Changes in facial soft tissue support with and without a maxillary labial flange

To quantify facial esthetic outcomes of prosthetic upper lip support in both full animation and repose for patients with an existing implant-supported fixed complete dental prosthesis (ISFCDP).

Twenty patients had a removable prosthetic labial flange fabricated for their existing maxillary prosthesis. The 3dMDface system was used to capture video sets of each patient going from repose to high smile with and without the labial flange. A single frame representing high smile and repose was selected from each video. Five facial anatomic markers and 21 individual points on the upper lip were evaluated for both image sets using quantitative photometric analysis. To provide a qualitative assessment, the same images were shown to dentists, laypeople, and the research subjects (patients) to determine which they found to be more esthetically pleasing, or if there was no difference. Quantitative data was evaluated using paired t-tests.

The two-dimensional analysis showed a difference with and without a labial flange for lip projection and lip thickness. Additionally, 13 out of 21 landmarks in the three-dimensional analysis showed differences when comparing the superimposed labial flange and no flange linear difference values between high smile and repose. Survey results showed that research subjects (54.41%), dentists (51.50%), and laypeople (44.50%), all preferred labial flange versus no flange photos or were not able to tell a difference.

Qualitative and quantitative results suggest that a prosthetic labial flange has an impact on upper lip support. Clinicians should consider lip support both in full animation and repose when treatment planning for the maxillary ISFCDP.