Evaluation of Facial Soft Tissue Inheritance in Patients with Angle’s Class II and Class III Malocclusion Compared with Angle’s Class I Malocclusion in Patients Undergoing Orthodontic Treatment in Central India

Background: Facial esthetics is a key determinant of orthodontic treatment outcomes and patient satisfaction. Although orthodontic correction primarily targets the dentoskeletal framework, post-treatment facial appearance is strongly influenced by soft-tissue morphology, which is partly governed by hereditary factors. Limited evidence exists on parent–offspring resemblance of facial soft tissues across different malocclusion patterns. Aim: To evaluate parent–offspring resemblance of facial soft-tissue characteristics across Angle’s Class I, Class II, and Class III malocclusions using standardized photogrammetric analysis. Materials and Methods: This cross-sectional observational study included 45 parent–offspring triads (father, mother, and offspring) aged 18–25 years for offspring and 40–55 years for parents, recruited from Central India. Participants were categorized into Angle’s Class I, II, or III malocclusion groups (n = 15 per group). Standardized frontal and profile facial photographs were obtained in natural head position. Linear, angular, and proportional soft-tissue parameters were identified using defined facial landmarks. Parent– offspring resemblance was assessed using correlation coefficients, and heritability was estimated using Falconer’s approximation (h² ≈ 2r). Statistical significance was set at p < 0.05. Results: Statistically significant parent–offspring correlations were observed for multiple soft-tissue parameters, with variation across malocclusion classes. Vertical facial proportions demonstrated stronger father–offspring correlations in Class I and Class II malocclusions, whereas lip prominence and chin-related parameters showed greater maternal resemblance in Class III malocclusion. Estimated heritability values varied across facial regions and malocclusion groups, indicating differential genetic influence on soft-tissue morphology. Conclusion: Facial soft-tissue characteristics exhibit measurable parent–offspring resemblance that differs across Angle’s malocclusion classes. These findings suggest that hereditary soft-tissue traits may influence facial esthetic outcomes following orthodontic treatment and should be considered during diagnosis and treatment planning.