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Comparative Evaluation of Soft-Tissue Profile Among Skeletal Class I, Class II and Class III Malocclusions Using Z-Angle, E-Line and Nasolabial Angle: A Retrospective Cephalometric Study


Authors : Dr. Mahesh Kumar Y.; Dr. Sharath Kumar Shetty; Dr. Priyanka Ann Kuruvilla

Volume/Issue : Volume 11 - 2026, Issue 9 - September


Google Scholar : https://tinyurl.com/7knwzeu5

DOI : https://doi.org/10.38124/ijisrt/26sep1200

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background: Assessment of the soft-tissue profile formed an important part of orthodontic diagnosis because changes in the underlying skeletal and dental structures were reflected, to varying degrees, in the facial appearance. Sagittal skeletal discrepancies were commonly accompanied by differences in lip prominence, facial convexity and the relationship between the nose, lips and chin. The Z-angle, Ricketts E-line and nasolabial angle provided simple cephalometric methods for evaluating these characteristics.  Aim: The study aimed to compare selected soft-tissue profile characteristics among skeletal Class I, Class II and Class III malocclusions using the Z-angle, upper and lower lip position relative to the E-line, and nasolabial angle.

Keywords : Cephalometry; Soft-Tissue Profile; Skeletal Malocclusion; Skeletal Class I; Skeletal Class II; Skeletal Class III; ZAngle; E-Line; Nasolabial Angle; Orthodontic Diagnosis.

References :

  1. Merrifield LL. The profile line as an aid in critically evaluating facial esthetics. Am J Orthod. 1966;52:804-822.
  2. Ricketts RM. Esthetics, environment, and the law of lip relation. Am J Orthod. 1968;54:272-289.
  3. Holdaway RA. A soft-tissue cephalometric analysis and its use in orthodontic treatment planning. Am J Orthod. 1983;84:1-28.
  4. Subtelny JD. A longitudinal study of soft tissue facial structures and their profile characteristics, defined in relation to underlying skeletal structures. Am J Orthod. 1959;45:481-507.
  5. Bishara SE, Hession TJ, Peterson LC. Longitudinal soft-tissue profile changes: a study of three analyses. Am J Orthod. 1985;88:209-223.
  6. Kasai K. Soft tissue adaptability to hard tissues in facial profiles. Am J Orthod Dentofacial Orthop. 1998;113:674-684.
  7. Tanic T, et al. The influence of antero-posterior dentoskeletal pattern on the value of nasal soft tissue angles: a cephalometric study. Folia Med. 2020.
  8. Otuyemi O, Afolabi DA, Oyewole T. Ricketts' E-line profile preferences among Nigerian orthodontists, orthodontic trainees, and a young undergraduate students' population. Niger J Clin Pract. 2022;25(4):541-547.
  9. Chaudhary S, et al. A retrospective study comparing nose, lip, and chin morphology in Class I, Class II, and Class III skeletal relationships in patients visiting to the Department of Orthodontics, BPKIHS: a cephalometric study. Int J Dent. 2022;2022:2252746.
  10. Correlation of the Upper Nasolabial Angle With Skeletal Patterns and Nasal Morphology in Indian Adults: An Observational Study. 2024.
  11. Comparison of Nasal Parameters and Correlation with Cephalometric Soft Tissue Parameters in Skeletal Class I, II and III. J World Fed Orthod. 2025;14(6):565. doi:10.1016/j.ejwf.2025.07.521.

Background: Assessment of the soft-tissue profile formed an important part of orthodontic diagnosis because changes in the underlying skeletal and dental structures were reflected, to varying degrees, in the facial appearance. Sagittal skeletal discrepancies were commonly accompanied by differences in lip prominence, facial convexity and the relationship between the nose, lips and chin. The Z-angle, Ricketts E-line and nasolabial angle provided simple cephalometric methods for evaluating these characteristics.  Aim: The study aimed to compare selected soft-tissue profile characteristics among skeletal Class I, Class II and Class III malocclusions using the Z-angle, upper and lower lip position relative to the E-line, and nasolabial angle.

Keywords : Cephalometry; Soft-Tissue Profile; Skeletal Malocclusion; Skeletal Class I; Skeletal Class II; Skeletal Class III; ZAngle; E-Line; Nasolabial Angle; Orthodontic Diagnosis.

Paper Submission Last Date
31 - October - 2026

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