Hard- and soft-tissue symmetry comparison in patients with Class III malocclusion

Duran, Gökhan Serhat; Di̇ndaroğlu, Furkan; Kutlu, Pınar

doi:10.1016/j.ajodo.2018.05.021

Cited by 26 publications

(17 citation statements)

References 35 publications

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“…Three-dimensional surface imaging provides a powerful tool to accurately capture and preserve the 3D form of the entire face. In this study, the chin was identified as the most asymmetric region and with relatively large individual variation among skeletal Class III patients, which is consistent with previous findings (1,16). This most likely results from positional displacement or morphological alteration of the mandible (17,22).…”

Section: Discussionsupporting

confidence: 91%

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Facial asymmetry assessment in skeletal Class III patients with spatially-dense geometric morphometrics

Fan

Chen

et al. 2021

European Journal of Orthodontics

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Summary Objective Quantification and visualization of the location and magnitude of facial asymmetry is important for diagnosis and treatment planning. The objective of this study was to analyze the asymmetric features of the face for skeletal Class III patients using spatially-dense geometric morphometrics. Methods Three-dimensional facial images were obtained for 86 skeletal Class III patients. About 7160 uniformly sampled quasi-landmarks were automatically identified on each face using template mapping technique. The pointwise surface-to-surface distance between original and mirror face was measured and visualized for the whole face after robust Procrustes superimposition. The degree of overall asymmetry in an individual was scored using a root-mean-squared-error. Automatic partitioning of the face was obtained, and the severity of the asymmetry compared among seven facial regions. Results Facial asymmetry was mainly located on, but not limited to, the lower two-thirds of the face in skeletal Class III patients. The lower cheek and nose asymmetry were detected to have more extensive and of a greater magnitude of asymmetry than other facial anatomical regions but with various individual variations. The overall facial asymmetry index and the regional facial asymmetry indices were higher in males and patients with chin deviation. Conclusions Soft tissue asymmetry is predominately presented in the lower-third of the face in skeletal Class III patients and with various variations on other facial anatomical regions. Morphometric techniques and computer intensive analysis have allowed sophisticated quantification and visualization of the pointwise asymmetry on the full face.

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Section: Discussionsupporting

confidence: 91%

“…The template face was partitioned into seven anatomical regions. The method used by Duran et al (16) was modified for the segmentation of the face. The landmarks that were used to partition the face were in Table 1.…”

Section: )Automatic Partitioning Of the Face And Asymmetry Evaluation Of Different Facial Regionsmentioning

confidence: 99%

Facial asymmetry assessment in skeletal Class III patients with spatially-dense geometric morphometrics

Fan

Chen

et al. 2021

European Journal of Orthodontics

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“…[5][6][7][8][9] One now obsolete approach for the study of asymmetry is the use of 2D radiography. [11][12][13][14] The studies that used CBCT analysis to evaluate skeletal and dental asymmetries in Class II subdivision patients also cannot agree on their results. Minich et al and Sanders et al found statistical skeletal and dental differences between the sides on patients with Class II subdivision malocclusion.…”

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confidence: 99%

A 3D mirroring and colormap asymmetry study of Class II subdivision patients

Apostolopoulos

Palomo

Rizzante

et al. 2021

Orthod Craniofacial Res

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On average, approximately 35% of the population in the United States has normal occlusion, while the rest has some degree of malocclusion. 1 Class II malocclusion is the second most common type of malocclusion present in the population after Class I malocclusion. The Class II subdivisions are characteristic by having a Class I relation on one side and a Class II relation on the other, clearly expressing an asymmetry. The Class II subdivision corresponds to 45%-50% of all Class II patients. 2,3 For objective esthetics, the pursuit of symmetry is ideal but it is a rare phenomenon in the general population. 4 Anthropologic and radiographic investigations have shown that it is more common than not to have skeletal and dental differences between the two sides of the craniofacial complex. [5][6][7][8][9][10]

