Each participant was seated upright while measurements were taken with a disposable 15 cm marked ruler. The GD over the maxillary right central incisor was measured using a specially manufactured millimeter ruler while the patient smiled the widest (Figure 1 a). The distance between the sub-nasal and the most inferior part of the lip at the midline in the resting position and in maximum smile was used to determine the MLLR and maxillary lip length at maximum smile (MLLS) (Figure 1 b,c). Measurements less than 20 mm were determined to be the short upper lip in the current study based on earlier data that stated the normal average lip length is 21.2 ± 2.4 mm to 23.4 ± 2.5 mm [22 (link),23 (link)]. Finally, the amount of translation of the inferior border of the lip from the rest position at maximal smile was used to measure lip mobility. Hypermobile lip was diagnosed whenever translation exceeded 6 mm [12 (link)]. The same calibrated periodontist took all measurements at the baseline, one-month, six months, and one-year post-surgical follow-up.
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