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Three-dimensional geometric analysis of facial symmetry in skeletal class I individuals

Year 2024, Volume: 29 Issue: 2, 100 - 109, 29.05.2024
https://doi.org/10.21673/anadoluklin.1390504

Abstract

Aim: Our aim in this study is to determine anatomical points to detect asymmetry on both sides of the face, to make morphometric measurements according to age/sex, and to compare facial asymmetry index values according to sex.

Methods: Three-dimensional (3D) Computed Tomography (CT) images of 90 individuals of both sexes (45 female, 45 male) were included in our study. Morphometric measurements of the face were made using the 3D Slicer software package on these images. To evaluate facial asymmetry in more detail, measurements were made using 3D-CT, and asymmetry index values were calculated.

Results: When we analyzed according to sex, female right Condylion-Gonion-Menton angle (CoGoMe_Rˆ) values were statistically higher than males (p=0.049). There was no statistical difference between the asymmetry index values of males and females (p>0.05). According to the Pearson correlation test, a statistically weak positive correlation was found between age with CoGoMe_Rˆ, left Condylion-Gonion-Menton angle (CoGoMe_Lˆ) (in both r=0.228, p=0.031), and Condylion-Menton (CoMe) asymmetry (r=0.237, p=0.024). According to the Pearson correlation test, a statistically weak negative correlation was found between age and Condylion-Subspinale (CoSs) asymmetry (r=-0.209, p=0.048).

Conclusions: It is observed that the measurements around the mandible show more changes with age. In sex comparisons, although most of the facial morphometric measurements of males were significantly larger than those of females, no significant difference was found in the asymmetry index values.

Ethical Statement

The approval of the XXX University Non-Interventional Clinical Research Ethics Committee (Date: 02.03.2023, Approval Decision No: 2023/21) was obtained.

