statistically significant difference in height of philtrum and vermilion between before and after camouflage in patients (P<0.05). Conclusions: The results of this study suggest that mandibular advancement surgery plays a serious role in the clinical appearance of lip soft tissue, which can be used as a predictor of patient profile prior to surgery. [ABSTRACT FROM AUTHOR]

Introduction: Prosthodontic rehabilitation aims to achieve the best possible facial esthetic appearance for a patient. Attaining facial symmetry forms the basic element for esthetics, and knowledge of the midline of face will result in a better understanding of dentofacial esthetics. Currently, there are no guidelines that direct the choice of specific anatomic landmarks to determine the midline of the face or mouth. Most clinicians choose one specific anatomic landmark and an imaginary line passing through it. Thus, the clinician is left with no established guidelines to determine facial midline. Objective: The purpose of the study is to digitally determine the relationship of facial landmarks with midline of face and formulate a guideline for choosing anatomic landmark among Punjabi population. Materials and Methods: Three commonly used anatomic landmarks, namely nasion, tip of the nose, and tip of the philtrum, were marked clinically on 100 participants (age range: 21–45 years). Frontal full-face digital images of the participants in smile were then made under standardized conditions. Midline analysis was carried out digitally using an image analyzing software. The entire process of midline analysis was done by a single observer and repeated twice. Reliability analysis and one-sample t-tests were conducted. Results: The results indicated that each of the four landmarks deviated uniquely and significantly (P < 0.001) from the midlines of the face as well as the mouth. Conclusions: Within the limitations of the study, the hierarchy of anatomic landmarks closest to the midline of the face in smile was as follows: (1) Intercommissural midlines, (2) Tip of philtrum, (3) Nasion, (4) Tip of the nose, and (5) Dental midlines. The hierarchy of anatomical landmarks closest to the intercommissural/mouth midline was: (1) Tip of philtrum, (2) Tip of the nose, (3) Nasion, and (4) dental midline.

The philtrum is well known as a median groove within the upper lip of mammalian species. However, a peculiar serpentine duct was identified within the mucosal surface of the camel philtrum. To the best of the author's knowledge, the available literature did not mention any information regarding the presence of a complete duct in such location. For these, this study was aimed to reveal the gross and microscopic structure as well as to discuss the possible functions of this labial duct in dromedar y. Twenty snouts from 20 camel heads were used. The labial duct had unique morphological and microscopic structure. It was a median highly tor tuous duct with proximal and distal segments conn ected to each other through a capillary portion. The latter revealed only at the microscopic level. The duct had two entrances, the proximal and distal papillae. Importantly, the microscopic studies revealed that it also had a n olfactory por tion. In con clusion, the labial duct in camel s is a peculiar anatomical s tructure, which may function as an organ of alarm. [ABSTRACT FROM AUTHOR]

In the treatment of philtral ridge deficiency in cleft lip patients, optimal results are difficult to obtain due to visible scarring following surgery. The purpose of this article is to introduce a novel strategy for philtrum reconstruction along with an evaluation of postoperative outcomes of this technique. All patients with a deficiency of the philtrum underwent reconstruction of the philtral ridge and upper lip using an orbicularis oris muscle flap with a specific re-suturing technique in our study. The convexity of the philtral ridge was evaluated pre- and postoperatively at rest and while puckering using patient photography as well as three-dimensional simulation technology. Postoperative outcomes and complications were assessed during follow-up, including a patient satisfaction survey. Thirty cleft lip patients underwent treatment in this study using a specific orbicularis oris muscle re-suturing technique. The average age of the 13 male and 17 female patients was 31.5 years. The follow-up period ranged from 6 months to 3.5 years with an average of 10.3 months. Postoperative results showed an aesthetic reconstructed philtral ridge with stable outcome. Complications included acute infection (1 case) and temporary stiffness of smile (3 cases). No systemic complications occurred. All patients were satisfied with their results, and none required further surgery. We propose a simple, effective, and reproducible technique involving an orbicularis oris muscle flap for the creation of the philtral column in secondary cleft lip deformity. Our approach allowed aesthetically pleasing and stable outcomes. Although the short-term results of the philtrum reconstruction seem to be adequate there is no information on the long-term situation, and therefore no general recommendation to adopt this method can be given. [ABSTRACT FROM AUTHOR]

