Cephalometric predictors of optimal facial soft-tissue profile in adult Asian subjects with Class II malocclusion treated via maxillary premolar extraction: A cross-sectional study.

Introduction: Class II malocclusion is most commonly treated using maxillary premolar extractions. The objective of this study was to predict cephalometric parameters associated with favorable facial soft-tissue profiles in adult Asian subjects with Class II malocclusion treated via maxillary premolar extractions.

Methods: A cross-sectional study was performed with 46 patients equally divided into favorable (FG) and unfavorable groups. The sample was divided on the basis of subjective and objective criteria. Subjectively, pretreatment and posttreatment facial silhouettes were shown to the panel of orthodontists to rate via the visual analog scale. Objectively, posttreatment soft-tissue cephalometric variables were taken. The sample receiving 60% visual analog scale and ideal posttreatment soft-tissue measurements were included in FG. Paired t test and independent t test were applied to determine the significant changes within and between both groups. To predict the cephalometric and occlusal variables associated with FG outcome, the Cox regression analysis was applied.

Results: On the evaluation of pretreatment cephalometric variables, the independent t test showed statistically significant differences for UI-NA (P = 0.42), Wits appraisal plane (0.010), upper lip to E-line (0.047), and interincisal angle (P = 0.049). Evaluation of the pretreatment occlusal variables the independent t test and chi-square test showed overjet (P = 0.018) and molar relationship (P = 0.045) to be statistically significant. The Cox regression analysis showed no cephalometric or occlusal variables to be statistically significant to predict the soft-tissue outcomes. A statistically significant strong correlation was also observed between the subjective and objective evaluation methods.

Conclusions: Cephalometric analysis may be more valuable as a diagnostic rather than a predictive tool for favorable soft-tissue outcomes.