{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T14:50:00Z","timestamp":1774536600157,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>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 \u00b1 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\u2019s 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 &lt; 0.001). Horizontal upper lip changes correlated with horizontal movements of upper (r = 0.70, p &lt; 0.01) and lower incisors (r = 0.64, p &lt; 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.<\/jats:p>","DOI":"10.3390\/bioengineering13040379","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:37:15Z","timestamp":1774532235000},"page":"379","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Soft Tissue Facial Profile and Dentoskeletal Changes in High-Angle Skeletal Class II Patients After Orthodontic Treatment: A Retrospective Cephalometric Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7761-8921","authenticated-orcid":false,"given":"Kay Shuen","family":"Chan","sequence":"first","affiliation":[{"name":"Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"},{"name":"College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China"},{"name":"National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1774-6186","authenticated-orcid":false,"given":"Zhiyi","family":"Shan","sequence":"additional","affiliation":[{"name":"Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","first-page":"75","article-title":"Vertical Growth Versus Anteroposterior Growth As Related To Function And Treatment","volume":"34","author":"Schudy","year":"1964","journal-title":"Angle Orthod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"186","DOI":"10.4041\/kjod.2017.47.3.186","article-title":"Impact of skeletal divergence on oral health-related quality of life and self-reported jaw function","volume":"47","author":"Antoun","year":"2017","journal-title":"Korean J. Orthod."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Xiao, C.-Q., Wan, Y.-D., Yan, Z.-B., Li, Y.-Q., Fan, P.-D., Cheng, Q.-Y., and Xin, X. (2022). Do Specific Craniomaxillofacial Features Correlate with Psychological Distress in Adult Pretreatment Orthodontic Patients? A Cephalometric Study. Dis. Markers, 9694413.","DOI":"10.1155\/2022\/9694413"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.bj.2019.05.009","article-title":"Investigate the oral health impact and quality of life on patients with malocclusion of different treatment needs","volume":"42","author":"Liu","year":"2019","journal-title":"Biomed. J."},{"key":"ref_5","first-page":"32","article-title":"Evaluation of masseter muscle morphology in different types of malocclusions using cone beam computed tomography","volume":"12","author":"Becht","year":"2014","journal-title":"Int. Orthod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/joor.70091","article-title":"Assessment of Orofacial Muscle Strength, Masticatory and Swallowing Function in Children Indicated for Orthodontic Treatment-A Preliminary Investigation","volume":"53","author":"Aldausari","year":"2026","journal-title":"J. Oral Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1053\/j.sodo.2013.07.002","article-title":"The Morphological Characteristics, Growth, and Etiology of the Hyperdivergent Phenotype","volume":"19","author":"Buschang","year":"2013","journal-title":"Semin. Orthod."},{"key":"ref_8","unstructured":"Proffit, W.R., Fields, H.W., Larson, B.E., and Sarver, D.M. (2018). Contemporary Orthodontics, Elsevier. [6th ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/0974909820130705S","article-title":"Comparative study of mandibular morphology in patients with hypodivergent and hyperdivergent growth patterns: A cephalometric study","volume":"47","author":"Gowda","year":"2013","journal-title":"J. Indian Orthod. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"630.e1","DOI":"10.1016\/j.joms.2019.11.023","article-title":"The Opinion of Different Observer Groups About the Esthetic Impact and Need for Surgical Correction of Varying Submental Lengths","volume":"78","author":"Naini","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ajodo.2020.09.030","article-title":"Influence of incisor inclination and anterior vertical facial height on facial attractiveness in an adult Asian male","volume":"161","author":"Ali","year":"2022","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/S0889-5406(95)70132-X","article-title":"The Probability Index","volume":"107","author":"Gramling","year":"1995","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_13","unstructured":"Manzo, P. (2025). Soft Tissue Paradigm in Orthodontics. Mosby\u2019s Orthodontic Review-E-Book, Elsevier."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1080\/27705781.2022.2120742","article-title":"Profile changes after class II treatment with twin force appliance in patients with different facial patterns","volume":"81","author":"Pedro","year":"2022","journal-title":"Clin. Investig. Orthod."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Booij, J.W., Serafin, M., Fastuca, R., Kuijpers-Jagtman, A.M., and Caprioglio, A. (2022). Skeletal, Dental and Soft Tissue Cephalometric Changes after Orthodontic Treatment of Dental Class II Malocclusion with Maxillary First Molar or First Premolar Extractions. J. Clin. Med., 11.","DOI":"10.3390\/jcm11113170"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1093\/ejo\/cjx003","article-title":"Short-term hard and soft tissue changes after mandibular advancement surgery in Class II patients: A retrospective cephalometric study","volume":"39","author":"Storms","year":"2017","journal-title":"Eur. J. Orthod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2519","DOI":"10.1038\/s41598-024-51322-1","article-title":"Three-dimensional analysis of hard and soft tissue changes in skeletal class II patients with high mandibular plane angle undergoing surgery","volume":"14","author":"Zhang","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lo, L.-J., Weng, J.-L., Ho, C.-T., and Lin, H.