{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:08:05Z","timestamp":1780078085651,"version":"3.54.0"},"reference-count":45,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background\/Objectives: Soft tissue profile plays a crucial role in orthodontic diagnosis and treatment planning. However, limited data exist regarding differences in facial soft tissue angles among adolescents with different classes of malocclusion. This study aimed to evaluate variations in soft tissue facial angles among patients with Angle Class I, II, and III malocclusions aged 12\u201316 years using profile photographs. Methods: This retrospective observational study included 489 patients (330 females and 159 males; mean age 13.69 \u00b1 1.30 years) examined between January 2008 and December 2018. 3D Slicer (Brigham and Women\u2019s Hospital, Boston, MA, USA) was used only for landmark positioning and coordinate extraction from 2D profile photographs. Five facial angles were measured: Nasion\u2013Nose tip\u2013Pogonion (Na-T-Pg), Glabella\u2013Subnasale\u2013Pogonion (Gl-Sn-Pg), Pogonion\u2013Nasion\u2013Upper lip (Pg-Na-Ls), Pogonion\u2013Nasion\u2013Lower lip (Pg-Na-Li), and Pogonion\u2013Subnasale\u2013Upper lip (Pg-Sn-Ls). Statistical analysis was performed using R software, including ANOVA and t-tests, with significance set at p &lt; 0.05. Results: Patients with Class III malocclusion demonstrated significantly higher mean values of the Na-T-Pg and Gl-Sn-Pg angles and lower values of the Pg-Na-Ls, Pg-Na-Li, and Pg-Sn-Ls angles compared with Class I and Class II malocclusions (p &lt; 0.05), indicating mandibular protrusion. Conversely, Class II malocclusion showed lower Na-T-Pg and Gl-Sn-Pg angles and higher Pg-Na-Ls, Pg-Na-Li, and Pg-Sn-Ls values, consistent with mandibular retrusion relative to the maxilla. No clinically significant sex-related differences were observed in most parameters. Conclusions: Significant differences in facial soft tissue angles exist among adolescents with different malocclusion classes. These findings highlight the importance of soft tissue analysis in orthodontic diagnosis and may support the development of artificial intelligence-based tools for automated malocclusion assessment and treatment planning.<\/jats:p>","DOI":"10.3390\/dj14060324","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:36:18Z","timestamp":1780076178000},"page":"324","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Facial Soft Tissue Angles in Adolescents with Angle Class I, II, and III Malocclusion Using Profile Image Analysis"],"prefix":"10.3390","volume":"14","author":[{"given":"Kristina","family":"Cernova","sequence":"first","affiliation":[{"name":"Private Practice \u201ciDental\u201d, LV-1001 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3983-315X","authenticated-orcid":false,"given":"Andris","family":"Abeltins","sequence":"additional","affiliation":[{"name":"Department of General Dentistry, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2443-9582","authenticated-orcid":false,"given":"Oskars","family":"Radzins","sequence":"additional","affiliation":[{"name":"Institute of Stomatology, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8353-4187","authenticated-orcid":false,"given":"Anda","family":"Slaidina","sequence":"additional","affiliation":[{"name":"Department of General Dentistry, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref_1","unstructured":"Farkas, L.G. (1994). Anthropometry of the Head and Face, Raven Press. [2nd ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.2319\/120715-833.1","article-title":"Reproducibility and Reliability of Three-Dimensional Soft Tissue Landmark Identification","volume":"86","author":"Baysal","year":"2016","journal-title":"Angle Orthod."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7751516","DOI":"10.1155\/2021\/7751516","article-title":"Extraction vs. Nonextraction on Soft-Tissue Profile Change in Patients with Malocclusion: A Systematic Review and Meta-Analysis","volume":"2021","author":"Moon","year":"2021","journal-title":"BioMed Res. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"48","DOI":"10.2319\/041513-291.1","article-title":"Longitudinal Study of Cephalometric Soft Tissue Profile Traits","volume":"84","author":"Bergman","year":"2014","journal-title":"Angle Orthod."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"301501","DOI":"10.1155\/2014\/301501","article-title":"Age Changes of Jaws and Soft Tissue Profile","volume":"2014","author":"Sharma","year":"2014","journal-title":"Sci. World J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0002-9416(69)80007-2","article-title":"A Statistical Evaluation of Nasal Growth","volume":"56","author":"Chaconas","year":"1969","journal-title":"Am. J. Orthod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1093\/ejo\/cjl104","article-title":"Changes of the Soft Tissue Profile During Growth","volume":"29","author":"Wisth","year":"2007","journal-title":"Eur. J. Orthod."