J Korean Assoc Oral Maxillofac Surg.  2013 Aug;39(4):168-174.

3-Dimensional analysis for class III malocclusion patients with facial asymmetry

• Kim EJ
• Ki EJ
• Cheon HM
• Choi EJ
• Kwon KH

Abstract

OBJECTIVES
The aim of this study is to investigate the correlation between 2-dimensional (2D) cephalometric measurement and 3-dimensional (3D) cone beam computed tomography (CBCT) measurement, and to evaluate the availability of 3D analysis for asymmetry patients.
MATERIALS AND METHODS
A total of Twenty-seven patients were evaluated for facial asymmetry by photograph and cephalometric radiograph, and CBCT. The 14 measurements values were evaluated and those for 2D and 3D were compared. The patients were classified into two groups. Patients in group 1 were evaluated for symmetry in the middle 1/3 of the face and asymmetry in the lower 1/3 of the face, and those in group 2 for asymmetry of both the middle and lower 1/3 of the face.
RESULTS
In group 1, significant differences were observed in nine values out of 14 values. Values included three from anteroposterior cephalometric radiograph measurement values (cant and both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles). In group 2, comparison between 2D and 3D showed significant difference in 10 factors. Values included four from anteroposterior cephalometric radiograph measurement values (both maxillary height, both body height) and six from lateral cephalometric radiographs (both ramus length, both lateral ramal inclination, and both gonial angles).
CONCLUSION
Information from 2D analysis was inaccurate in several measurements. Therefore, in asymmetry patients, 3D analysis is useful in diagnosis of asymmetry.

Keyword

Cephalometry; Cone-beam computed tomography; Analysis; Facial asymmetry

MeSH Terms

Cephalometry
Cone-Beam Computed Tomography
Facial Asymmetry
Humans
Malocclusion

Figure

• 

  Fig. 1 The measurement of lateral cephalogrphic radiography with V-ceph program (A) and 3-dimensional image with OnDemand program (B). In 2-dimensional image, the program divided right and left side based on the fact that closer part to film tends to show more radiopaque in lateral cephalogram. Lateral ramal inclination was represented the red angle between posterior ramal border (yellow line) and Frankfort horizontal plane (black line). Ramal length displayed blue line, and we measured gonial angle formed by Ar-Go-Me. (Ar: articulare, Go: gonion, Me: menton, Po: porion, Cd post: posterior condyle point, Cd sup: highest point of the condyle, Go post: posterior gonion point, Go inf: lowest point of the Go area, Or: orbitale)

• 

  Fig. 2 The measurement of antero-posterior cephalographic radiograph. The line connecting both orbitale was used as a standard. Midsagittal line perpendicular to the line connecting both orbitale and passing nasion point was used as a vertical standard (A). The measurement of 3-dimensional image with OnDemand program. The plane including both orbitale and porion was a standard plane and the plane passing nasion and dens is midsagittal plane (B). Frontal ramal inclination (red angle): angle between both orbitale line (black line) and yellow line from lateral condylar point and lateral Go point, body height: orange line, maxillary height: blue line. (N: nasion, Or: orbitale, Cd lat: lateral condyle point, U6CP: upper first molar buccomesial cusp point, L3CP: mandible canine cusp point, Go lat: lateral gonion point)

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