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Chang Gung Medical Journal 2011Facial asymmetry is common in humans. Significant facial asymmetry causes both functional as well as esthetic problems. When patients complain of facial asymmetry, the... (Review)
Review
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.
Topics: Facial Asymmetry; Humans; Orthognathic Surgery; Osteogenesis, Distraction
PubMed: 21880188
DOI: No ID Found -
The Angle Orthodontist 1994Asymmetry in the face and dentition is a naturally occurring phenomenon. In most cases facial asymmetry can only be detected by comparing homologous parts of the face.... (Review)
Review
Asymmetry in the face and dentition is a naturally occurring phenomenon. In most cases facial asymmetry can only be detected by comparing homologous parts of the face. The etiology of asymmetry includes: a) Genetic or congenital malformations e.g. hemifacial microsomia and unilateral clefts of the lip and palate; b) Environmental factors, e.g. habits and trauma; c) Functional deviations, e.g. mandibular shifts as a result of tooth interferences. Dental asymmetries and a variety of functional deviations can be treated orthodontically. On the other hand, significant structural facial asymmetries are not easily amenable to orthodontic treatment. These problems may require orthopedic correction during the growth period and/or surgical management at a later point. Patient complaints and desires need to be addressed since they may vary from unrealistic expectations to a lack of concern even in the presence of large deviations. With mild dental, skeletal and soft tissue deviations the advisability of treatment should be carefully considered.
Topics: Facial Asymmetry; Humans; Malocclusion
PubMed: 8010527
DOI: 10.1043/0003-3219(1994)064<0089:DAFAAR>2.0.CO;2 -
BMJ Case Reports Feb 2019Unilateral condylar hyperplasia is characterised by slow progressive growth of the different parts of mandible, the aetiology of which is still unclear. It is a... (Review)
Review
Unilateral condylar hyperplasia is characterised by slow progressive growth of the different parts of mandible, the aetiology of which is still unclear. It is a self-limiting condition mostly seen between the age of 11-30 years causing facial asymmetry and its progression ceases after a certain time. In literature until now very few cases have been reported and every case that is being reported adds to its features or the aetiology. Previously, it has been classified into two types that is, hemimandibular hyperplasia and hemimandibular elongation. Here, we report a similar case with a few features distinct from those reported earlier.
Topics: Adult; Facial Asymmetry; Humans; Hyperplasia; Male; Malocclusion; Mandible; Mandibular Condyle; Oral Surgical Procedures; Osteotomy; Treatment Outcome
PubMed: 30737324
DOI: 10.1136/bcr-2018-227569 -
Oral Diseases Sep 2017Fibrous dysplasia (FD) is a rare bone disease caused by postzygotic somatic activating mutations in the GNAS gene, which lead to constitutive activation of adenylyl... (Review)
Review
Fibrous dysplasia (FD) is a rare bone disease caused by postzygotic somatic activating mutations in the GNAS gene, which lead to constitutive activation of adenylyl cyclase and elevated levels of cyclic AMP, which act on downstream signaling pathways and cause normal bone to be replaced with fibrous tissue and abnormal (woven) bone. The bone disease may occur in one bone (monostotic), multiple bones (polyostotic), or in combination with hyperfunctioning endocrinopathies and hyperpigmented skin lesions (in the setting of McCune-Albright Syndrome). FD is common in the craniofacial skeleton, causing significant dysmorphic features, bone pain, and dental anomalies. This review summarizes the pathophysiology, clinical findings, and treatment of FD, with an emphasis on the craniofacial and oral manifestations of the disease.
Topics: Cafe-au-Lait Spots; Craniofacial Abnormalities; Diagnosis, Differential; Facial Asymmetry; Fibrous Dysplasia of Bone; Fibrous Dysplasia, Polyostotic; Humans; Malocclusion; Puberty, Precocious
PubMed: 27493082
DOI: 10.1111/odi.12563 -
PloS One 2023Symmetry is a fundamental biological concept in all living organisms. It is related to a variety of physical and social traits ranging from genetic background integrity...
