Clinical Paper
Orthognathic Surgery
A comparison of craniofacial morphology in patients with and without facial asymmetry—a three-dimensional analysis with computed tomography

https://doi.org/10.1016/j.ijom.2005.04.006Get rights and content

Abstract

This study intended to evaluate the morphological characteristics of the cranial base and maxillomandibular structures of facial asymmetry in adult patients, so as to determine whether mandibular asymmetry is a result of primary mandibular deformity or if it is influenced by cranial base deformity.

Forty-two adult patients with dentofacial deformity were placed into two groups according to the deviation of the chin: Asymmetry group (n = 24) and Non-asymmetry group (n = 18). They were compared with three-dimensional (3D) CT reformatted images using a 3D visualization and analyzing program. The differences between the two groups, the correlation between the cranial base and maxillomandibular asymmetry were evaluated statistically.

The degree of cranial base asymmetry in the Asymmetry group was not statistically different from the Non-asymmetry group. The asymmetric condyle position was found to be associated with skull base characteristics. The 3D position of the condyle and cranial base, however, was not closely related with mandibular asymmetry. The results showed that the cranial measurement variables were not the dominant factors that determined the degree of facial asymmetry.

It seems that the mandibular skeletal factors itself, functional or intrinsic asymmetric growth potential, compensate or aggravate the influence of cranial asymmetry during the growth period.

Section snippets

Patients

The present study consisted of 42 adult patients (20 males, 22 females) with dentofacial deformity who had undergone a 3D CT scan for the purpose of presurgical evaluation at the Department of Oral and Maxillofacial Surgery, Kyungpook National University Hospital. The subjects were divided into two groups: Asymmetry group (n = 24, average age = 23.4) and Non-asymmetry group (n = 18, average age = 22.6). As the mandibular chin has the greatest effect in determining facial appearance15, facial asymmetry

Results

The errors of intra-observer precision were 1.4 mm, 1.0 mm, 1.3 mm for the x, y, and z coordinates, respectively, whereas it was 1.62° for the angular measurements and 1.7 mm for the linear measurements. There was no statistical difference detected between the original and repeated measurements.

Discussion

This study intended to quantify craniofacial morphology in adult patients who visited our clinic in order to correct their facial asymmetry. Relating factors of morphological deformity between the cranial and maxillomandibular structures in the three planes of space were investigated, which had not been thoroughly analyzed before. Previously, the morphological characteristics of an asymmetric face had been analyzed by two-dimensional (2D) radiographs. In the 3D study, measurements (distance,

Acknowledgment

This work was supported by a Grant from the Korea Research Foundation (KRF-2004-003-E00227).

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