Posttreatment Growth and the Facial Profile in Orthodontic Patients

Most orthodontic patients begin treatment as young teenagers, so considerable facial growth occurs thereafter, extending at least into their 20s. Objectives: This study documented the growth, notably changes in the facial profile, from the end of comprehensive orthodontic treatment to the age of about 30 years. Methods: Patients (n=80) all were premolar-extraction cases and were recalled an average of 15 years out of treatment and assessed cephalometrically. A Cartesian coordinate system was used to partition changes in the skeletodental profile (7 variables) and integumental profile (10 variables) into horizontal and vertical components relative to Frankfort Horizontal with registration at Sella. Results: Facial growth was statistically significant in males in all dimensions, notably vertically, following treatment, but not so in females where growth vectors were much smaller. The profile grew differentially: The nose and chin grew forward much more than the upper face and lips. The lips, particularly the upper lip, grew forward at very modest rates, especially in women; relative to Sella, A Point, Labrale superius and inferius diminished ca. 0.5 mm in women while increasing about 2 mm in men. Conclusions: Growth flattened the profile in that the lips were more retrusive by early adulthood because the nose and chin grew forward much more. The situation was comparable in the two sexes because, while males were larger and grew more, the changes were proportionate in men and women. Consequently, it is more appropriate to treat adolescent patients to adolescent norms—which accounts for subsequent growth—rather than to adult standards.