References

  • Ercan I, Ozdemir ST, Etoz A, et al. Facial asymmetry in young healthy subjects evaluated by statistical shape analysis. J Anat. 2008;213(6):663-9.
  • Maheshwari S, Verma SK, Gaur A, et al. Diagnosis and management of facial asymmetries. J Orthod Res. 2015;3:81-7.
  • Lum V, Goonewardene MS, Mian A, et al. Three-dimensional assessment of facial asymmetry using dense correspondence, symmetry, and midline analysis. Am J Orthod Dentofacial Orthop. 2020;158(1):134-46.
  • Matthews H, de Jong G, Maal T, et al. Static and motion facial analysis for craniofacial assessment and diagnosing diseases. Annu Rev Biomed Data Sci. 2022;5:19-42.
  • Thiesen G, Gribel BF, Freitas MP. Facial asymmetry: a current review. Dent Press J Orthod. 2015;20(6):110-25.
  • Alaşalvar F, Kocadereli İ. Ortodontide hasta-hekim ilişkisi ve hasta psikolojisi. Atatürk Üniv Diş Hekim Fak Derg. 2015;10:167-76.
  • Severt TR, Proffit WR. The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina. Int J Adult Orthod Orthognath Surg. 1997;12(3):171-6.
  • Haraguchi S, Takada K, Yasuda Y. Facial asymmetry in subjects with skeletal Class III deformity. Angle Orthod. 2002;72(1):28-35.
  • Westesson PL, Tallents RH, Katzberg RW, et al. Radiographic assessment of asymmetry of the mandible. Am J Neuroradiol. 1994;15(5):991-9.
  • Koldaş T, Hayırlıoğlu T, Keskin C, et al. Surgical treatment of mandibular laterognathism. J Istanbul Univ Fac Dent. 2013;29(2):89-93.
  • D’Ascanio L, Lancione C, Pompa G, et al. Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. Int J Pediatr Otorhinolaryngol. 2010;74(10):1180-3.
  • Ferrario VF, Sforza C, Ciusa V, et al. The effect of sex and age on facial asymmetry in healthy subjects: a cross-sectional study from adolescence to mid-adulthood. J Oral Maxillofac Surg. 2001;59(4):382-8.
  • Rajpara Y, Shyagali TR. An assessment of sexual dimorphism in relation to facial asymmetry in esthetically pleasing faces. Acta Inform Med. 2015;23(1):44-8.
  • Riedel RA. The relation of maxillary structures to cranium in malocclusion and in normal occlusion. Angle Orthod. 1952;22(3):142-5.
  • Steiner CC. Cephalometrics for you and me. Am J Orthod. 1953;39(10):729-55.
  • Kim SJ, Ahn HW, Hwang KJ, et al. Respiratory and sleep characteristics based on frequency distribution of craniofacial skeletal patterns in Korean adult patients with obstructive sleep apnea. PLoS One. 2020;15(7):e0236284.
  • Büyükçavuş MH, Kale B. Maksilla ile mandibulanın sagittal yön ilişkisini gösteren farklı sefalometrik parametrelerin karşılaştırılması. SDÜ Sağlık Bilimleri Derg. 2019;10(3):289-92.
  • Turley PK. Orthodontic management of the short face patient. Semin Orthod. 1996;2(2):138-53.
  • Gurlek Celik N, Akman B. Anatomical analysis of foramen magnum: A 3D Slicer CT study. Med Rec. 2023;5(Suppl 1):182-6.
  • Acer N, Arpacay BK, Gray SB, et al. Structural and functional changes in the brains of guitarist musicians: volumetric, VBM, and resting state fMRI study. J Clin Pract Res. 2024;46(1):47-57.
  • Akhil G, Senthil Kumar KP, Raja S, et al. Three-dimensional assessment of facial asymmetry: A systematic review. J Pharm Bioallied Sci. 2015;7(Suppl 2):S433-S7.
  • Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D Slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging. 2012;30(9):1323-41.
  • Ryckman MS, Harrison S, Oliver D, et al. Soft tissue changes after maxillomandibular advancement surgery assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2010;137(Suppl):S86-93.
  • Habets LLMH, Bezuur JN, Naeiji M, et al. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil. 1988;15:465-71.
  • Smith WM. Hemispheric and facial asymmetry: faces of academe. J Cogn Neurosci. 1998;10(6):663-7.
  • Coleman SR, Grover R. The anatomy of the aging face: Volume loss and changes in 3-dimensional topography. Aesthet Surg J. 2006;26(1S):S4-9.
