Soft Tissue Profile Changes Resulting From Retraction of Maxillary Incisors

Abstract

Background: Facial esthetics play a vital role in orthodontic treatment planning, as the relationship between dental movement and soft-tissue adaptation determines overall facial harmony. Retraction of maxillary incisors, commonly performed after premolar extraction, is known to influence lip posture and nasolabial morphology. However, ethnic variations and limited prospective data on South Asian populations have restricted the generalizability of previous findings. Objective: To determine the changes in soft-tissue profile, specifically upper and lower lip positions relative to Ricketts’ E-line, following orthodontic retraction of maxillary incisors in Class II Division 1 malocclusion patients, and to assess whether these changes differ by age or gender. Methods: A prospective observational study was conducted among 200 patients aged 13–23 years with Class II Division 1 malocclusion treated at Sandeman Provincial Hospital, Quetta, Pakistan. All underwent extraction of maxillary first premolars and standardized anterior retraction with transpalatal arch anchorage. Lateral cephalograms were recorded pre- and post-retraction, and linear measurements from the E-line to upper (UL) and lower lips (LL) were analyzed using SPSS v23. Nonparametric tests compared pre- and post-treatment values, with significance set at p < 0.05. Results: Mean UL and LL positions decreased significantly from +2.19 ± 1.87 mm and +1.85 ± 0.12 mm pre-treatment to –2.03 ± 0.40 mm and –1.69 ± 0.20 mm post-treatment (p < 0.001). No statistically significant differences were observed across age (<18 vs ≥18 years) or gender groups (p > 0.68). Conclusion: Retraction of maxillary incisors significantly improves soft-tissue balance by reducing lip protrusion relative to the E-line, independent of patient age or gender. These results provide regionally relevant quantitative benchmarks for predicting facial esthetic outcomes in orthodontic treatment.