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/0002-9416(59)90014-4","article-title":"A Longitudinal Study of Soft Tissue Facial Structures and Their Profile Characteristics, Defined in Relation to Underlying Skeletal Structures","volume":"45","author":"Subtelny","year":"1959","journal-title":"Am. J. Orthod."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/0002-9416(79)90162-3","article-title":"Vertical Growth of the Lips: A Serial Cephalometric Study","volume":"75","author":"Vig","year":"1979","journal-title":"Am. J. Orthod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1097\/PRS.0b013e31818820d8","article-title":"Single-Split Technique for Correction of Severe Facial Asymmetry","volume":"122","author":"Bergeron","year":"2008","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_11","first-page":"341","article-title":"Facial Assymetry: Etiology, Evaluation and Management","volume":"34","author":"Cheong","year":"2011","journal-title":"Chang Gung Med. J."},{"key":"ref_12","unstructured":"Enlow, D.H., and Hans, M.G. (2008). Handbook of Facial Growth, WB Saunders. [2nd ed.]."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e207","DOI":"10.1016\/j.ajodo.2020.10.016","article-title":"Does Age Influence Self-Perception of the Soft-Tissue Profile in Children?","volume":"159","author":"Varatharaju","year":"2021","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_14","first-page":"171","article-title":"The Prevalence of Facial Asymmetry in the Dentofacial Deformities Population at the University of North Carolina","volume":"12","author":"Proffit","year":"1997","journal-title":"Int. J. Adult Orthodon. Orthognath. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cenzato, N., Nobili, A., and Maspero, C. (2021). Prevalence of Dental Malocclusions in Different Geographical Areas. Dent. J., 9.","DOI":"10.3390\/dj9100117"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3109\/00016355509028164","article-title":"Adolescent Age Changes in Sagittal Jaw Relation","volume":"12","author":"Palling","year":"1955","journal-title":"Acta Odontol. Scand."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1037\/0735-7036.108.3.233","article-title":"Human Facial Attractiveness and Sexual Selection","volume":"108","author":"Grammer","year":"1994","journal-title":"J. Comp. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/BF02692202","article-title":"Criteria of Facial Attractiveness in Five Populations","volume":"4","author":"Jones","year":"1993","journal-title":"Hum. Nat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/0002-9416(85)90170-8","article-title":"The Influence of Dentofacial Appearance on the Social Attractiveness of Young Adults","volume":"87","author":"Shaw","year":"1985","journal-title":"Am. J. Orthod."},{"key":"ref_20","first-page":"66","article-title":"Surgical Correction of Masseter Muscle Hypertrophy Associated with Unilateral Prognathism: Report of case","volume":"15","author":"Eubanks","year":"1957","journal-title":"J. Oral Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S1073-8746(98)80014-5","article-title":"Development of Asymmetries","volume":"4","author":"Kronmiller","year":"1998","journal-title":"Semin. Orthod."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"647","DOI":"10.5005\/jp-journals-10024-2313","article-title":"Effectiveness of the American Board of Orthodontics Discrepency Index in Predicting Treatment Time","volume":"19","author":"Aljehani","year":"2018","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1093\/ejo\/cjab083","article-title":"The Validation of Orthodontic Artificial Intelligence Systems that Perform Orthodontic Diagnoses and Treatment Planning","volume":"44","author":"Shimizu","year":"2022","journal-title":"Eur. J. Orthod."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Albalawi, F., and Alamoud, K.A. (2022). Trends and Application of Artificial Intelligence Technology in Orthodontic Diagnosis and Treatment Planning\u2014A Review. Appl. Sci., 12.","DOI":"10.3390\/app122211864"},{"key":"ref_25","first-page":"227","article-title":"An Opening Chapter of the First Generation of Artificial Intelligence in Medicine","volume":"10","author":"Kulikowski","year":"2015","journal-title":"Med. Inform."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6999","DOI":"10.1109\/TNNLS.2021.3084827","article-title":"A Survey of Convolutional Neural Networks: Analysis, Applications, and Prospects","volume":"33","author":"Li","year":"2022","journal-title":"IEEE Trans. Neural Netw. Learn. Syst."