  • Penke L, Bates TC, Gow AJ, et al. Symmetric faces are a sign of successful cognitive aging. Evol Hum Behav. 2009;30(6):429-37.
  • Freng A, Kvam E, Kramer J. Facial skeletal dimensions in patients with nasal septal deviation. Scand J Plast Reconstr Surg. 1988;22(1):77-81.
  • Yao F, Lawson W, Westreich RW. Effect of midfacial asymmetry on nasal axis deviation: indications for use of the subalar graft. Arch Facial Plast Surg. 2009;11(3):157-64.
  • Kim MY, Rha KS, Weissman JD, et al. Correlation of asymmetries facial growth with deviated nasal septum. Laryngoscope. 2011;121(6):1144-8.
  • Yi JS, Jang YJ. Frequency and characteristics of facial asymmetry in patients with deviated noses. JAMA Facial Plast Surg. 2015;17(4):265-9.
  • Linden OE, He JK, Morrison CS, et al. The relationship between age and facial asymmetry. Plast Reconstr Surg. 2018;142(5):1145-52.
  • Vleggaar D, Fitzgerald R. Dermatological implications of skeletal aging: a focus on supraperiosteal volumization for perioral rejuvenation. J Drugs Dermatol. 2008;7:209-20.
  • Fitzgerald R, Graivier MH, Kane M, et al. Update on facial aging. Aesthet Surg J. 2010;30(1):11S-24S.
  • Skomina Z, Verdenik M, Hren NI. Effect of aging and body characteristics on facial sexual dimorphism in the Caucasian population. PLoS One. 2020;15(5):e0231983.
  • D’Antò V, Pango Madariaga AC, Rongo R, et al. Distribution of the Condylion-Gonion-Menton (CoGoMe) angle in a population of patients from Southern Italy. Dent J (Basel). 2019;7(4):104.
  • Green H, Curnoe D. Sexual dimorphism in Southeast Asian crania: A geometric morphometric approach. Homo. 2009;60(6):517-34.
  • Bigoni L, Velemínská J, Bružek J. Three-dimensional geometric morphometric analysis of cranio-facial sexual dimorphism in a Central European sample of known sex. Homo. 2010;61(1):16-32.
  • Milella M, Franklin D, Belcastro MG, et al. Sexual differences in human cranial morphology: Is one sex more variable or one region more dimorphic? Anat Rec (Hoboken). 2021;304(12):2789-810.
  • Ferrario VF, Sforza C, Miani A, et al. Craniofacial morphometry by photographic evaluations. Am J Orthod Dentofacial Orthop. 1993;103(4):327-37.
  • Hodges-Simeon CR, Albert G, Richardson GB, et al. Was facial width-to-height ratio subject to sexual selection pressures? A life course approach. PLoS One. 2021;16(3):e0240284.
  • Butovskaya ML, Rostovtseva VV, Mezentseva AA. Facial and body sexual dimorphism are not interconnected in the Maasai. J Physiol Anthropol. 2022;41(1):3.
  • Toneva D, Nikolova S, Tasheva-Terzieva E, et al. A geometric morphometric study on sexual dimorphism in viscerocranium. Biology (Basel). 2022;11(9):1333.
  • Smith WM. Hemispheric and facial asymmetry: gender differences. Laterality. 2000;5(3):251-8.
  • Ferrario VF, Sforza C, Poggio CE, et al. Distance from symmetry: a three-dimensional evaluation of facial asymmetry. J Oral Maxillofac Surg. 1994;52(11):1126-32.
  • Peck S, Peck L, Kataja M. Skeletal asymmetry in esthetically pleasing faces. Angle Orthod. 1991;61(1):43-8.
  • Shaner DJ, Peterson AE, Beattie OB, et al. Assessment of soft tissue facial asymmetry in medically normal and syndrome-affected individuals by analysis of landmarks and measurements. Am J Med Genet. 2000;93(2):143-54.
  • Sajid M, Shafique T, Riaz I, et al. Facial asymmetry-based anthropometric differences between gender and ethnicity. Symmetry. 2018;10(7):232.
  • Huang CS, Liu XQ, Chen YR. Facial asymmetry index in normal young adults. Orthod Craniofac Res. 2013;16(2):97-104.
  • Blasi A, Nucera R, Ronsivalle V, et al. Asymmetry index for the photogrammetric assessment of facial asymmetry. Am J Orthod Dentofacial Orthop. 2022;162(3):394-402.
  • Nakamura T, Okamoto K, Maruyama T. Facial asymmetry in patients with cervicobrachial pain and headache. J Oral Rehabil. 2001;28(11):1009-14.

