A 27-year follow-up of soft tissue profile changes in Class II patients

Abstract

BackgroundThe study aimed at evaluating the long-term soft tissue profile changes in Class II division 1 growing patients treated with cervical headgear appliance without tooth extraction. MethodsLateral radiographs of 24 patients were analyzed at three different time points: pre-treatment (T1); post-treatment (T2); long-term post-treatment (T3) (mean follow-up period of 27 years). The following angles were evaluated: Nasolabial, Holdaway, Mentolabial, GPrPog and Soft Tissue Profile. The linear distances evaluated were: Upper Lip Thickness, Lower Lip Thickness, Upper Lip to E-plane, Lower Lip to E-plane, Nasal Prominence, Upper Lip Length, Lower Lip Length and Chin Thickness. In addition, cephalometric superimpositions were made to measure the distance between soft tissue landmarks over the study periods. ResultsA decrease in face convexity due to lip repositioning and mandibular development was found as a treatment result. Long-term follow-up showed substantial growth of the nose, increased labial vertical flaccidity and anterior residual growth of the chin. ConclusionsEarly interception of Class II malocclusion allowed reduction of facial profile convexity, but the labial hypotonia and continued growth of the chin and nose promoted a concave profile in the long term.