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Design uses a multicenter observational study in New Zealand with participants aged ≥15. Method combines video-based expression recording and automated smile detection, with clinical scoring (Asher-McDade), myotonometry, and QoL/esthetics/personality questionnaires. Results show group-specific perioral mechanical differences and associations between nasolabial esthetics, scar elasticity, smile propensity, and smile-related QoL impacts.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/association-of-clinical-biomechanical-and-psychosocial-factors-with-smile-dynamics-in-unilateral-cleft-lip-a-multicenter-observational-study/438924/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/association-of-clinical-biomechanical-and-psychosocial-factors-with-smile-dynamics-in-unilateral-cleft-lip-a-multicenter-observational-study/438924.png","ImageObject",300,407,{"name":92,"@type":93},"Theodore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the study objective regarding smile dynamics in UCL±P?","Question",{"text":113,"@type":114},"To investigate the association between clinical, biomechanical, and psychosocial factors and smiling behavior in individuals with treated unilateral cleft lip with or without cleft palate, compared with non-cleft controls.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were smiles assessed in the study?",{"text":118,"@type":114},"Participants viewed an amusing video while facial expressions were recorded. Smile features were automatically detected with software, and clinical outcomes and esthetics were scored using the Asher-McDade system; perioral biomechanical properties were measured via myotonometry.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key findings about mechanical properties and smile-related outcomes?",{"text":122,"@type":114},"Participants with UCL±P showed higher stiffness and tone at the cleft scar site and altered elasticity adjacent to the scar. Nasolabial esthetics and scar elasticity correlated with smile duration and relative smile time, while UCL±P was linked to lower esthetics scores and greater impacts on smile-related quality of life in social contacts and dental self-confidence.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},438924,1790722442,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":36,"preview_page_count":4},7971461740886,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Original article  \nAssociation of Clinical, Biomechanical, and Psychosocial Factors with Smile Dynamics in Unilateral Cleft Lip: AMulticenter Observational Study  \nLucinda Wong, BDS, DClinDent 1, Fiona Firth, BDS, DClinDent 1, Peter Fowler, BDS, DClinDent, PhD 1 , Hannah Jack, BDS, DClinDent 1, Hamza Bennani, MS, PhD 1 , Thomas Noble Campbell, BDS 1, and Mauro Farella, DDS, Spec Ortho, PhD 1,2   \nThe Cleft Palate Craniofacial Journal 2026, Vol. 63(1) 49‐64  \n© 2024, American Cleft Palate Craniofacial Association  \nArticle reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/10556656241291649](DOI: 10.1177/10556656241291649)[ ](DOI: 10.1177/10556656241291649)[journals.sagepub.com/home/cpc](journals.sagepub.com/home/cpc)  \nAbstract  \nObjective: To investigate the association between clinical, biomechanical, and psychosocial factors and smiling behavior in individuals with treated unilateral cleft lip with or without cleft palate (UCL ± P) compared to non-cleft controls.  \nDesign: Multicenter observational study in New Zealand.  \nParticipants: Individuals aged ≥ 15 (N = 42) comprised 2 study groups: a UCL±P group (N = 21) and a non-cleft control group (N = 21).  \nMethods: Participants viewed an amusing video while their facial expressions were recorded. Smile features were automatically detected via software. A clinical outcome, nasolabial esthetics, was scored using the Asher-McDade system. Perioral biomechanical properties were measured via myotonometry. Smile Esthetics-related Quality of Life (SERQoL), Orofacial Esthetics Scale (OES), and personality (IPIP-NEO-60) questionnaires were completed.  \nResults: Smile features and personality traits did not differ between the groups. Participants with UCL± P exhibited higher stiffness (+44.2%; Cohen’s d = 1.6) and tone (+22.6%; Cohen’s d = 1.9) at the cleft scar site, and higher decrement (or lower elasticity,+8.5%; Cohen’s d = 0.8) adjacent to the scar. Nasolabial esthetics and elasticity of the scar correlated with the duration of smilesand relative smile time (−0.50\u003CR\u003C−0.44; p \u003C .05). Participants in the UCL± P group had lower scores for the OES and higher impacts on SERQoL for social contacts and dental self-confidence.  \nConclusions: Adolescents and adults with UCL± P exhibit similar smile behavior as their cleft-free peers—at least in non-social settings. Nasolabial esthetics and perioral biomechanical properties are associated with propensity to smile. UCL±P is negatively associated with smile-related quality of life and an individual’s perception of their facial appearance.  \nKeywords  \nartificial intelligence, assessment, cleft lip, lip function, orthodontics, quality of life, young adults, scarring  \nIntroduction  \nIndividuals with cleft lip and/or palate (CL/P) undergo a comprehensive treatment journey. The course of care varies greatly depending on the diagnosis, which can range from an isolated notch in the lip or uvula, through to a full separation of the lip and palate extending though alveolar bone and into the nasal cavity. Treatment requires a multidisciplinary approach involving both surgical and non-surgical interventions. While the primary goal is to restore orofacial function and appearance, in many cases it is unavoidable that certain remnants of the cleft, such as scar tissue and altered smile esthetics, may be visible even after treatment is complete, particularly when the lip is affected.  \nPeople with CL/P may face ongoing functional, esthetic, and psychosocial challenges.1–3 While overall psychological outcomes appear to be similar between children with CL/P and their non-cleft peers, symptoms such as anxiety and  \n1 Discipline of Orthodontics, Faculty of Dentistry, University of Otago, Dunedin, New Zealand  \n2 Department of Surgical Sciences, University of Cagliari, Cagliari, Italy  \nCorresponding Author:  \nMauro Farella, Discipline of Orthodontics, Sir John Walsh Research I","cbCaipvjMEfQqkcT","https://ap.wps.com/l/cbCaipvjMEfQqkcT","pdf",1787442,16,"English","# Abstract\n## Objective\n## Design\n## Participants\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What was the study objective regarding smile dynamics in UCL±P?\",\"answer\":\"To investigate the association between clinical, biomechanical, and psychosocial factors and smiling behavior in individuals with treated unilateral cleft lip with or without cleft palate, compared with non-cleft controls.\"},{\"question\":\"How were smiles assessed in the study?\",\"answer\":\"Participants viewed an amusing video while facial expressions were recorded. Smile features were automatically detected with software, and clinical outcomes and esthetics were scored using the Asher-McDade system; perioral biomechanical properties were measured via myotonometry.\"},{\"question\":\"What were the key findings about mechanical properties and smile-related outcomes?\",\"answer\":\"Participants with UCL±P showed higher stiffness and tone at the cleft scar site and altered elasticity adjacent to the scar. Nasolabial esthetics and scar elasticity correlated with smile duration and relative smile time, while UCL±P was linked to lower esthetics scores and greater impacts on smile-related quality of life in social contacts and dental self-confidence.\"}]","Association of Clinical, Biomechanical, and Psychosocial Factors with Smile Dynamics in Unilateral Cleft Lip: A Multicenter Observational Study | PDF",1790686888]