İskelet sınıf I bireylerde yüz simetrisinin üç boyutlu geometrik analizi

Year 2024, Volume: 29 Issue: 2, 100 - 109, 29.05.2024
https://doi.org/10.21673/anadoluklin.1390504

Abstract

Amaç: Bu çalışmadaki amacımız yüzün her iki tarafındaki asimetriyi tespit edebilmek için anatomik noktaları belirlemek, yaşa/cinsiyete göre morfometrik ölçümleri yapmak ve yüz asimetri indeks değerlerini cinsiyete göre karşılaştırmaktır.

Yöntemler: Çalışmamıza her iki cinsiyete ait 90 bireyin (45 kadın, 45 erkek) üç boyutlu (3D) Bilgisayarlı Tomografi (BT) görüntüleri dahil edilmiştir. Bu görüntüler üzerinden 3D Slicer yazılım paketi kullanarak yüzün morfometrik ölçümleri yapılmıştır. Yüz asimetrisinin daha ayrıntılı değerlendirilebilmesi için 3D-CT kullanılarak ölçümler yapıldı ve asimetri indeks değerleri hesaplandı.

Bulgular: Cinsiyete göre incelediğimizde, kadınların sağ Condylion-Gonion-Menton açı değerleri erkeklerden istatistiksel olarak yüksekti (p=0.049). Erkek ve kadınların asimetri indeks değerleri arasında istatistiksel olarak fark bulunmadı (p>0.05). Yaş ile sağ Condylion-Gonion-Menton açısı, sol Condylion-Gonion-Menton açısı (her ikisinde r=0.228, p=0.031) ve Condylion-Menton asimetrisi (r=0.237, p=0.024) arası Pearson korelasyon testine göre istatistiksel olarak anlamlı zayıf pozitif korelasyon bulundu. Yaş ile Condylion-Subspinale asimetrisi arası Pearson korelasyon testine göre istatistiksel olarak anlamlı zayıf negatif korelasyon bulundu (r=-0.209, p=0.048).

Sonuçlar: Mandibula etrafındaki ölçümlerin yaşla birlikte daha çok değişiklik gösterdiği gözlenmektedir. Cinsiyet karşılaştırmalarında ise, erkeklerin yüz bölgesindeki morfometrik ölçümlerinin birçoğu kadınlara göre anlamlı olarak büyük olmasının yanında asimetri indeks değerlerinde anlamlı fark bulunmadı.

