BACKGROUND: There is a debate over the influence of sex on facial soft tissue physiognomies. Therefore, the present study used teleradiographs to assess and compare the soft tissue physiognomies between males and females in a sample from Saudi Arabia who have various orthodontic malocclusions.

MATERIAL AND METHODS: We obtained 221 lateral cephalometric radiographs taken from orthodontic clinics of patients ages 16–26 years (114 males and 107 females) living in the central and eastern regions of Saudi Arabia. OnyxCeph3TM digital software was used to analyze the dentoskeletal classification of the sample as class I (n=84), class II division 1 (n=42), class II division 2 (n=33), and class III (n=62). Burstone analysis of 6 linear measurements for facial soft tissue thickness (FSTT) was used. We used descriptive analysis and the independent-samples t test using SPSS version 25 for Windows (Chicago, IL) with p<0.05 set as the level of statistical significance.

RESULTS: Male patients with a class I dento-skeletal relationship showed thicker FSTT; the most significant thickness was seen near the glabella, followed by the upper/lower lip and sub-labiomental sulcus areas. Male patients with class II division 1 showed a substantial difference in FSTT at subnasal, lower lip, and sub-labiomental sulcus areas. No significant difference in FSTT was found between males and females among class II division 2 and class III patients.

CONCLUSIONS: These observations of significant changes in facial structures of Saudis between males and females should be of great help for diagnosis of orthodontic cases in Saudi adults.

Keywords: Cephalometry, Orthodontics, Radiography, Dual-Energy Scanned Projection, Adolescent, Anatomic Landmarks, Face, Lip, malocclusion, Malocclusion, Angle Class II, Radiography, Saudi Arabia, Sex Characteristics, young adult