Gender-based Comparison of Prediction Accuracy in Soft-tissue Cephalometric Variables Post Fixed-functional Appliance Therapy Using Dolphin VTO Software

Background Fixed-functional appliances (FFAs) are commonly used to correct skeletal Class II malocclusions in adolescents, enhancing mandibular growth and facial esthetics. Dolphin Imaging’s Visual Treatment Objective (VTO) module simulates soft tissue changes, but its predictive accuracy after FFA therapy remains uncertain, especially across sexes. Aim To evaluate and compare Dolphin VTO soft-tissue prediction accuracy between males and females following FFA treatment. Materials and Methods Lateral cephalograms from 40 Class II adolescents (20 males, 20 females) were analyzed. Predicted and actual post-treatment soft-tissue values were compared using paired and independent t -tests. Results Dolphin VTO predictions for soft-tissue changes post fixed-functional therapy had moderate accuracy, with the highest errors in angular parameters and areas involving vertical projection. Males had the greatest error in the H-angle, while females showed the largest discrepancy in the soft tissue facial angle (S.T. angle). A statistically significant gender difference was seen only in the S.T. angle ( P = .04), with females showing greater deviation. Other parameters showed no significant gender-based differences, though variability was slightly higher in females. Conclusion Dolphin VTO is generally accurate, but gender-specific discrepancies should be considered in treatment planning and monitoring soft tissue changes during and after FFA treatment to ensure that patients achieve their desired facial esthetics.