{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T09:28:55Z","timestamp":1793784535038,"version":"4.6.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether initial lip asymmetry predicts long-term symmetry changes in patients with unilateral cleft lip and alveolus (UCLA) and to characterize patterns of region-specific morphic change relevant to orthodontic planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>University-based orthodontic clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Among 80 UCLA patients treated between 2008 and 2023, 42 with standardized frontal photographs at two treatment stages (before active orthodontic treatment [T1] and before comprehensive orthodontic treatment [T2]) under rest and smile conditions were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>\n                      Ten lip-related measures (7 linear distances, 3 angular variables) were obtained from frontal images, and left-to-right asymmetry was calculated as the difference between the noncleft and cleft sides (noncleft-cleft). Longitudinal change was defined as \u0394\u2009=\u2009T2 \u2212 T1. Paired\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      tests with effect sizes (Cohen's dz) and false discovery rate adjustment were used, and importance scores were used to visualize the combined magnitude and robustness of changes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall lip symmetry tended to improve from T1 to T2 in both rest and smile conditions. Measure 2 (peak of Cupid's bow to oral commissure distance) and Measure 6 (lower lip width) exhibited negative \u0394 values with moderate effect sizes (dz\u2009=\u20090.39-0.42) in unadjusted analyses. After adjustment for multiple comparisons, no comparisons remained statistically significant; however, effect-size patterns suggested consistent, moderate improvement in symmetry in regions around the Cupid's bow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Initial lip asymmetry influences long-term symmetry changes in UCLA patients. Quantitative assessment of region-specific symmetry changes may support interdisciplinary planning focused on individualized soft-tissue outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261444401","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:13:24Z","timestamp":1778562804000},"page":"4101-4109","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Initial Lip Asymmetry on Long-Term Lip Symmetry in Unilateral Cleft Lip and Alveolus Patients: An Orthodontic Perspective"],"prefix":"10.1177","volume":"63","author":[{"given":"Yusei","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0654-1521","authenticated-orcid":false,"given":"Takenobu","family":"Ishii","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiki","family":"Morikawa","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dai","family":"Ariizumi","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Narita","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-7865","authenticated-orcid":false,"given":"Akira","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruo","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Tokyo Dental College Chiba Dental Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3653-0348","authenticated-orcid":false,"given":"Tatsuya","family":"Ishigaki","sequence":"additional","affiliation":[{"name":"Chiba Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Nishii","sequence":"additional","affiliation":[{"name":"Tokyo Dental College"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1994_031_0116_tdeofa_2.3.co_2"},{"issue":"2","key":"e_1_3_3_3_2","first-page":"246","article-title":"Rotation-advancement principle in cleft lip closure","volume":"1","author":"Millard DR","year":"1964","unstructured":"Millard DRJr. Rotation-advancement principle in cleft lip closure. 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