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Liu, J., Zhang, C., and Shan, Z. (2023). Application of Artificial Intelligence in Orthodontics: Current state and Future Perspectives. Healthcare, 11.","DOI":"10.3390\/healthcare11202760"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tanikawa, C., Tan, T.J., and Takada, K. (2024). Facial Soft-Tissue Shape Changes after Fixed Edgewise Treatment with Premolar Extraction in Individual Artificial-Intelligence-Classified Facial Profile Patterns. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04512-2"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"105610","DOI":"10.1155\/2010\/105610","article-title":"Artificial Neural Network-Based System for PET Volume Segmentation","volume":"2010","author":"Sharif","year":"2010","journal-title":"Int. J. Biomed. Imaging"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.image.2016.05.007","article-title":"Deep Convolutional Neural Networks for Pedestrian Detection","volume":"47","author":"Monti","year":"2016","journal-title":"Signal Process. Image Commun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8828677","DOI":"10.1155\/2021\/8828677","article-title":"Application of Physical Examination Data on Health Analysis and Intelligent Diagnosis","volume":"2021","author":"Wang","year":"2021","journal-title":"BioMed. Res. Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/ocr.12517","article-title":"Artificial Intelligence in Orthodontics: Where are we now? A scoping Review","volume":"24","year":"2021","journal-title":"Orthod. Craniofac. Res."},{"key":"ref_33","first-page":"94","article-title":"Aesthetic Perception of Patient in Developmental Age in Interceptive Orthodontic Treatment","volume":"25","author":"Parisi","year":"2024","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Liu, L., Liu, Y., Guo, K., Ma, H., and Yang, F. (2025). Soft and Hard Tissue Changes after Compensatory Treatment in Skeletal Class III Malocclusion. PLoS ONE, 20.","DOI":"10.1371\/journal.pone.0322551"},{"key":"ref_35","unstructured":"(2026, May 18). Children in Latvia Collection of Statistics, Available online: https:\/\/admin.stat.gov.lv\/system\/files\/publication\/2024-08\/Nr_05_Berni_Latvija_2024_%2824_00%29_LV_EN.pdf."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1177\/00220345630420014701","article-title":"Variations in the Growth Pattern of the Human Mandible","volume":"42","year":"1963","journal-title":"J. Dent. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/0889-5406(92)70094-Q","article-title":"Facial Growth in Females 14 to 20 Years of Age","volume":"101","author":"Foley","year":"1992","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S0889-5406(97)80022-4","article-title":"Arch Width Changes from 6 Weeks to 45 Years","volume":"111","author":"Bishara","year":"1997","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_39","first-page":"806","article-title":"Spectrum and Management of Dentofacial Deformities in a Multiethnic Asian Population","volume":"76","author":"Chew","year":"2006","journal-title":"Angle Orthod."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"168.e1","DOI":"10.1016\/j.ajodo.2008.11.023","article-title":"Impact of Facial Asymmetry in Visual Perception: A 3-dimensional data analysis","volume":"137","author":"Alpers","year":"2010","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s40510-015-0106-9","article-title":"Facial Asymmetry Assessment in Adults Using 3D Imaging","volume":"16","author":"Patel","year":"2015","journal-title":"Prog. Orthod."},{"key":"ref_42","first-page":"177","article-title":"Growth Changes in the Soft Tissue Facial Profile","volume":"60","author":"Nanda","year":"1990","journal-title":"Angle Orthod."},{"key":"ref_43","first-page":"141","article-title":"An Assessment of Asymmetry in the Normal Craniofacial Complex","volume":"48","author":"Shah","year":"1978","journal-title":"Angle Orthod."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e523","DOI":"10.1016\/j.ajodo.2010.10.020","article-title":"Evaluating Craniofacial Asymmetry with Digital Cephalometric Images and Cone-beam Computed Tomography","volume":"139","author":"Hollender","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/ejo\/cjl037","article-title":"Visualizing Three-Dimensional Facial Soft-Tissue Changes Following Orthognathic Surgery","volume":"29","author":"Miller","year":"2007","journal-title":"Eur. J. Orthod."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/6\/324\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:57:54Z","timestamp":1780077474000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/6\/324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":45,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["dj14060324"],"URL":"https:\/\/doi.org\/10.3390\/dj14060324","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]}}}