Губы, рот и область рта


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RESEARCHARTICLE
ElementsofMorphology:StandardTerminologyforthe
Lips,Mouth,andOralRegion
JohnC.Carey,
*M.MichaelCohenJr.,
CynthiaJ.R.Curry,
KoenraadDevriendt,
LewisB.Holmes,
andAlainVerloes
*Correspondenceto:
HowtoCitethisArticle:
CareyJC,CohenMMJr.,CurryCJR,
DevriendtK,HolmesLB,VerloesA.2009.
Elementsofmorphology:Standard
terminologyforthelips,mouth,andoral
2009Wiley-Liss,Inc.
                    
          
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skin,vermilionborder,vermilionandoralmucosa.Thenormal
FIG.1.Thisdrawingdepictsthemajoranatomiclandmarks
ofthelipsandmouth(seetext).
FIG.2.Thisdrawingdepictstheimportantfeaturesofthe
oralcavity(seetext).
CupidsBow,Absent
Denition
:Lackofparamedianpeaksandmediannotchofthe
upperlipvermilion(Fig.4).
Comment
:Thisbowisoftenabsentina
Thinvermilionofthe
upperlip
,butthatshouldbeassessedseparately.Thisndingis
commonlyassociatedwith
Smoothphiltrum
,butthatshouldbe
FIG.3.
Commissuralpit
.Thesearealwayslocatedatthe
samepositionatthecornersoftheoralaperture.
FIG.4.
AbsentCupidsbow
.Thisfeatureisoftenassociated
withathinvermilionoftheupperlipasinthischild.
FIG.5.
ExaggeratedCupidsbow
FIG.6.Frecklingofthevermilionofthelowerlip.
FIG.7.Typical
lippits
.Note:theseareusuallyjustlateralto
themidline.
Lip,thick:see
Vermilion,upperlip,thin
Lip,upperthin:see
Vermilion,upperlip,thin
Mouth,tented:see
Vermilion,upperlip,tented
Nasolabialcrease,hypoplastic:see
Nasolabialfold,
underdeveloped
Nasolabialcrease,prominent:see
Nasolabialfold,prominent
Nasolabialcrease,underdeveloped:see
Nasolabialfold,
underdeveloped
NasolabialFold,Prominent
Denition
:Exaggeratedbulkinessofthecreaseorfoldofskin
FIG.8.
Prominentnasolabialfold.
FIG.9.
Underdevelopednasolabialfold.
FIG.10.
Perioralhyperpigmentation.
FIG.11.
Evertedvermilionofthelowerlip
.Thedesignation
typicallythickerthantheupperone.Theheightofthevermilionof
FIG.12.
Thickvermilionofthelowerlip.
FIG.13.
Thinvermilionofthelowerlip
FIG.14.
Evertedvermilionoftheupperlip
FIG.15.
Tentedvermilionoftheupperlip
FIG.16.
Thickvermilionoftheupperlip
.Thisisthepreferred
designationratherthancoarseorfulllipsincethe
describedfeatureisthevermilionofthelip,notthelip
Comments
:Normalvaluesfortheheightofthevermilionare
available[Farkas,1981],butmeasurementsarenotcommonly
FIG.17.ThisguredisplaysthecommonlyusedLikertscale,1
5,thatrangesfromthe
Thickvermilionoftheupperlip
(1)to
Thinvermilion
;in
FIG.18.
Thinvermilionoftheupperlip
.Notethe
Cupidsbow
aswell.
FIG.19.
Fibroussyngnathia
.See
Oralsynechiae
aswell.
Mouth,DownturnedCornersof
Denition
:Oralcommissurespositionedinferiortothemidline
labialssure(Fig.21).
subjective
Comment
:Thisndingshouldbeassessedwiththemouth
closed,thelipsinrelaxedcontact,andthefacerelaxed.Thending
maybedifculttoassessifthelowerlipisenlarged.
Replaces
:Carpmouth;Fishmouth(pejorativeterms)
Mouth,sh:see
Mouth,downturnedcornersof
Mouth,Narrow
Denition
FIG.20.
Intra-oralhyperpigmentation.
FIG.21.
Downturnedcornersofthemouth
.Heretheoral
commissuresarepositionedinferiortothemidlinelabial
FIG.22.
Narrowmouth
FIG.23.
Upturnedcornersofthemouth
FIG.24.
Widemouth
.Thiswidthoftheoralaperturecanbe
easilymeasured.
accompanyaccessoryfrenula,buttheseshouldbeassessed
Synonyms
:Supernumeraryoralfrenulum;Extraoralfrenulum
Oralfrenulum,extra:see
Oralfrenulum,accessory
Oralfrenulum,supernumerary:see
Oralfrenulum,accessory
OralSynechia
Denition
FIG.25.
Accessoryoralfrenulum
ofthelower(A)andupper
lips(B)indifferentpatients.
