Ethnic differences in upper lip response to incisor retraction

Introduction: The purpose of this retrospective longitudinal study was to investigate the response of the upper lip to incisor retraction and to ascertain the effect of ethnicity on this response. Methods: Pretreatment and posttreatment lateral cephalograms of 88 postpubertal female patients (44 black and 44 white; mean age, 18.45 years) were evaluated. The groups were matched by age and the amount of incisor retraction at incisor superius. Results: Although significant pretreatment differences existed between the groups in some cephalometric measurements, analysis of the treatment changes demonstrated significant differences only in incisor inclination. Hard and soft tissue changes of the black group were more downward, whereas changes in the white group were more backward. Multivariate regression analysis showed that the horizontal response of the upper lip to hard tissue changes at subnasale and superior labial sulcus was different in whites than in blacks. At subnasale, stepwise multivariate regression analysis showed that ethnicity contributed to the upper lip response to incisor retraction and was significantly greater in the white group. Conclusions: The hard and soft tissue treatment changes of the black group were more downward, and those of the white group were more backward. Ethnic differences exist in the soft tissue response to hard tissue changes in the upper lip, and at subnasale and the superior labial sulcus; however, these response differences at superior labial sulcus can be explained by the ethnic differences in initial lip thickness and incisor inclination; they are not due in and of themselves to ethnicity. The change at prosthion was significantly correlated with the response of the upper lip at labrale superius to incisor retraction. Ethnicity added no increase to the predictability of the response. When incisor retraction was performed, the final horizontal upper lip position could be accurately and reliably predicted.