Analysis of facial features and prediction of lip position in skeletal class III malocclusion adult patients undergoing surgical-orthodontic treatment



This study presents a retrospective study aimed to analyze the facial features at each stage of surgical-orthodontic treatment for skeletal class III malocclusion, and predict the changes in the lips after treatment.

Materials and methods

There were 49 skeletal class III malocclusion patients treated with bimaxillary surgery and orthodontic treatment enrolled in this study. Lateral cephalograms were obtained before treatment (T0), 1 month before surgery (T1), 1 month after surgery (T2), and after debonding (T3) for cephalometric measurements. After the measurement of the required variables, paired t-test, Pearson’s correlation analysis, and multiple linear regression were performed using SPSS 19.0.


The main factors associated with changes in the upper lip included ΔUIE-V, ΔA-V, ΔU1A-V, and ΔL1A-V, and those associated with changes in the lower lip included ΔLIE-V, ΔL1A-V, ΔB-V, ΔPog-V, and Δfacial angle. The predicted regression equation for the horizontal change in the upper lip was represented as ΔUL-vertical reference line (VRL) = 9.430 + 0.779 (ΔUIE-VRL) − 0.542(VULT) (P < 0.05) with a mean error of 1.04 mm; the corresponding equation for the lower lip was ΔLL-VRL = −1.670 + 0.530 (ΔB-VRL) + 0.360 (Ls-E) + 0.393 (ΔLIE-VRL) (P < 0.05), with a mean error of 1.51 mm.


This study explored the relationship between orthognathic surgery and changes in the lips and obtained the predictive equations of lip position after treatment by using multiple linear regression, which likely offers a reference for prediction of soft tissue changes before surgical-orthodontic treatment in patients with skeletal class III malocclusion.

Clinical relevance

The findings can help dentists to rapidly predict the lip changes after surgical-orthodontic treatment in patients with skeletal class III malocclusion. The study has been registered with the Chinese Clinical Trial Registration (No: ChiCTR1800017694).

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cone beam computed tomography


the horizontal reference line


intra-group correlation coefficient


labrale inferius


the root apex of the lower central incisor


the incisal edge of the lower central incisor


lower lip




Statistical Product and Service Solutions


the root apex of the upper central incisor


the incisal edge of the upper central incisor


upper lip


the vertical reference line


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This work was supported by grants from the National Natural Science Foundation of China (51672009), Beijing Municipal Natural Science Foundation (7172241), National Natural Science Founds for Outstanding Young Scholars of China (81922019), and National Youth Top-notch Talent Support Program (QNBJ2019-3).

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Correspondence to Yan Wei or Bing Han.

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Lu, W., Song, G., Sun, Q. et al. Analysis of facial features and prediction of lip position in skeletal class III malocclusion adult patients undergoing surgical-orthodontic treatment. Clin Oral Invest (2021).

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  • Skeletal class III malocclusion
  • Orthognathic surgery
  • Multiple linear regression
  • Cephalometric analyses
  • Lip morphology