Bone morphology differences between displaced and contralateral side in patients with facial asymmetry: 3D-CT study

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DOI:

https://doi.org/10.21615/cesodon.33.2.3

Keywords:

facial asymmetry, face morphology, X-Ray computed axial tomography, anatomy

Abstract

Introduction and objetive: Facial asymmetries are a frequent esthetic and functional problem.To describe the craniofacial morphologic variability, in patients with facial asymmetry. Materials and methods: 53 patients (23 men and 30 women) with facial asymmetry were studied using 3D computed axial tomography reconstruction. The long side, exhibiting the asymmetry, and the contralateral side (shorter side presen­ting mandibular deviation), were compared in frontal and sagittal planes. Results: Five kinds of facial asymmetry were identified: Hemimandibular elongation (HE, n = 26; 49%) Hemimandibular hyperplasia (n = 4; 7.5%), asymmetric mandibular prog­nathism (PMA, n = 14; 25.4%), glenoid fossa asymmetry (n = 2; 3.8%) and functional laterognathism. (n = 7; 13,2%). 64.1% cases had left side mandibular deviation. In the frontal plane the distance from the mid-sagittal plane to malar, yugal and gonion point was higher in the contralateral side (p<0.05). In the sagittal plane mandibular ramus width was higher in the displaced side (p<0.05) and mandibular body length was higher in the contralateral side (p<0.001). Regarding the two most prevalent groups (HE and AMP), the presence of a symphysis deviation > 5.1mm is associated to higher probability of having HE [OR: 4.05, CI 95%: 1.02-16.0]. Conclusion: Patients with facial asymmetry present craniofacial morphological side differences in the frontal and sagittal planes, useful to identify different entities that cause this alteration.

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References

Peck S, Peck L, Kataia M. Skeletal asymmetry in esthetically pleasing faces. Angle Orthod 1991; 61:43-48.

Kawamoto HK, Kim SS, Jarrahy R, Bradley JP. Differential diagnosis of the idio¬pathic laterally deviated mandible. Plast Reconstr Surg 2009;124:1599–15609.

Wang TT, Wessels L, Hussain G, Merten S. Discriminative thresholds in facial asymmetry: a review of the literature. Aesthetic Surg J 2017; 37: 375–385.

Kantomaa T. The shape of the glenoid fossa affects the growth of the mandible. Eur J Orthod 1988; 10: 249–254.

Woodside DG, Metaxas A, Altuna G. The influence of functional appliance therapy on glenoid fossa remodeling. Am J Orthod Dentofac Orthop 1987;92: 181-98.

Sejrsen B, Jakobsen J, Skovgaard LT, Kjaer I. Growth in the external cranial base evaluated on human dry skulls, using nerve canal openings as references. Acta Odontol Scand 1997; 55:356-364.

Minoux M, Rijli FM. Molecular mechanisms of cranial neural crest cell migration and patterning in craniofacial development. Development 2010; 137:2605-2621.

Kim JY, Jung HD, Jung YS, Hwang CJ, Park HS. A simple classification of facial asymmetry by TML system. J Craniomaxillofac Surg 2014;42:313-320.

Hwang HS, Youn IS, Lee KH, Lim HJ. Classification of facial asymmetry by cluster analysis. Am J Orthod Dentofac Orthop 2007;132:279.e1-6.

López DF, Botero JR, Muñoz JM, Cárdenas RA. Are There Mandibular Morpho¬logical Differences in the Various Facial Asymmetry Etiologies? A Tomographic Three-Dimensional Reconstruction Study. J Oral Maxillofac Surg 2019;77:2324- 2338.

Rodrigues AF, Fraga MR, Vitral RW. Computed tomography evaluation of the tem¬poromandibular joint in Class II Division 1 and Class III malocclusion patients: Condylar symmetry and condyle-fossa relationship. Am J Orthod Dentofac Or¬thop 2009; 136:199-206.

Wolford LM, Movahed R, Perez DE. A classification system for conditions causing condylar hyperplasia. J Oral Maxillofac Surg 2014;72 (3):567-595.

Nelke KH, Pawlak W, Morawska-Kochman M, Łuczak K. Ten Years of Observations and Demographics of Hemimandibular Hyperplasia and Elongation. Journal Cra¬nio-Maxillofacial Surg 2018;46:979-986.