Symmetry is a fundamental biological concept in all living organisms. It is related to a variety of physical and social traits ranging from genetic background integrity and developmental stability to the perception of physical appearance. Within this context, the study of human facial asymmetry carries a unique significance. Here, we validated an efficient method to assess 3D facial surface symmetry by best-fit approximating the original surface to its mirrored one. Following this step, the midsagittal plane of the face was automatically defined at the midpoints of the contralateral corresponding vertices of the superimposed models and colour coded distance maps were constructed. The method was tested by two operators using facial models of different surface size. The results show that the midsagittal plane definition was highly reproducible (maximum error < 0.1 mm or°) and remained robust for different extents of the facial surface model. The symmetry assessments were valid (differences between corresponding bilateral measurement areas < 0.1 mm), highly reproducible (error < 0.01 mm), and were modified by the extent of the initial surface model. The present landmark-free, automated method to assess facial asymmetry and define the midsagittal plane of the face is accurate, objective, easily applicable, comprehensible and cost effective.
Topics: Humans; Facial Asymmetry; Imaging, Three-Dimensional; Cephalometry; Head; Bias
PubMed: 38011159
DOI: 10.1371/journal.pone.0294528 -
Advances in Clinical and Experimental... Nov 2017Some degree of congenital or acquired asymmetry is normal and universal. Significant facial asymmetry, however, causes both aesthetic, as well as functional problems.... (Review)
Review
Some degree of congenital or acquired asymmetry is normal and universal. Significant facial asymmetry, however, causes both aesthetic, as well as functional problems. The comprehensive management of facial symmetry is scarcely addressed.1-5 Differing etiologies, heterogeneous material, and different ages of patients tend to produce fragmentary reports, the more so as evidence-based evaluation of outcomes is almost impossible. Therefore, a presentation of the general rules of treatment, illustrated by our own material collected from the Hospital and Clinic of Plastic Surgery in Polanica-Zdrój and from private surgical and orthodontic practice, could be regarded as useful and justified. Special attention has been given to both functional and cosmetic problems encountered in severe congenital and acquired asymmetries. The management of selected craniofacial malformations in so-called rare clefts, cleft lip and palate, and craniofacial microsomia (CFM), as well as large hemangiomas and neurofibromas, have been discussed. Additionally, the treatment of extensive and asymmetrical post-traumatic deformities and defects is discussed with particular attention given to problems related to ankylosis of the temporomandibular joints. Numerous examples of one-stage procedures, as well as combined, multidisciplinary treatments are presented.
Topics: Cleft Lip; Cleft Palate; Craniofacial Abnormalities; Facial Asymmetry; Humans
PubMed: 29264890
DOI: 10.17219/acem/68976 -
Scientific Reports Nov 2022There is now scientific evidence that, in dogs, distinctive facial actions are produced in response to different emotionally-arousing stimuli suggesting a relationship...
There is now scientific evidence that, in dogs, distinctive facial actions are produced in response to different emotionally-arousing stimuli suggesting a relationship between lateralized facial expressions and emotional states. Although in humans, relationships between facial asymmetry and both emotional and physiological distress have been reported, there are currently no data on the laterality of dogs' facial expressions in response to social stimuli with respect to canine behavioral disorders. The aim of the present work was to investigate the facial asymmetries of dogs with fear and aggressive behavior towards humans during two different emotional situations: (1) while the dogs were alone in the presence of their owners and (2) during the approach of an unfamiliar human being. Overall, our results demonstrated high levels of asymmetries in facial expressions of dogs displaying fear and aggressive behaviors towards humans indicating that measuring facial asymmetries in dogs could prove to be a useful non-invasive tool for investigating physiology-based behavioral disorders.
Topics: Dogs; Humans; Animals; Facial Asymmetry; Facial Expression; Fear; Emotions; Face
PubMed: 36380072
DOI: 10.1038/s41598-022-24136-2 -
Journal of Current Ophthalmology 2015Torticollis can arise from nonocular (usually musculoskeletal) and ocular conditions. Some facial asymmetries are correlated with a history of early onset ocular... (Review)
Review
Torticollis can arise from nonocular (usually musculoskeletal) and ocular conditions. Some facial asymmetries are correlated with a history of early onset ocular torticollis supported by the presence of torticollis on reviewing childhood photographs. When present in an adult, this type of facial asymmetry with an origin of ocular torticollis should help to confirm the chronicity of the defect and prevent unnecessary neurologic evaluation in patients with an uncertain history. Assessment of facial asymmetry consists of a patient history, physical examination, and medical imaging. Medical imaging and facial morphometry are helpful for objective diagnosis and measurement of the facial asymmetry, as well as for treatment planning. The facial asymmetry in congenital superior oblique palsy is typically manifested by midfacial hemihypoplasia on the side opposite the palsied muscle, with deviation of the nose and mouth toward the hypoplastic side. Correcting torticollis through strabismus surgery before a critical developmental age may prevent the development of irreversible facial asymmetry. Mild facial asymmetry associated with congenital torticollis has been reported to resolve with continued growth after early surgery, but if asymmetry is severe or is not treated in the appropriate time, it might remain even with continued growth after surgery.