References

  • Ercan I, Ozdemir ST, Etoz A, et al. Facial asymmetry in young healthy subjects evaluated by statistical shape analysis. J Anat. 2008;213(6):663-9.
  • Maheshwari S, Verma SK, Gaur A, et al. Diagnosis and management of facial asymmetries. J Orthod Res. 2015;3:81-7.
  • Lum V, Goonewardene MS, Mian A, et al. Three-dimensional assessment of facial asymmetry using dense correspondence, symmetry, and midline analysis. Am J Orthod Dentofacial Orthop. 2020;158(1):134-46.
  • Matthews H, de Jong G, Maal T, et al. Static and motion facial analysis for craniofacial assessment and diagnosing diseases. Annu Rev Biomed Data Sci. 2022;5:19-42.
  • Thiesen G, Gribel BF, Freitas MP. Facial asymmetry: a current review. Dent Press J Orthod. 2015;20(6):110-25.
  • Alaşalvar F, Kocadereli İ. Ortodontide hasta-hekim ilişkisi ve hasta psikolojisi. Atatürk Üniv Diş Hekim Fak Derg. 2015;10:167-76.
  • Severt TR, Proffit WR. The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina. Int J Adult Orthod Orthognath Surg. 1997;12(3):171-6.
  • Haraguchi S, Takada K, Yasuda Y. Facial asymmetry in subjects with skeletal Class III deformity. Angle Orthod. 2002;72(1):28-35.
  • Westesson PL, Tallents RH, Katzberg RW, et al. Radiographic assessment of asymmetry of the mandible. Am J Neuroradiol. 1994;15(5):991-9.
  • Koldaş T, Hayırlıoğlu T, Keskin C, et al. Surgical treatment of mandibular laterognathism. J Istanbul Univ Fac Dent. 2013;29(2):89-93.
  • D’Ascanio L, Lancione C, Pompa G, et al. Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. Int J Pediatr Otorhinolaryngol. 2010;74(10):1180-3.
  • Ferrario VF, Sforza C, Ciusa V, et al. The effect of sex and age on facial asymmetry in healthy subjects: a cross-sectional study from adolescence to mid-adulthood. J Oral Maxillofac Surg. 2001;59(4):382-8.
  • Rajpara Y, Shyagali TR. An assessment of sexual dimorphism in relation to facial asymmetry in esthetically pleasing faces. Acta Inform Med. 2015;23(1):44-8.
  • Riedel RA. The relation of maxillary structures to cranium in malocclusion and in normal occlusion. Angle Orthod. 1952;22(3):142-5.
  • Steiner CC. Cephalometrics for you and me. Am J Orthod. 1953;39(10):729-55.
  • Kim SJ, Ahn HW, Hwang KJ, et al. Respiratory and sleep characteristics based on frequency distribution of craniofacial skeletal patterns in Korean adult patients with obstructive sleep apnea. PLoS One. 2020;15(7):e0236284.
  • Büyükçavuş MH, Kale B. Maksilla ile mandibulanın sagittal yön ilişkisini gösteren farklı sefalometrik parametrelerin karşılaştırılması. SDÜ Sağlık Bilimleri Derg. 2019;10(3):289-92.
  • Turley PK. Orthodontic management of the short face patient. Semin Orthod. 1996;2(2):138-53.
  • Gurlek Celik N, Akman B. Anatomical analysis of foramen magnum: A 3D Slicer CT study. Med Rec. 2023;5(Suppl 1):182-6.
  • Acer N, Arpacay BK, Gray SB, et al. Structural and functional changes in the brains of guitarist musicians: volumetric, VBM, and resting state fMRI study. J Clin Pract Res. 2024;46(1):47-57.
  • Akhil G, Senthil Kumar KP, Raja S, et al. Three-dimensional assessment of facial asymmetry: A systematic review. J Pharm Bioallied Sci. 2015;7(Suppl 2):S433-S7.
  • Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D Slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging. 2012;30(9):1323-41.
  • Ryckman MS, Harrison S, Oliver D, et al. Soft tissue changes after maxillomandibular advancement surgery assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2010;137(Suppl):S86-93.
  • Habets LLMH, Bezuur JN, Naeiji M, et al. The orthopantomogram, an aid in diagnosis of temporomandibular joint problems. II. The vertical symmetry. J Oral Rehabil. 1988;15:465-71.
  • Smith WM. Hemispheric and facial asymmetry: faces of academe. J Cogn Neurosci. 1998;10(6):663-7.
  • Coleman SR, Grover R. The anatomy of the aging face: Volume loss and changes in 3-dimensional topography. Aesthet Surg J. 2006;26(1S):S4-9.
  • Penke L, Bates TC, Gow AJ, et al. Symmetric faces are a sign of successful cognitive aging. Evol Hum Behav. 2009;30(6):429-37.
  • Freng A, Kvam E, Kramer J. Facial skeletal dimensions in patients with nasal septal deviation. Scand J Plast Reconstr Surg. 1988;22(1):77-81.
