A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic plane
Abstract Understanding age-related changes in the position of the upper lip relative to the esthetic plane (UL-EP) and lower lips relative to the esthetic plane (LL-EP) is crucial for optimizing aesthetic outcomes in orthodontic and orthognathic treatment. Previous studies often lack comprehensive a...
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Nature Portfolio
2025-04-01
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| Online Access: | https://doi.org/10.1038/s41598-025-98777-4 |
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| author | Xiaoqi Zhang Waseem AI-Gumaei Lu Xing Xiaoqian Zhang Minqi Li Hu Long Wenli Lai |
| author_facet | Xiaoqi Zhang Waseem AI-Gumaei Lu Xing Xiaoqian Zhang Minqi Li Hu Long Wenli Lai |
| author_sort | Xiaoqi Zhang |
| collection | DOAJ |
| description | Abstract Understanding age-related changes in the position of the upper lip relative to the esthetic plane (UL-EP) and lower lips relative to the esthetic plane (LL-EP) is crucial for optimizing aesthetic outcomes in orthodontic and orthognathic treatment. Previous studies often lack comprehensive adjustments for confounding factors and ignore the nonlinear relationships. This study addresses these issues by investigating age-related changes in upper and lower lip positions relative to the E-line. This cross-sectional study analyzed the lip positions of 2961 individuals (Age: 21.45 ± 7.43). Data were adjusted for confounding factors, including gender, dental, skeletal, and soft tissue parameters. Statistical methods, including Restricted Cubic Splines (RCS), multivariate regression, interaction analysis, and mediation analysis, were employed to identify age-related changes and their interactions. The findings indicate a significant decrease in both UL-EP and LL-EP distances with increasing age, following non-linear patterns of rapid decline, slight increase, and gradual decrease. Interaction analysis revealed significant interactions between age and variables such as gender, ANB, SN-MP, L1-MP, and overjet. The UL-EP decreases most rapidly in males with a Class III hypodivergent skeletal pattern and lingual inclination of lower incisors. In contrast, the LL-EP decreases most rapidly in patients with a Class III skeletal pattern and normal overjet. Mediation analysis suggests that age influences lip position through factors such as overjet, ANB, L1-MP, and Prn-Sn. These findings underscore the multi-phase, non-linear changes in lip position with age and highlight the critical role of age-specific considerations in orthodontic and orthognathic treatment planning. By identifying precisely when, where, and for whom these changes occur, clinicians can facilitate more individualized and effective outcomes. |
| format | Article |
| id | doaj-art-690de3aad178486a993d6748ace2b428 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-690de3aad178486a993d6748ace2b4282025-08-20T03:13:57ZengNature PortfolioScientific Reports2045-23222025-04-0115111210.1038/s41598-025-98777-4A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic planeXiaoqi Zhang0Waseem AI-Gumaei1Lu Xing2Xiaoqian Zhang3Minqi Li4Hu Long5Wenli Lai6State Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityYunnan Key Laboratory of Stomatology Affiliated Hospital of Stomatology School of Stomatology Kunming Medical UniversityDepartment of Bone Metabolism, School and Hospital of Stomatology, Cheeloo College of Medicine , Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesState Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityAbstract Understanding age-related changes in the position of the upper lip relative to the esthetic plane (UL-EP) and lower lips relative to the esthetic plane (LL-EP) is crucial for optimizing aesthetic outcomes in orthodontic and orthognathic treatment. Previous studies often lack comprehensive adjustments for confounding factors and ignore the nonlinear relationships. This study addresses these issues by investigating age-related changes in upper and lower lip positions relative to the E-line. This cross-sectional study analyzed the lip positions of 2961 individuals (Age: 21.45 ± 7.43). Data were adjusted for confounding factors, including gender, dental, skeletal, and soft tissue parameters. Statistical methods, including Restricted Cubic Splines (RCS), multivariate regression, interaction analysis, and mediation analysis, were employed to identify age-related changes and their interactions. The findings indicate a significant decrease in both UL-EP and LL-EP distances with increasing age, following non-linear patterns of rapid decline, slight increase, and gradual decrease. Interaction analysis revealed significant interactions between age and variables such as gender, ANB, SN-MP, L1-MP, and overjet. The UL-EP decreases most rapidly in males with a Class III hypodivergent skeletal pattern and lingual inclination of lower incisors. In contrast, the LL-EP decreases most rapidly in patients with a Class III skeletal pattern and normal overjet. Mediation analysis suggests that age influences lip position through factors such as overjet, ANB, L1-MP, and Prn-Sn. These findings underscore the multi-phase, non-linear changes in lip position with age and highlight the critical role of age-specific considerations in orthodontic and orthognathic treatment planning. By identifying precisely when, where, and for whom these changes occur, clinicians can facilitate more individualized and effective outcomes.https://doi.org/10.1038/s41598-025-98777-4E-lineEsthetic planeLipsFacial estheticsAgeCephalometric |
| spellingShingle | Xiaoqi Zhang Waseem AI-Gumaei Lu Xing Xiaoqian Zhang Minqi Li Hu Long Wenli Lai A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic plane Scientific Reports E-line Esthetic plane Lips Facial esthetics Age Cephalometric |
| title | A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic plane |
| title_full | A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic plane |
| title_fullStr | A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic plane |
| title_full_unstemmed | A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic plane |
| title_short | A cross-sectional study of age-related changes in the position of upper and lower lips relative to the esthetic plane |
| title_sort | cross sectional study of age related changes in the position of upper and lower lips relative to the esthetic plane |
| topic | E-line Esthetic plane Lips Facial esthetics Age Cephalometric |
| url | https://doi.org/10.1038/s41598-025-98777-4 |
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