-H. (2018). Three-dimensional region-based study on the relationship between soft and hard tissue changes after orthognathic surgery in patients with prognathism. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0200589"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1095.e1","DOI":"10.1016\/j.joms.2018.01.005","article-title":"The influential bony factors and vectors for predicting soft tissue responses after orthognathic surgery in mandibular prognathism","volume":"76","author":"Han","year":"2018","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1007\/s00784-018-2609-5","article-title":"Changes in the facial soft-tissue profile after mandibular orthognathic surgery","volume":"23","author":"Rupperti","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jobcr.2018.07.003","article-title":"Soft tissue facial profile changes after orthodontic treatment with or without tooth extractions in Class I malocclusion patients: A comparative study","volume":"9","author":"Freitas","year":"2019","journal-title":"J. Oral Biol. Craniofac. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/ocr.12506","article-title":"Three-dimensional soft tissue changes in orthodontic extraction and non-extraction patients: A prospective study","volume":"24","author":"Rongo","year":"2021","journal-title":"Orthod. Craniofac. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1177\/14653125221093390","article-title":"Rejuvenation of the ageing face and the role of orthodontics: Guidelines for management","volume":"49","author":"Mavreas","year":"2022","journal-title":"J. Orthod."},{"key":"ref_24","first-page":"e231","article-title":"True vertical validation in facial orthognathic surgery planning","volume":"5","year":"2013","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4103\/jos.jos_174_21","article-title":"Factors that affect lip changes following incisor retraction in Vietnamese adults with a convex facial profile","volume":"11","author":"Le","year":"2022","journal-title":"J. Orthod. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/0002-9416(82)90187-7","article-title":"Changes in nasolabial angle related to maxillary incisor retraction","volume":"82","author":"Lo","year":"1982","journal-title":"Am. J. Orthod."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Eslami, N., Bardideh, E., Soltaninezhad, P., and Sadeghnezhad, P. (2025). Impact of orthodontic treatment on nasolabial fold: A systematic review and meta-analysis. Clin. Investig. Orthod., 1\u20139.","DOI":"10.1080\/27705781.2025.2600694"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Quinzi, V., Paskay, L.C., D\u2019Andrea, N., Albani, A., Monaco, A., and Saccomanno, S. (2021). Evaluation of the Nasolabial Angle in Orthodontic Diagnosis: A Systematic Review. Appl. Sci., 11.","DOI":"10.3390\/app11062531"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"852","DOI":"10.4067\/S0717-95022017000300009","article-title":"Upper and Lower Lip Soft Tissue Thicknesses Differ in Relation to Age and Sex","volume":"35","author":"Karaca","year":"2017","journal-title":"Int. J. Morphol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/eos.12409","article-title":"Soft tissue changes following extraction vs. nonextraction orthodontic fixed appliance treatment: A systematic review and meta-analysis","volume":"126","author":"Konstantonis","year":"2018","journal-title":"Eur. J. Oral Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"505","DOI":"10.2319\/030718-189.1","article-title":"Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars","volume":"89","author":"Nguyen","year":"2019","journal-title":"Angle Orthod."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2319\/010924-24.1","article-title":"Incidence of unexpected condylar displacement following comprehensive orthodontic treatment in adults","volume":"95","author":"Jang","year":"2025","journal-title":"Angle Orthod."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1016\/j.ijom.2018.05.022","article-title":"Soft tissue assessment before and after mandibular advancement or setback surgery using three-dimensional images: Systematic review and meta-analysis","volume":"47","author":"Lisboa","year":"2018","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"276","DOI":"10.4041\/kjod22.260","article-title":"Pattern of lip retraction according to the presence of lip incompetence in patients with Class II malocclusion","volume":"53","author":"Fang","year":"2023","journal-title":"Korean J. Orthod."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"101420","DOI":"10.1016\/j.jormas.2023.101420","article-title":"Facial soft tissue thickness measurement method and relationship with BMI, age and sex","volume":"124","author":"Piombino","year":"2023","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1044\/2015_JSLHR-S-14-0325","article-title":"Effects of age, sex, and body position on orofacial muscle tone in healthy adults","volume":"58","author":"Dietsch","year":"2015","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"8515","DOI":"10.1038\/s41598-019-44837-5","article-title":"Relationship between age, BMI, head posture and superficial neck muscle stiffness and elasticity in adult women","volume":"9","author":"Kocur","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.ajodo.2015.03.033","article-title":"Perioral soft tissue evaluation of skeletal Class II Division 1: A lateral cephalometric study","volume":"148","author":"Lee","year":"2015","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4103\/jos.jos_38_22","article-title":"Gender differences in lower facial soft tissue thickness among different skeletal patterns, based on soft tissue cephalometric analysis","volume":"11","author":"Alhumadi","year":"2022","journal-title":"J. Orthod. Sci."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/4\/379\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:51:10Z","timestamp":1774533070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/4\/379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["bioengineering13040379"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering13040379","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]}}}