La restauration du philtrum est un aspect souvent négligé dans la technique de lifting labial à cicatrice péri narinaire, ou bien fait appel secondairement à de simples compléments par injection d'acide hyaluronique. Nous ne sommes pas partisans de la classique cicatrice continue en corne de vache car, d'une part, nous estimons que l'essentiel du raccourcissement labial tient à la résection sous narinaire dont l'excursion interne conditionne le résultat final, et, d'autre part, que le rapprochement de 2 revêtements cutanés de nature très différente (columelle et lèvre) peut entraîner une cicatrice visible. La base de la columelle est particulièrement bien vascularisée par l'anastomose de branches issues de la carotide externe via l'artère labiale supérieure et de branches septales distribuées par le système carotidien interne. Nous considérons donc que cette zone de chaque côté de la base de la columelle constitue le pivot vasculaire de notre « lambeau en moustache » dessiné suivant la classique incision de plastie péri narinaire : ce lambeau est desépidermisé puis totalement détaché du muscle orbiculaire sauf à sa partie interne où il est simplement discisé pour ne pas compromettre sa vascularisation ; il est ensuite pivoté à 90° et inséré dans un tunnel aménagé dans le plan cutanéo musculaire jusqu'à la lèvre rouge, correspondant ainsi au rétablissement des 2 crêtes philtrales. Ainsi l'ensemble des déformations labiale supérieure observées avec le temps (allongement et convexité de la lèvre blanche, aplatissement des crêtes philtrales sont corrigés de manière durable. L'intervention est menée sous anesthésie locale et si besoin les autres éléments du vieillissement (perte du volume de la lèvre rouge, rides verticales, défaut de pigmentation etc.) peuvent être corrigé sans risque dans le même temps. The restoration of the philtrum is an often neglected aspect in the technique of labial lifting with a perinasal scar, or it is secondarily resorted to by simple injections of hyaluronic acid. We are not in favor of the classic continuous bull's horn scar because, on the one hand, we consider that most of the labial shortening is due to the nasal floor resection -the internal excursion of which determines the final result-, and on the other hand that the approximation of 2 skins of very different nature (columella and lip) may cause a visible scar. The base of the columella is particularly well vascularized by the anastomosis of branches derived from the external carotid artery via the superior labial artery and septal branches distributed from the internal carotid system. We therefore consider that this zone on each side of the base of the columella constitutes the vascular pivot of our "mustache flap" drawn according to the classic peri nasal incision: this flap is desepidermized and then totally elevated from the orbicularis muscle except for its internal part where it is simply discarded so as not to compromise its vascularity; it is then rotated at 90° and inserted into a tunnel fitted in the subcutaneous plane down to the red lip corresponding to the restoration of the 2 philtral crests. Thus, all of the superior labial deformations observed over time (elongation and convexity of the white lip, flattening of the philtrum are corrected in a long lasting manner. The intervention is carried out under local anesthesia and, if necessary, the other elements of aging (loss of volume of the red lip, vertical wrinkles, defect of pigmentation etc.) can be corrected without risk at the same time. [ABSTRACT FROM AUTHOR]

Lip and perioral surgery, like any other esthetic surgery, requires an exact and convenient measurement tool to ensure reliable and reproducible outcomes. Although three-dimensional measuring equipment has proven its effectiveness in measuring facial parameters over the past two decades, it has some drawbacks, including high cost, long scanning times, and non-portability. Thus, digital photography remains the standard tool of measurement in esthetic surgery to date. Many authors have presented evaluation and measurement methods using digital photography in combination with different tools. However, there are no specific tools for the perioral region. Therefore, we devised a specific ruler for perioral measurements. The ruler has differently colored lines for length and angle measurements and a reference point for correct positioning. It can be used in preoperative consultation, intraoperative orientation, and postoperative evaluation. Level of Evidence IV This 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. [ABSTRACT FROM AUTHOR]

Background: A lot of research on interalar distance, intercanthal distance, bizygomatic width, and intercanine width has been done for selecting the size of the anterior teeth, but there is no reliable method for selection of anterior teeth. In this article, the upper lip length and philtrum length are evaluated to check the correlation with anterior teeth size. Aim: The aim is to examine the relationship of upper lip length and philtrum length to maxillary central and lateral incisors teeth proportions in dentate patients. Materials and Methods: A total of 25 males and 25 females with the age of 18-21 years were selected for the study. They were seated in an upright position, and a flexible ruler was used to measure their upper lip length and philtrum length. A Vernier caliper was used to measure the height and width of the central and lateral incisors. The results were tabulated and significant correlations were studied. Results: In females, the upper lip length coincides with twice the height and width of the lateral incisors, whereas philtrum length coincides with width of the central incisors. In males, the mean height and width of both the central and lateral incisors are statistically significant with philtrum length and upper lip length. Conclusion: In the study, philtrum length can be taken as guide for selecting width of the central incisor in females. It can also use as guide for height and width of the both incisors in males. Lip length can be used as guide for selecting the size of both central and lateral incisors in males, whereas in females it can be used only for selecting lateral incisor size. [ABSTRACT FROM AUTHOR]

