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

Background: The 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.Methods: Lateral radiographs of 24 patients were analyzed at three different time points: pre-treatment (T1); posttreatment (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.Results: A 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.Conclusions: Early 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.