Face symmetry assessment abilities: Clinical implications for diagnosing asymmetry

Abstract

Introduction An accurate assessment of face symmetry is necessary for the development of a dentofacial diagnosis in orthodontics, and an understanding of individual differences in perception of face symmetry between patients and providers is needed to facilitate successful treatment. Methods Orthodontists, general dentists, and control participants completed a series of tasks to assess symmetry. Judgments were made on pairs of upright faces (similar to the longitudinal assessment of photographic patient records), inverted faces, and dot patterns. Participants completed questionnaires regarding clinical practice, education level, and self-confidence ratings for symmetry assessment abilities. Results Orthodontists showed expertise compared with controls (P <0.001), whereas dentists showed no advantage over controls. Orthodontists performed better than dentists, however, in only the most difficult face symmetry judgments (P = 0.006). For both orthodontists and dentists, accuracy increased significantly when assessing symmetry in upright vs inverted faces (t = 3.7, P = 0.001; t = 2.7, P = 0.02, respectively). Conclusions Orthodontists showed expertise in assessing face symmetry compared with both laypersons and general dentists, and they were more accurate when judging upright than inverted faces. When using accurate longitudinal photographic records to assess changing face symmetry, orthodontists are likely to be incorrect in less than 15% of cases, suggesting that assistance from some additional technology is infrequently needed for diagnosis.

Influence of occlusal plane inclination and mandibular deviation on esthetics

“…While dentists and orthodontists analyzed the smile more carefully, detailing problems such as buccal corridor and midline deviation, the attention of laypeople did not focus so much on the oral region, as they reported details of the face other than the teeth, such as earrings and eyes, in addition to subjective characteristics such as sympathy and happiness. According to Jackson et al, 21 orthodontists have a clear advantage in assessing facial symmetry when compared with laypeople, and an advantage over general clinical dentists in the most difficult cases.…”

Identifying Three-Dimensional Facial Fluctuating Asymmetry in Normal Pediatric Individuals: A Panel Assessment Outcome Study of Clinicians and Observers

“…From an ecology and evolutionary biology standpoint, perfect bilateral symmetry is defined as the optimal outcome of the development of bilateral traits in the absence of perturbations [1]. For human facial anthropometrics, perfect bilateral symmetry almost never exists, because random variations in asymmetry, within limits, have been recognized as normal and are called facial fluctuating asymmetry [2,3,4,5,6,7,8,9,10,11,12,13,14,15]. When facial asymmetry is clinically obvious (called facial asymmetric deformity, which is more commonly directional rather than fluctuating), surgical or nonsurgical treatment may be required [3,4,5].…”

“…For human facial anthropometrics, perfect bilateral symmetry almost never exists, because random variations in asymmetry, within limits, have been recognized as normal and are called facial fluctuating asymmetry [2,3,4,5,6,7,8,9,10,11,12,13,14,15]. When facial asymmetry is clinically obvious (called facial asymmetric deformity, which is more commonly directional rather than fluctuating), surgical or nonsurgical treatment may be required [3,4,5]. Since the restoration of symmetry is the main goal of facial asymmetric deformity reconstruction, establishing facial fluctuating asymmetry by specific ethnic and age groups is crucial as it may be adopted as a target of treatment as well as applied as normative data for genetics, orthodontics, and surgical disciplines [6,7,8,9,10,11].…”

Nonsurgical Correction of Facial Asymmetry and Occlusal Plane Cant in a Nongrowing Female: A Case Report

“…A comprehensive diagnosis is important in patients with facial asymmetry so as to formulate a treatment plan suited for each patient. [5,6] A clinician has to keep in consideration the treatment needs and desire of the patient before deriving the treatment plan for a case.…”