PubMed: 27239567
DOI: 10.1016/j.joco.2015.10.005 -
Dental Press Journal of Orthodontics 2015The term "asymmetry" is used to make reference to dissimilarity between homologous elements, altering the balance between structures. Facial asymmetry is common in the... (Review)
Review
The term "asymmetry" is used to make reference to dissimilarity between homologous elements, altering the balance between structures. Facial asymmetry is common in the overall population and is often presented subclinically. Nevertheless, on occasion, significant facial asymmetry results not only in functional, but also esthetic issues. Under these conditions, its etiology should be carefully investigated in order to achieve an adequate treatment plan. Facial asymmetry assessment comprises patient's first interview, extra- as well as intraoral clinical examination, and supplementary imaging examination. Subsequent asymmetry treatment depends on patient's age, the etiology of the condition and on the degree of disharmony, and might include from asymmetrical orthodontic mechanics to orthognathic surgery. Thus, the present study aims at addressing important aspects to be considered by the orthodontist reaching an accurate diagnosis and treatment plan of facial asymmetry, in addition to reporting treatment of some patients carriers of such challenging disharmony.
Topics: Esthetics; Facial Asymmetry; Humans; Orthognathic Surgery
PubMed: 26691977
DOI: 10.1590/2177-6709.20.6.110-125.sar -
The Cleft Palate-craniofacial Journal :... Apr 2019Longitudinal evaluation of asymmetry of the surgically managed unilateral cleft lip and palate (UCLP) to assess the impact of facial growth on facial appearance.
OBJECTIVE
Longitudinal evaluation of asymmetry of the surgically managed unilateral cleft lip and palate (UCLP) to assess the impact of facial growth on facial appearance.
DESIGN
Prospective study.
SETTING
Glasgow Dental Hospital and School, University of Glasgow, United Kingdom.
PATIENTS
Fifteen UCLP infants.
METHOD
The 3-D facial images were captured before surgery, 4 months after surgery, and at 4-year follow-up using stereophotogrammetry. A generic mesh which is a mathematical facial mask that consists of thousands of points (vertices) was conformed on the generated 3-D images. Using Procustean analysis, an average facial mesh was obtained for each age-group. A mirror image of each average mesh was mathematically obtained for the analysis of facial dysmorphology. Facial asymmetry was assessed by measuring the distances between the corresponding vertices of the original and the mirror copy of the conformed meshes, and this was displayed in color-coded map.
RESULTS
There was a clear improvement in the facial asymmetry following the primary repair of cleft lip. Residual asymmetry was detected around the nasolabial region. The nasolabial region was the most asymmetrical region of the face; the philtrum, columella, and the vermillion border of the upper lip showed the maximum asymmetry which was more than 5 mm. Facial growth accentuated the underlying facial asymmetry in 3 directions; the philtrum of the upper lip was deviated toward the scar tissue on the cleft side. The asymmetry of the nose was significantly worse at 4-year follow-up ( P < .05).
CONCLUSION
The residual asymmetry following the surgical repair of UCLP was more pronounced at 4 years following surgery. The conformed facial mesh provided a reliable and innovative tool for the comprehensive analysis of facial morphology in UCLP. The study highlights the need of refining the primary repair of the cleft and the potential necessity for further corrective surgery.
Topics: Cleft Lip; Cleft Palate; Facial Asymmetry; Humans; Imaging, Three-Dimensional; Infant; Nose; Prospective Studies; United Kingdom
PubMed: 29870280
DOI: 10.1177/1055665618780108