AbstractPurposeTo apply geometric morphometrics and multivariate statistics to evaluate changes of the face for female Chinese patients who underwent orthodontic treatment with different type of anchorage control.MethodsForty‐six adult female patients were enrolled including 33 four first premolar extraction cases (17 patients with mini‐implants for maximum anchorage control and 16 patients without mini‐implants) and 13 non‐extraction cases with minimum treatment duration of 15 months. Spatially dense correspondence was established among all the images The pre‐and post‐treatment average faces of the two extraction groups and the non‐extraction group were generated. Partial least squares regression was used to test the statistical significance of the effects of treatment for different anchorage choice.ResultsThe upper and lower lips were retruded significantly after treatment in the extraction groups. In the maximum anchorage control group, the temple and cheek were depressed by approximately 1 mm, and the zygomatic regions were increased in the mid‐face. However, these changes were not statistically significant. In comparison, no statistically significant facial changes occurred in the non‐extraction group.ConclusionsThe anchorage choice and the removal of four first premolar extraction influence lip shape as well as the perioral regions. However, extraction treatment does not impact the appearance of the cheeks and temples on a statistically level, as compared to orthodontic treatment without premolar extractions. Spatially dense geometric morphometric facilitates comprehensive treatment effect quantification and visualization on the full facial changes for improving orthodontic outcome evaluation.