When image guidance is not available or when there is a need to confirm the findings of such technology, superficial landmarks can still play a role in providing surgeons with estimations of the position of deeper anatomical structures. To our knowledge, surface landmarks for the position of the odontoid process have not been investigated. We have therefore performed an anatomical study to investigate such a landmark. One-centimeter metallic rods were placed on the philtrum of the upper lip of 20 cadaveric head specimens. To assess the position relative to the odontoid process, we took lateral and anteroposterior radiographs and recorded the measurements. Descriptive findings from radiographic observations indicated a reasonable approximation between the philtrum and the midpoint of the odontoid process. Based on our results, we suggest that the philtrum of the upper lip can serve as a first line estimation of the position of the odontoid process and can assist in verifying this bony structure following the use of image guidance. [ABSTRACT FROM AUTHOR]

Objective: Restoration of the philtral region following traumatic, cleft, and tumor surgeries is often difficult due to influence of this feature to whole facial beauty. The aim of this study is to investigate the types and measurements of the philtrum and its relationship with the upper lip using a software. Methods: Standard personal photographs of the philtral region were obtained from 200 young adults participated in this study. Linear analyses (the lengths of philtral column and dimple; the philtral width) and angular analyses (apex and central angles of Cupid's bow) were measured as reference points. As for the shape of the philtral column, it was categorized as four distinct types: parallel, triangular, concave, and unclear type. Results: The philtral width was 11.37 ± 1.9 mm in males, 10.21 ± 1.80 mm in females. The length of the philtral dimple was 18.16 ± 3.6 mm in males, 18.16 ± 3.6 mm in females. Compared with women, both of the measured average philtral reference lengths displayed a significantly greater value in men. In the meanwhile, compared to women, the angular measurements of Cupid's bow (i.e., the apex and central angle of Cupid's bow) were smaller in men. It was 127.47 ± 12.74° mm in males, 134.1 ± 11.38° mm in females. The triangular and concave types were associated with a substantial fraction in men, whereas the triangular and parallel types were predominant in women. There were significant gender differences in the esthetic rankings of philtral column shapes. Conclusions: These results suggest digitalized reference values relative to the philtral column which may increase the success of the individual reconstructive treatment of the surgical procedures and reduce possible asymmetrical appearance. With the help of certain software, this research has made possible to investigate the ideal parameters of philtral construction in defining the best surgical solution for the patient. [ABSTRACT FROM AUTHOR]

A variety of eruption disturbances arise during the transitional dentition period, which can be broadly classified as disturbances related to time and disturbances related to position. The occurrence of ectopic eruption is relatively common, but ectopically positioned tooth piercing the philtrum is a rare clinical presentation. This is a case report of a 70-year-old female who presented with the chief complaint of an abnormally positioned tooth piercing out from the upper lip to the Department of Oral and Maxillofacial Surgery, Karnavati School of Dentistry, Uvarsad, Gandhinagar, Gujarat, India. As per the patient's history, labially erupted tooth was piercing the philtrum for 60 years and it was visible extraorally from the philtrum and was painful. [ABSTRACT FROM AUTHOR]

Median cleft is the midline cleft of the lip. It develops due to incomplete or failed fusion of the median nasal prominence. It can present with minimal deformities such as involvement of the vermilion border, or complex clefting of the midline structures and brain. Median clefts are broadly classified as true and false clefts. This case report describes a rare case of median cleft of the upper lip involving the white roll, which was not associated with any other deformities. Treatment included reconstruction of the philtrum and the cupid’s bow while maintaining vermilion fullness and continuity, and minimizing scar formation. Various techniques have been advocated for treatment of this type of median upper lip cleft. Here we describe a technique using Pfeifer incision to correct our patient’s defect. Pfeifer incision consists of wavy lines and its use has been advocated for correction of various craniofacial abnormalities. Keywords: Median Cleft Lip; Hypertelorism; Craniofacial Abnormalities