Unsatisfactory profile changes (dishing in of the face or increase in facial fullness) have been common complaints after orthodontic treatment. Some have even blamed extraction of premolars without proper torque control of the anterior segments. Likewise, excessive expansion of the dental arch in the anterior-posterior direction will result in increased fullness of the lip and sticking of incisors. Careful planning and adequate communication with patients helps to reduce the chance of the complaints.
A review concluded that orthodontics does not affect facial profile adversely, whilst also highlighting areas where planning is crucial. Soft tissue changes also occur naturally with age, regardless of orthodontic intervention.Proper diagnosis should take account of skeletal form, tooth position, and soft tissue form so as to negate any detrimental effect on profile due to treatment mechanics. Ultimately, the patient’s expectation of the finished profile dictates the choice of treatment.