Association Between Soft Tissue Facial Profile and Dentoskeletal Changes in High-Angle Skeletal Class II Patients After Orthodontic Treatment: A Retrospective Cephalometric Study

Orthodontic treatment of high-angle skeletal Class II patients often leads to unsatisfactory facial profiles, highlighting the need to understand the relationship between dentoskeletal changes and soft tissue profile alterations. This retrospective study examined female Southern Chinese patients (n = 21, mean age 24.7 ± 4.8) with high-angle skeletal class II. Pre- and post-treatment lateral cephalograms were analysed for linear, angular, and proportional changes. Correlations between facial profile changes and dentoskeletal modifications were assessed using Pearson and Spearman’s coefficients. Results showed moderate correlations between changes in the facial angle with changes to the skeletal facial angle and skeletal Y-axis. A nearly perfect correlation was found between horizontal movements of the skeletal gnathion and changes in the nasolabial angle (r = 0.99, p < 0.001). Horizontal upper lip changes correlated with horizontal movements of upper (r = 0.70, p < 0.01) and lower incisors (r = 0.64, p < 0.01). No significant correlations were found between alterations to the incisors and changes in the facial angle or Y-axis. In conclusion, facial angle, Y-axis, and proportion changes relate closely to skeletal alterations but not to incisor positional changes, while lip changes correspond with incisor movements in high-angle skeletal Class II female patients. These findings are population-specific and require validation in male and other ethnic cohorts.