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Influence of orthodontic treatment modalities on nasolabial angle variations in skeletal Class II: a narrative review of the literature

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Abstract

Objective: The following narrative review aims to evaluate changes in the nasolabial angle in patients with skeletal Class II malocclusion treated with different orthodontic protocols.

Methods: A review of the scientific literature was conducted using PubMed, Scopus, and Google Scholar databases. Randomized clinical trials, prospective and retrospective studies, systematic reviews, and meta-analyses in English, without publication-date restrictions, were included.

Results: This narrative review highlighted variations in the nasolabial angle by treatment type. Removable functional appliances showed a greater increase in the angle than fixed functional appliances. Intraoral appliances, when used without skeletal anchorage, showed a slight reduction in the angle due to incisal proclination. Regarding extraoral appliances, however, there is still no significant scientific evidence in the literature about their effects on the nasolabial angle. Treatment with miniscrews, on the other hand, creates a more stable anchorage for maxillary molar distalization and therefore causes a marked increase in the nasolabial angle. Extraction treatment results in a greater increase in the nasolabial angle than in the non-extraction group. This increase is further accentuated when extraction treatment is combined with skeletal anchorage using miniscrews, attributable to greater incisor retrusion.

Conclusion: The nasolabial angle represents a key parameter to consider and, where possible, control in orthodontic planning to optimize the aesthetics of the facial profile. A proper treatment option should be evaluated individually to improve the facial profile.

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Authors

Brunilda Gashi Cenkoglu - Faculty of Dental Medicine, Department of Dentistry, Western Balkans University, Albania

Giorgio Gastaldi - Vita-Salute San Raffaele University, Milan, Italy, and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy

Sara Rossanò Milano - Vita-Salute San Raffaele University, Milan, Italy, and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy

Anna Volontè - Vita-Salute San Raffaele University, Milan, Italy, and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy

Alfredo De Rosa - Dipartimento di Scienze della Vita, della Salute e delle Professioni Sanitarie, Università Link Campus University, Roma, Italy

Andrea Boggio - Vita-Salute San Raffaele University, Milan, Italy, and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy

Dorian Kostandini - Faculty of Dental Medicine, Department of Dentistry, Western Balkans University, Albania

How to Cite
Gashi Cenkoglu, B., Gastaldi, G., Rossanò Milano, S., Volontè, A., De Rosa, A., Boggio, A., & Kostandini, D. (2026). Influence of orthodontic treatment modalities on nasolabial angle variations in skeletal Class II: a narrative review of the literature. Annali Di Stomatologia, 17(3), 711–721. https://doi.org/10.59987/ads/2026.3.711-721

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