FIG.26.
Oralsynechiae
.Notetheobviousbrousbands.
FIG.27.
U-shapedvermilionoftheupperlip
.Notethe
contourofthevermilionandtheshapeoftheoralaperture.
FIG.28.
Alveolarridgeovergrowth
.Notetheincreasedwidth
ofthealveolarridge.
Comment
:Theanteriorthirdofthetongueisusuallyfreeoris
partiallyattachedtotheoorofthemouthbythelingualfrenulum.
Thereisaspectrumrangingfromfusionofthetonguetotheoorof
themouth(ankyloglossiainferiorum)toalingualfrenulumthat
isshortoranchoredtowardthetipofthetongue(tonguetie).
Ankyloglossiamaybeassociatedwithamildindentationofthetip
ofthetongue,whichshouldnotbecodedasa
Bidtongue
Replaces
:Ankyloglossiainferiorum;tonguetie
Anodontia:see
Oligodontia
CentralIncisor,SingleMaxillary
Denition
:Presenceofonemaxillarycentralincisorpositionedin
themidline(Fig.30).
objective
Comment
:Ifasinglemaxillarycentralincisorispresent
butnotpositionedinthemidline,thiscouldbehypodontia
Ologodontia
),butthiscannotbeevaluatedwithouta
radiograph.
DentalCrowding
Denition
FIG.29.
.Notetheaccompanyingshort
lingualfrenulumandmildindentationofthetonguetip.
FIG.30.A
singlecentralmaxillaryincisor
.Thelateral
incisorsarenormalmakingtherecognitionofthisfeature
difcultonrstglance.
FIG.31.
Dentalcrowding
FIG.32.
.See
Eruption,Delayed
Denition
:Tootheruptionmorethan2SDbeyondthemean
eruptionage.
objective
Comment
:Thistermshouldnotbeusedinapatientwith
Gingivalovergrowth
.Thereareestablishednormsforthetiming
FIG.33.
Gingivalovergrowth
FIG.34.
.Notethetonguesposterior
placementintheoralcavityandthepresenceofthe
formula.(FigurecourtesyofBryanHall.)
FIG.35.Macrodontia.Thetoothwidthiseasilymeasured.
FIG.36.
:Thetermisnotdenedheresincethendingrequiresa
radiograph,asistrueforanodontiaandfortheotherdesignationof
toothagenesis,hypodontia.Thetermshypodontiaandoligodontia
FIG.37.
Openbite
FIG.38.
Shorthardpalate
.(FigurecourtesyofAlanRope.)
FIG.39.
Highpalate
.NoteaNarrowpalateisadifferent
featureandcanproducethefalseappearanceofahigh
Comments
FIG.40.Narrowpalate.Note
Prominentpalatineridges
FIG.41.
Submucouscleftpalate
.Notethe
Cleftuvula
theblueindentationofthesoftpalate.(Figurecourtesyof
RobertShprintzen.)
FIG.42.Prominentpalatineridges.Notethemoreobvious
softtissueridgesandfolds.
FIG.43.
Comments
:Widespacingcanbesecondarytoincreasedroom
byanunusuallylargedentalarch,microdontiaormixedprimary
andsecondarydentition.Itshouldbecarefullynotedthatslight
FIG.44.
Bidtongue
FIG.45.
Furrowedtongue
FIG.46.
Largetongue
FIG.47.
Lobulatedtongue
Tongue,Protruding
Denition
FIG.48.
Protrudingtongue
.Notethepositionofthetongue.
FIG.49.
Smalltongue
FIG.50.
Smoothtongue
.Notethesurfaceofthetonguein
thispatient.
FIG.51.
Nataltooth
.Notetheeruptionofthistoothinthis
newborninfant.
Tooth,Supernumerary
Denition
FIG.52.
Supernumerarytooth
.Notetheextracentralincisor
FIG.53.
Absentuvula
.(FigurecourtesyofRobert
FIG.54.
Broaduvula
.(FigurecourtesyofRobert
FIG.55.
Cleftuvula
.Oftencalledabiduvula,thisfeatureis
acomponentofa
submucouspalate
butiscommonasan
isolatedfeature.
FIG.56.
Longuvula
.Notetheuvulaisalsocleft.(Figure
courtesyofRobertShprintzen.)
thesoftpalate,thebaseofthetongue,andthehead.Therefore,
judgmentofchangeinlengthoftheuvuladependsheavilyonthe
experienceoftheobserver.
Uvula,Narrow
Denition
:Decreasedwidthoftheuvula(Fig.57).
subjective
Uvula,Short
Denition
:Decreasedlengthoftheuvula(Fig.58).
subjective
Comments
:Objectivemeasurementofthelengthoftheuvula
FIG.57.
Narrowuvula
.(FigurecourtesyofRobert
FIG.58.
Shortuvula
.(FigurecourtesyofRobert

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