Journal of the Chinese Medical Association
Volume 73, Issue 1 , Pages 29-34, January 2010

Analysis of Facial Skeletal Characteristics in Patients With Chin Deviation

  • Jenny Hwai-Jen Fong

      Affiliations

    • School of Dentistry, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • ,
  • Ho-Tai Wu

      Affiliations

    • Division of Oral and Maxillofacial Surgery, Taipei, Taiwan, R.O.C.
    • ,
  • Ming-Chu Huang

      Affiliations

    • Division of Orthodontics, Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • ,
  • Yu-Wei Chou

      Affiliations

    • Division of Oral and Maxillofacial Surgery, Taipei, Taiwan, R.O.C.
    • ,
  • Lin-Yang Chi

      Affiliations

    • School of Dentistry, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • ,
  • Yao Fong

      Affiliations

    • Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan, R.O.C.
    • ,
  • Shou-Yen Kao

      Affiliations

    • School of Dentistry, National Yang-Ming University, Taipei, Taiwan, R.O.C.
    • Division of Oral and Maxillofacial Surgery, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Shou-Yen Kao, Department of Dentistry, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 4 March 2009; accepted 1 December 2009.

Article Outline

Background

This study was undertaken to investigate the facial skeletal features associated with chin deviation.

Methods

Twenty-five patients (14 males and 11 females) diagnosed with chin deviations of more than 2 mm were recruited. Fifteen skeletal landmarks, including median and lateral points, were located on posteroanterior cephalo-grams. The CG–ANS (crista-galli of the ethmoid–anterior nasal spine) line and the perpendicular line through the CG were used as references. The differences between the distances from paired lateral points to reference lines were examined with intraclass correlation coefficients to analyze the symmetry of facial skeletal tissue. The factors associated with the amount or direction of chin deviation were analyzed by multiple regression analysis or by logistic regression analysis.

Results

Seventeen subjects (68%) showed chin deviation to the left side and 8 subjects (32%) to the right side. Sixty-eight percent of subjects presented with Angle Class III malocclusion. Horizontal distances of all paired lateral points to the y-axis, in mandibular body length and effective length, showed a low grade of symmetry. Only vertical distances of paired zygomaticofrontal sutures and zygonion points to the x-axis were asymmetric. However, there were no significant asymmetries of the gonial angle, ramus height, and vertical distances from other paired lateral points to the x-axis. The amount of chin deviation was associated with the absolute differences of the left and right antegonion to the y-axis and zygomaticofrontal suture to the x-axis. The direction of chin deviation was significantly associated with the difference in the effective length of bilateral mandibular halves.

Conclusion

Facial skeletal asymmetry exists in patients with chin deviation. This should be considered when planning treatment for both the nonsurgical and surgico-orthodontic cases with chin deviation.

Key Words:  asymmetry , chin deviation , facial skeleton , posteroanterior cephalogram