  • Yao F, Lawson W, Westreich RW. Effect of midfacial asymmetry on nasal axis deviation: indications for use of the subalar graft. Arch Facial Plast Surg. 2009;11(3):157-64.
  • Kim MY, Rha KS, Weissman JD, et al. Correlation of asymmetries facial growth with deviated nasal septum. Laryngoscope. 2011;121(6):1144-8.
  • Yi JS, Jang YJ. Frequency and characteristics of facial asymmetry in patients with deviated noses. JAMA Facial Plast Surg. 2015;17(4):265-9.
  • Linden OE, He JK, Morrison CS, et al. The relationship between age and facial asymmetry. Plast Reconstr Surg. 2018;142(5):1145-52.
  • Vleggaar D, Fitzgerald R. Dermatological implications of skeletal aging: a focus on supraperiosteal volumization for perioral rejuvenation. J Drugs Dermatol. 2008;7:209-20.
  • Fitzgerald R, Graivier MH, Kane M, et al. Update on facial aging. Aesthet Surg J. 2010;30(1):11S-24S.
  • Skomina Z, Verdenik M, Hren NI. Effect of aging and body characteristics on facial sexual dimorphism in the Caucasian population. PLoS One. 2020;15(5):e0231983.
  • D’Antò V, Pango Madariaga AC, Rongo R, et al. Distribution of the Condylion-Gonion-Menton (CoGoMe) angle in a population of patients from Southern Italy. Dent J (Basel). 2019;7(4):104.
  • Green H, Curnoe D. Sexual dimorphism in Southeast Asian crania: A geometric morphometric approach. Homo. 2009;60(6):517-34.
  • Bigoni L, Velemínská J, Bružek J. Three-dimensional geometric morphometric analysis of cranio-facial sexual dimorphism in a Central European sample of known sex. Homo. 2010;61(1):16-32.
  • Milella M, Franklin D, Belcastro MG, et al. Sexual differences in human cranial morphology: Is one sex more variable or one region more dimorphic? Anat Rec (Hoboken). 2021;304(12):2789-810.
  • Ferrario VF, Sforza C, Miani A, et al. Craniofacial morphometry by photographic evaluations. Am J Orthod Dentofacial Orthop. 1993;103(4):327-37.
  • Hodges-Simeon CR, Albert G, Richardson GB, et al. Was facial width-to-height ratio subject to sexual selection pressures? A life course approach. PLoS One. 2021;16(3):e0240284.
  • Butovskaya ML, Rostovtseva VV, Mezentseva AA. Facial and body sexual dimorphism are not interconnected in the Maasai. J Physiol Anthropol. 2022;41(1):3.
  • Toneva D, Nikolova S, Tasheva-Terzieva E, et al. A geometric morphometric study on sexual dimorphism in viscerocranium. Biology (Basel). 2022;11(9):1333.
  • Smith WM. Hemispheric and facial asymmetry: gender differences. Laterality. 2000;5(3):251-8.
  • Ferrario VF, Sforza C, Poggio CE, et al. Distance from symmetry: a three-dimensional evaluation of facial asymmetry. J Oral Maxillofac Surg. 1994;52(11):1126-32.
  • Peck S, Peck L, Kataja M. Skeletal asymmetry in esthetically pleasing faces. Angle Orthod. 1991;61(1):43-8.
  • Shaner DJ, Peterson AE, Beattie OB, et al. Assessment of soft tissue facial asymmetry in medically normal and syndrome-affected individuals by analysis of landmarks and measurements. Am J Med Genet. 2000;93(2):143-54.
  • Sajid M, Shafique T, Riaz I, et al. Facial asymmetry-based anthropometric differences between gender and ethnicity. Symmetry. 2018;10(7):232.
  • Huang CS, Liu XQ, Chen YR. Facial asymmetry index in normal young adults. Orthod Craniofac Res. 2013;16(2):97-104.
  • Blasi A, Nucera R, Ronsivalle V, et al. Asymmetry index for the photogrammetric assessment of facial asymmetry. Am J Orthod Dentofacial Orthop. 2022;162(3):394-402.
  • Nakamura T, Okamoto K, Maruyama T. Facial asymmetry in patients with cervicobrachial pain and headache. J Oral Rehabil. 2001;28(11):1009-14.
There are 51 citations in total.

Details

Primary Language English
Subjects Radiology and Organ Imaging
Journal Section ORIGINAL ARTICLE
Authors

Nihal Gürlek Çelik 0000-0002-1204-2668

Burcu Akman 0000-0002-1067-9008

Rabia Koca 0000-0002-9052-3002

Publication Date May 29, 2024
Submission Date November 14, 2023
Acceptance Date March 11, 2024
Published in Issue Year 2024 Volume: 29 Issue: 2

Cite

Vancouver Gürlek Çelik N, Akman B, Koca R. Three-dimensional geometric analysis of facial symmetry in skeletal class I individuals. Anatolian Clin. 2024;29(2):100-9.

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