Raijmakers P, Karssemakers L, Tuinzing D. Female predominance and effect of gender on unilateral condylar hyperplasia: A review and meta-analysis. J Oral Maxillofac Surg 2012;70 e72–e76.

López DF, Corral CM. Comparison of planar bone scintigraphy and single photon emission computed tomography for diagnosis of active condylar hyperplasia. J Cranio-Maxillofac Surg 2016;44:70-74.

Nitzan DW, Katsnelson A, Bermanis I, Brin I, Casap N. The clinical characteris¬tics of condylar hyperplasia: experience with 61 patients. J Oral Maxillofac Surg 2008;66:312-318.

Olate S, Almeida A, Alister JP, Navarro P, Netto H, Moraes M. Facial asymmetry and condylar hyperplasia: Considerations for diagnosis in 27 consecutive pa¬tients. Int J Clin Exp Med 2013;6:937-941.

Elbaz J, Wiss A, Raoul G, Leroy X, Hossein-Foucher C, Ferri J. Condylar hyperplasia: correlation between clinical, radiological, scintigraphic, and histologic features. J Craniofac Surg 2014;25:1085-1090.

Obwegeser HL, Makek MS. Hemimandibular hyperplasia - hemimandibular elon¬gation. J Maxillofac Surg 1986;14:183- 208.

Cohen, M.M. Perspectives on craniofacial asymmetry I: The biology of asymmetry. Int J Oral Maxillofac Surg1995; 24: 2-7.

Shetye PR, Grayson BH, Mackool RJ, McCarthy JG. Long-term stability and growth following unilateral mandibular distraction in growing children with craniofacial microsomia. Plast Reconstr Surg 2006;118:985-995.

Lisboa CO, Martins MM, Ruellas ACO, Ferreira DMTP, Maia LC, Mattos CT. Soft tissue assessment before and after mandibular advancement or setback surgery using three-dimensional images: systematic review and meta-analysis. Int J Oral Maxi¬llofac Surg 2018;47:1389-1397.

Kamata H, Higashihori N, Fukuoka H, Shiga M, Kawamoto T, Moriyama K. Com¬prending the three-dimensional mandibular morphology of facial asymmetry patients with mandibular prognathism. Progress in Orthodontics 2017;18(1):43.

Dong Y, Wang XM, Wang MQ, Widmalm SE. Asymmetric muscle function in pa¬tients with developmental mandibular asymmetry. J Oral Rehabil 2008;35:27-36.

Goto TK, Yamada T, Yoshiura K. Occlusal pressure, occlusal contact area, force and the correlation with the morphology of the jaw-closing muscles in patients with skeletal mandibular asymmetry. J Oral Rehabil 2008;35:594-603.

Schmid W, Mongini F. Factors in craniomandibular asymmetry: diagnostic principles and therapy. Mondo Ortod 1990;15:91-104.

Hinds EC, Reid LC, Burch RJ. Classification and management of mandibular asymmetry. Am J Surg 1960;100:825-834.

Rowe NL. Aetiology, clinical features, and treatment of mandibular deformity. Br Dent J 1960;108:64-96.

Bruce RA, Hayward JR. Condylar hyperplasia and mandibular asymmetry: a review. J Oral Surg 1968;26:281-290.

Ishizaki K, Suzuki K, Mito T, et al. Morphologic, functional, and occlusal characteri¬zation of mandibular lateral displacement malocclusion. Am J Orthod Dentofacial Orthop 2010;137:454.e1- e9.

Goto TK, Langenbach GE. Condylar Process Contributes to Mandibular Asymmetry: In Vivo 3D MRI Study. Clin Anat 2014;27(4):585-591.

Portada Revista CES Odontologia volumen 33(2) de 2020

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Published

2020-12-31

How to Cite

1.
López-Buitrago DF. Bone morphology differences between displaced and contralateral side in patients with facial asymmetry: 3D-CT study. CES odontol. [Internet]. 2020 Dec. 31 [cited 2024 May 12];33(2):23-38. Available from: https://revistas.ces.edu.co/index.php/odontologia/article/view/6043

Issue

Vol. 33 No. 2 (2020): CES Odontología

Section

Artículo de Investigación Científica y Tecnológica

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