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Shah SM , Joshi MR . An assessment of asymmetry in the normal craniofacial complex . Angle Orthod . 1978;48:141–148
  2. Peck S , Peck L , Kataji M . Skeletal asymmetry in esthetically pleasing faces . Angle Orthod . 1990;61:43–48
  3. Ferrario VF , Sforza C , Miani A , Tartaglia G . Craniofacial morphometry by photographic evaluations . Am J Orthod Dentofacial Orthop . 1993;103:327–337
  4. Ferrario VF , Sforza C , Poggio CE , Tartaglia G . Distance from symmetry: a three-dimensional evaluation of facial asymmetry . J Oral Maxillofac Surg . 1994;52:1126–1132
  5. Ferrario VF , Sforza C , Ciusa V , Dellavia C , Tartaglia GM . 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;59:382–388
  6. Zaidel DW , Cohen JA . The face, beauty, and symmetry: perceiving asymmetry in beautiful faces . Int J Neurosci . 2005;115:1165–1173
  7. Liukkonen M , Sillanmaki L , Peltomaki T . Mandibular asymmetry in healthy children . Acta Odontol Scand . 2005;63:168–172
  8. Chen FM , Lin TY , Peng CH , Tsay CH , Huang TH , Kao CT . A preliminary investigation on self-judgment of facial profile . Chung Shan Med J . 1995;6:17–23
  9. Severt TR , Proffit WR . The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina . Int J Adult Orthodon Orthognath Surg . 1997;12:171–176
  10. Bishara S , Burkey PS , Kharouf JG . Dental and facial asymmetries: a review . Angle Orthod . 1994;64:89–98
  11. Pirttiniemi P . Associations of mandibular and facial asymmetries: a review . Am J Orthod Dentofacial Orthop . 1994;106:191–200
  12. Pirttiniemi P . Normal and increased functional asymmetries in the craniofacial area . Acta Odontol Scand . 1998;56:342–345
  13. Enlow DH , Hans MG . In: Essentials of Facial Growth . Philadelphia: WB Saunders; 1996;p. 39–56
  14. Forsberg CT , Burston CJ , Hanley KJ . Diagnosis and treatment planning of skeletal asymmetry with the submental vertical radiograph . Am J Orthod . 1984;85:224–237
  15. Proffit WR , White RP . In: Surgical-orthodontic Treatment . St Louis: Mosby Year-Book; 1991;p. 483–549
  16. Pirttiniemi P , Kantomaa T . Relation of glenoid fossa morphology to mandibulofacial asymmetry, studied in dry human Lapp skulls . Acta Odontol Scand . 1992;50:235–243
  17. Melnick AK . A cephalometric study of mandibular asymmetry in a longitudinally followed sample of growing children . Am J Orthod Dentofacial Orthop . 1992;101:355–366
  18. Kiliaridis S , Bresin A , Holm J , Strid KG . Effects of masticatory muscle function on bone mass in the mandible of the growing rat . Acta Anat (Basel) . 1996;155:200–205
  19. Kiliaridis S , Engstrom C , Lindskog-Stockland B , Katsaros C . Craniofacial bone remodeling in growing rats fed a low-calcium and vitamin-D-deficient diet and the influence of masticatory muscle function . Acta Odontol Scand . 1996;54:320–326
  20. Raadsheer MC , Kiliaridis S , Van Eijden TM , Van Ginkel FC , Prahl-Andersen B . Masseter muscle thickness in growing individuals and its relation to facial morphology . Arch Oral Biol . 1996;41:323–332
  21. Bruce RA , Hayward JR . Condylar hyperplasia and mandibular asymmetry . J Oral Surg . 1968;26:281–290
  22. Obwegeser HL , Makek MS . Hemimandibular hyperplasia: hemimandibular elongation . J Maxillofac Surg . 1986;14:183–208
  23. Persson M . Mandibular asymmetry of hereditary origin . Am J Orthod . 1973;63:1–11
  24. Stabrun AE , Larheim TA , Höyreraal HM , Rösler M . Reduced mandibular dimensions and asymmetry in juvenile rheumatoid arthritis . Arthritis Rheum . 1988;31:602–611
  25. Speculand B . Unilateral condylar hypoplasia with ankylosis: radiographic findings . Br J Oral Surg . 1982;20:1–13
  26. Lund K . Mandibular growth and remodeling process after condylar fracture: a longitudinal roentgencephalometric study . Acta Odontol Scand . 1974;32(Suppl):3–11
  27. Plint DA , Ellisdon PS . Facial asymmetries and mandibular displacements . Br J Orthod . 1974;5:227–235
  28. Schmid W , Mongini F , Felisio A . A computer-based assessment of structural and displacement asymmetries of the mandible . Am J Orthod Dentofacial Orthop . 1991;100:19–34
  29. Kambylafkas P , Kyrkanides S , Tallents RH . Mandibular asymmetry in adult patients with unilateral degenerative joint disease . Angle Orthod . 2005;75:305–310
  30. Eisenberg RL , Dennis CA , May CR . In: Radiographic Positioning . 1st edition. Boston: Brown Company; 1989;p. 276–277
  31. Figalova P . Asymmetry of the face . Anthropologie . 1969;7:31–34
  32. Haraguchi S , Takada K , Yasuda Y . Facial asymmetry in subjects with skeletal class III deformity . Angle Orthod . 2002;72:28–35
  33. Lin TY , Huang CC , Huang TH , Kao CT . Posteroanterior cephalometric assessment of different malocclusions in adults . Int J Adult Orthodon Orthognath Surg . 1997;12:308–317
  34. Chang HP . Components of class III malocclusion in Chinese . Kaohsiung J Med Sci . 1995;1:144–155
  35. Kao CT , Chen FM , Lin TY , Huang TH . The craniofacial morphologic structure of the adult with Class III malocclusion . Int J Adult Orthodon Orthognath Surg . 1995;10:285–293
  36. Chou IC, Fong HJ, Kuang SH, Gi LY, Hwang FY, Lai YC, et al  A retrospective analysis of the stability and relapse of soft and hard tissue change after bilateral sagittal split osteotomy for mandibular setback of 64 Taiwanese patients . J Oral Maxillofac Surg . 2005;63:355–361
  37. Padwa BL , Kaiser MO , Kaban LB . Occlusal cant in the frontal plane as a reflection of facial asymmetry . J Oral Maxillofac Surg . 1997;55:811–816
  38. Langberg BJ , Arai K , Miner RM . Transverse skeletal and dental asymmetry in adults with unilateral lingual posterior crossbite . Am J Orthod Dentofacial Orthop . 2005;127:6–15

PII: S1726-4901(10)70018-6

doi:10.1016/S1726-4901(10)70018-6

Journal of the Chinese Medical Association
Volume 73, Issue 1 , Pages 29-34, January 2010

Article Tools