Facial and midfacial symmetry in cleft patients: Comparison to non-cleft children and influence of the primary treatment concept

Bouhjar, Nabil Ben; Kleinheinz, Johannes; Dirksen, Dieter; Berssenbrügge, Philipp; Runte, Christoph; Wermker, Kai

doi:10.1016/j.jcms.2019.01.041

Cited by 8 publications

(11 citation statements)

References 39 publications

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“…Significant improvements could only be demonstrated with the landmark-based 2D technique, showing a reduction in the affected/healthy side ratio of the distance from midline to lateral labial commissure, meaning the labial commissures were more symmetrical after treatment. However, 3D surface asymmetry quantification technology has also been successfully used to examine cleft lip and palate patients before and after treatment and to evaluate treatment success with different methods [91].…”

Section: Congenital Structural Asymmetries Of the Facementioning

confidence: 99%

Symmetry and Aesthetics in Dentistry

Runte

Dirksen

2021

Symmetry

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Animal bodies in general and faces in particular show mirror symmetry with respect to the median-sagittal plane, with exceptions rarely occurring. Bilateral symmetry to the median sagittal plane of the body also evolved very early. From an evolutionary point of view, it should therefore have fundamental advantages, e.g., more effective locomotion and chewing abilities. On the other hand, the recognition of bilaterally symmetric patterns is an important module in our visual perception. In particular, the recognition of faces with different spatial orientations and their identification is strongly related to the recognition of bilateral symmetry. Maxillofacial surgery and Dentistry affect effective masticatory function and perceived symmetry of the lower third of the face. Both disciplines have the ability to eliminate or mitigate asymmetries with respect to form and function. In our review, we will demonstrate symmetric structures from single teeth to the whole face. We will further describe different approaches to quantify cranial, facial and dental asymmetries by using either landmarks or 3D surface models. Severe facial asymmetries are usually caused by malformations such as hemifacial hyperplasia, injury or other diseases such as Noma or head and neck cancer. This could be an important sociobiological reason for a correlation between asymmetry and perceived disfigurement. The aim of our review is to show how facial symmetry and attractiveness are related and in what way dental and facial structures and the symmetry of their shape and color influence aesthetic perception. We will further demonstrate how modern technology can be used to improve symmetry in facial prostheses and maxillofacial surgery.

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Section: Congenital Structural Asymmetries Of the Facementioning

confidence: 99%

Symmetry and Aesthetics in Dentistry

Runte

Dirksen

2021

Symmetry

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“…[6][7][8][9][10] Since various factors can affect the FA phenotypes of cleft patients, it is necessary to adopt relatively strict criteria in the study design as follows: The ethnicity and age of subjects, the timing and methods of cheiloplasty, palatoplasty and alveolar bone grafting, and the methodology of orthodontic and orthopedic treatment should be identical to minimize the confounding effects; the subjects should have undergone OGS or distraction osteogenesis (DO) to ensure that they had real skeletal problems; analyzing asymmetry in the maxilla, maxillary dentition, mandibular dentition, and mandible is mandatory; and objective obtainment of the representative variables for cluster analysis using the principal components analysis (PCA) is necessary. [5][6][7][8][9][10][11] Ha et al 5 reported 5 FA phenotypes in noncleft class III patients who had undergone OGS as follows: nonasymmetry type (35.8%); maxillary-cant type (14.2%); mandibular-shift and yaw type (16.7%); complex type (9.2%); and maxillary reverse-cant type (24.2%). To the best knowledge of authors, no cluster analysis study has been conducted on the FA phenotypes of adult cleft patients, which confined the subjects and research methodology in terms of ethnicity, age, selection of representative cephalometric parameters, and completion of surgical orthodontic treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Since various factors can affect the FA phenotypes of cleft patients, it is necessary to adopt relatively strict criteria in the study design as follows: The ethnicity and age of subjects, the timing and methods of cheiloplasty, palatoplasty and alveolar bone grafting, and the methodology of orthodontic and orthopedic treatment should be identical to minimize the confounding effects; the subjects should have undergone OGS or distraction osteogenesis (DO) to ensure that they had real skeletal problems; analyzing asymmetry in the maxilla, maxillary dentition, mandibular dentition, and mandible is mandatory; and objective obtainment of the representative variables for cluster analysis using the principal components analysis (PCA) is necessary 5–11…”

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confidence: 99%

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Facial Asymmetry Phenotypes in Adult Patients With Unilateral Cleft Lip and Palate and Skeletal Class III Malocclusion Using Principal Component Analysis and Cluster Analysis

Hong

Kim

Yang

et al. 2023

Journal of Craniofacial Surgery

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incision to maximize the final cosmesis. With one hand on the mucosal side using the Boies elevator and the other hand in the external wound pocket using the Freer elevator, the fragment was bluntly grasped and rotated sideways, so as to place the concavity of the bone fragment face the mucosal surface. Due to the peculiarity of the fracture pattern, we underwent intraoperative fluoroscopy with an image intensifier to check for appropriate reduction. Anatomical reduction was confirmed. RESULTSPostoperative x-ray showed an anatomical reduction of the nasal bone. The patient was discharged on postoperative day 1. On a 3month follow-up CT and x-ray, the reduced fracture was well maintained in the proper position (Fig. 2 A and B). The preexisting puncture wound has almost faded away. The patient is being followed up to check on the proper growth of the nasal skeleton.

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“…Orofacial clefts involving cleft lip, alveolus and palate has been reported to constitute the most common congenital malformations affecting the craniofacial region among live births (Gorlin et al, 2001;Bouhjar et al, 2019;Jodeh et al, 2021). They are considered one of the most common birth defects that pose significant medical, psychological, social, and financial burden on the affected individuals and families (Mossey et al, 2009).…”

Section: Introductionmentioning

confidence: 99%