We investigated the frequency, site, amount, and direction of facial asymmetry in human adults with mandibular prognathism and examined if these characteristics were associated postnatally with cardinal clinical signs that may indicate a predisposition to facial asymmetry. Two hundred twenty young Japanese adults (69 men and 151 women) who exhibited skeletal Class III malocclusions were selected. The sample was divided into a Postnatal Factor Group and a Nonpostnatal Factor Group. The former group included those who had: (1) received orthodontic treatment using a chin cap; (2) exhibited clinical symptoms of temporomandibular joint (TMJ) disorder; (3) reported a history of maxillofacial trauma; or (4) radiographic abnormality of the condyles. Subjects with a deviation of more than 2 mm from the facial midline associated with any of the 4 landmarks (ANS, U1, L1 and Me) were classified as asymmetric and the asymmetry was measured on a postero-anterior (P-A) cephalogram. Radiographic facial asymmetry was found frequently (70%-85%, for Menton), and most obviously in the lower jaw (P < .05). Lateral displacement toward the left side of the face occurred more often than right-sided deviation (P < .001, for Menton). However, the Postnatal Factor Group showed a higher proportion of subjects with lateral deviation toward the right side (P = .0031) and a greater amount (P < .0001) of chin deviation. This was due to the fact that the subjects having TMJ problems as a postnatal factor showed no directional uniqueness in jaw deviation and exhibited a longer distance of deviation.

Facial Asymmetry in Subjects with Skeletal Class III Deformity

Facial asymmetry is common in humans. Significant facial asymmetry causes both functional as well as esthetic problems. When patients complain of facial asymmetry, the underlying cause should be investigated. The etiology includes congenital disorders, acquired diseases, and traumatic and developmental deformities. The causes of many cases of developmental facial asymmetry are indistinct. Assessment of facial asymmetry consists of a patient history, physical examination, and medical imaging. Medical imaging is helpful for objective diagnosis and measurement of the asymmetry, as well as for treatment planning. Components of soft tissue, dental and skeletal differences contributing to facial asymmetry are evaluated. Frequently dental malocclusion, canting of the occlusal level and midline shift are found. Management of facial asymmetry first aims at correcting the underlying disorder. Orthognathic surgery is performed for the treatment of facial asymmetry combined with dental occlusal problems. A symmetrical facial midline, harmonious facial profile and dental occlusion are obtained from treatment. Additional surgical procedures may be required to increase or reduce the volume of skeletal and soft tissue components on both sides to achieve better symmetry.

Facial asymmetry: etiology, evaluation, and management.

Craniofacial morphometry by photographic evaluations.

Occlusal cant in the frontal plane as a reflection of facial asymmetry

Morphological and positional asymmetries of young children with functional unilateral posterior crossbite.

No Available. From the Department of Orthodontics, Government Dental College and Hospital, Ahmedabad, Gujarat-India.

An assessment of asymmetry in the normal craniofacial complex.

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An assessment of asymmetry in the normal craniofacial complex.