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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

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Smile frameworks defined by the patient's facial pattern: A cross-sectional study.

Laura Avilés-Arias¹, María Dolores Oteo-Calatayud¹, Carlos Oteo-Morilla²

¹Orthodontics Section, Department of Clinical Dental Specialties, School of Dentistry, Complutense University of Madrid, Madrid, Spain.

American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics

|June 27, 2026

Summary

Facial patterns significantly influence smile framework shapes. Dolichofacial patterns show elliptical frames, mesofacial show crescent shapes, and brachyfacial show flat frames, guiding orthodontic treatment.

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Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model

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Area of Science:

Dentistry
Orthodontics
Facial Morphology

Background:

Facial patterns, including brachyfacial, mesofacial, and dolichofacial types, are key considerations in orthodontics.
The smile framework, defined by lip contours during smiling, is influenced by underlying facial structures.

Purpose of the Study:

To investigate the association between distinct facial patterns and specific smile framework characteristics.
To determine how facial morphology influences the visual presentation of the smile.

Main Methods:

120 participants were categorized into brachyfacial, mesofacial, and dolichofacial groups using cephalometric analysis.
Smile and rest positions were evaluated for smile framework, interlabial distance, intercommissural distance, and incisor/gingival exposure.
Two-way analysis of variance assessed the impact of facial pattern and sex on outcome measures.

Main Results:

Distinct smile frameworks were identified for each facial pattern: elliptical/football-shaped (dolichofacial), shallow crescent-shaped (mesofacial), and flat (brachyfacial).
Dolichofacial patterns exhibited significantly greater vertical measurements (interlabial distance, gingival/incisor exposure) compared to other groups.
Brachyfacial patterns showed significantly greater horizontal measurements (intercommissural distance).
Sex did not significantly influence most measured outcomes across facial pattern groups.

Conclusions:

Patient facial patterns are intrinsically linked to specific smile frameworks, irrespective of sex.
These findings highlight the anatomical constraints that define smile aesthetics and inform orthodontic treatment planning.
Understanding these associations is crucial for achieving predictable and aesthetically pleasing orthodontic outcomes.