Objective: To characterize symmetrical features of patients with facial asymmetry and thus to find the most reliable horizontal reference lines easily used in three-dimensional images. The hypothesis was that there is a difference in the location of bilateral landmarks of the upper skull between the normal occlusion sample and skeletal Class III patients with asymmetry.

Materials And Methods: Group 1 (normal occlusion sample) was composed of 20 Korean adults with normal occlusion and no noticeable asymmetry. Groups 2 through 4 were selected from patients who were diagnosed as skeletal Class III malocclusion and grouped according to the extent of asymmetry (group 2: symmetric mandible, no maxillary cant; group 3: asymmetric mandible, no maxillary cant; group 4: asymmetric mandible, more than 4 mm maxillary cant measured at maxillary first molars). Three-dimensional cone beam computed tomography images were taken before treatment, and bilateral landmarks of the skull were located and their vertical and horizontal differences compared.

Results: No statistically significant difference was noted in the position of bilateral landmarks between groups, except for AG (P < .05). AG showed significant differences in vertical dimension (P < .001) and in horizontal dimension (P < .0001) between groups. The mean of the difference was clearly greatest at FM.

Conclusions: The hypothesis is rejected. All groups had a similar pattern of asymmetry in the upper third of the face. Therefore, the transverse reference line of the bilateral Z or orbitale may be used even in patients with severe asymmetry of the maxilla with reference to the clinical photos.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8823123PMC
http://dx.doi.org/10.2319/102911-668.1DOI Listing

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