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“…As residual facial asymmetry after OGS treatment may negatively impact patients' perceptions about outcome requiring further revisionary surgical interventions [16][17][18][19] , the significance of preoperative prediction of this deformity should not be underestimated 15,16,20 . Therefore, it is of paramount that an accurate diagnosis of asymmetry is accomplished preoperatively for that a precise surgical planning and execution is performed 7,15,16,20 .In this setting, OGS planning has evolved over the past decades 15-24 . Traditionally, OGS planning has been constructed on two-dimensional (2D) cephalometry, 2D photographic analysis, articulators, and dental models 21,22 .…”

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confidence: 99%

“…Comparative studies between 2D and 3D planning methods have also been published but with most of endpoints being established grounded on skeletal framework-based analysis [28][29][30][31][32][33] . However, the OGS-treated patients concerns are mainly centered on the facial soft tissue feature as it is the final response of bone movements and remodeling during postoperative follow up 15,17,19,20,27 . It is consequently fundamental that additional outcome studies are conducted by implementing a well-delineated methodology based on accurate quantitative and qualitative evaluation of facial soft tissue dimensions and comparisons between OGS-treated patients and normal individuals.…”

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confidence: 99%

Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery

Hsu

Denadai

Pai

et al. 2020

Sci Rep

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Computer-assisted 3D planning has overcome the limitations of conventional 2D planning-guided orthognathic surgery (OGS), but difference for facial contour asymmetry outcome has not been verified to date. This comparative study assessed the facial contour asymmetry outcome of consecutive patients with unilateral cleft lip and palate who underwent 2D planning (n = 37)-or 3D simulation (n = 38)-guided OGS treatment for correction of maxillary hypoplasia and skeletal Class III malocclusion between 2010 and 2018. Normal age-, gender-, and ethnicity-matched individuals (n = 60) were enrolled for comparative analyses. 2D (n = 60, with 30 images for each group) and 3D (n = 43, with 18 and 25 images for 2D planning and 3D simulation groups, respectively) photogrammetric-based facial contour asymmetry-related measurements were collected from patients and normal individuals. The facial asymmetry was further verified by using subjective perception of a panel composed of 6 blinded raters. On average, the facial contour asymmetry was significantly (all p < 0.05) reduced after 3D virtual surgery planning for all tested parameters, with no significant differences between post-OGS 3D simulation-related values and normal individuals. No significant differences were observed for pre-and post-OGS values in conventional 2D planning-based treatment, with significant (all p < 0.05) differences for all normal individuals-related comparisons. This study suggests that 3D planning presents superior facial contour asymmetry outcome than 2D planning.Orthognathic surgery (OGS) plays a key role for successful management of a myriad of facial deformities associated with malocclusion, with facial asymmetry feature being most frequently associated with skeletal class III malocclusion 1-3 . Particularly, patients with unilateral cleft lip and palate differ from the noncleft population, because they have a congenital orofacial defect compromising both the bone and soft tissues on the lesion side 4-6 , which may be expressed as facial asymmetry 7-15 . Skeletal mature patients with clefts frequently presents with maxillomandibular disharmony (maxillary hypoplasia and skeletal class III malocclusion) which requires OGS treatment 7-15 . As residual facial asymmetry after OGS treatment may negatively impact patients' perceptions about outcome requiring further revisionary surgical interventions [16][17][18][19] , the significance of preoperative prediction of this deformity should not be underestimated 15,16,20 . Therefore, it is of paramount that an accurate diagnosis of asymmetry is accomplished preoperatively for that a precise surgical planning and execution is performed 7,15,16,20 .In this setting, OGS planning has evolved over the past decades 15-24 . Traditionally, OGS planning has been constructed on two-dimensional (2D) cephalometry, 2D photographic analysis, articulators, and dental models 21,22 . However, this planning modality presents limitations for challenging clinical scenarios such as patients with clefts associated with malocclusion a...

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Hard- and soft-tissue symmetry comparison in patients with Class III malocclusion

Cited by 26 publications

References 35 publications

Facial asymmetry assessment in skeletal Class III patients with spatially-dense geometric morphometrics

Facial asymmetry assessment in skeletal Class III patients with spatially-dense geometric morphometrics

A 3D mirroring and colormap asymmetry study of Class II subdivision patients

Outcome of facial contour asymmetry after conventional two-dimensional versus computer-assisted three-dimensional planning in cleft orthognathic surgery

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