An evaluation of dynamic lip-tooth characteristics during speech and smile in adolescents.

This retrospective study was conducted to measure lip-tooth characteristics of adolescents. Pretreatment video clips of 1242 consecutive patients were screened for Class-I skeletal and dental patterns. After all inclusion criteria were applied, the final sample consisted of 50 patients (27 boys, 23 girls) with a mean age of 12.5 years. The raw digital video stream of each patient was edited to select a single image frame representing the patient saying the syllable "chee" and a second single image representing the patient's posed social smile and saved as part of a 12-frame image sequence. Each animation image was analyzed using a SmileMesh computer application to measure the smile index (the ratio of the intercommissure width divided by the interlabial gap), intercommissure width (mm), interlabial gap (mm), percent incisor below the intercommissure line, and maximum incisor exposure (mm). The data were analyzed using SAS (version 8.1). All recorded differences in linear measures had to be > or = 2 mm. The results suggest that anterior tooth display at speech and smile should be recorded independently but evaluated as part of a dynamic range. Asking patients to say "cheese" and then smile is no longer a valid method to elicit the parameters of anterior tooth display. When planning the vertical positions of incisors during orthodontic treatment, the orthodontist should view the dynamics of anterior tooth display as a continuum delineated by the time points of rest, speech, posed social smile, and a Duchenne smile.