Document Type: Original Article

Authors

Dept. of Orthodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

Abstract

 
Statement of the Problem: The degree of asymmetry perception of dental and medical practitioners is influenced by several factors. The perceived asymmetry affect the treatment plan design.
Purpose: The aim of the present study was to investigate the consistency of facial asymmetry and identify amounts of transverse asymmetry that can be regarded as normal and may benefit from correction.
Materials and Method: At first, three-dimensional images of a man and a women volunteer were obtained. Then transverse changes were applied by ZBrush software so that for each volunteer, seven 3D images of their face with varying degree of facial transverse asymmetry were created. Then, the images were displayed to four groups of observers including layperson, general dentists, orthodontists, and maxillofacial surgeons. Finally, the consistency of the perception of these four groups of observers with the different degrees of facial asymmetry was compared.
Results: Fourteen photographic samples were evaluated and ranked by 80 observers in four groups. The consistency of the perception of the facial transverse asymmetry was equal to 33%, which indicated a lack of consistency.
Conclusion: According to the findings of this study, there was no consistency between the groups.

Keywords

[1]  Huang Y, Xue X, Spelke E, Huang L, Zheng W, Peng K. The aesthetic preference for symmetry dissociates from early-emerging attention to symmetry. Sci Rep. 2018; 8: 6263.

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

[3]  Grammer K, Thornhill R. Human (Homo sapiens) facial attractiveness and sexual selection: the role of symmetry and averageness. J Comp Psychol. 1994; 108: 233-242.

[4]  Macgregor FC. Social and psychological implications of dentofacial disfigurement. Angle Orthod. 1970; 40: 231-233.

[5]  Rumsey N, Clarke A, White P, Wyn-Williams M, Garlick W. Altered body image: appearance-related concerns of people with visible disfigurement. J Adv Nurs. 2004; 48: 443-453.

[6]  Patcas R, Bernini DAJ, Volokitin A, Agustsson E, Rothe R, Timofte R. Applying artificial intelligence to assess the impact of orthognathic treatment on facial attractiveness and estimated age. Int J Oral Maxillofac Surg. 2019; 48: 77‐83.

[7]  McAvinchey G, Maxim F, Nix B, Djordjevic J, Linklater R, Landini G. The perception of facial asymmetry using 3-dimensional simulated images. Angle Orthod. 2014; 84: 957-965.

[8]  Monnet-Corti V, Antezack A, Pignoly M. Perfecting smile esthetics: keep it pink. Orthod Fr. 2018; 89: 771-780.

[9]  Chisini LA, Noronha TG, Ramos EC, Dos*Santos-Junior RB, Sampaio KH, Faria ESAL, et al. Does the skin color of patients influence the treatment decision-making of dentists? A randomized questionnaire-based study. Clin Oral Investig. 2019; 23: 1023-1030.

[10]          Little AC, Burt DM, Penton-Voak IS, Perrett DI. Self-perceived attractiveness influences human female preferences for sexual dimorphism and symmetry in male faces. Proc Biol Sci. 2001; 268(1462): 39-44.

[11]          Bispo*de*Carvalho*Barbosa P, de*Andrade*Vieira W, de*Macedo*Bernardino I, Costa MM, Pithon MM, Paranhos LR. Aesthetic facial perception and need for treatment in simulated laterognathism in male faces of different ethnicities. Oral Maxillofac Surg. 2019; 23: 407-413.

[12]          Lee SF, Dumrongwongsiri S, Lo LJ. Perception of Lip Cant as a Sign of Facial Deformity: Assessment by Laypersons and Professionals on Composite Face Photographs. Ann Plast Surg. 2019; 82(1S Suppl 1): S140‐ S143.

[13]          Chu EA, Farrag TY, Ishii LE, Byrne PJ. Threshold of visual perception of facial asymmetry in a facial paralysis model. Arch Facial Plast Surg. 2011; 13: 14-19.

[14]          Naini FB, Donaldson AN, McDonald F, Cobourne MT. Assessing the influence of asymmetry affecting the mandible and chin point on perceived attractiveness in the orthognathic patient, clinician, and layperson. J Oral Maxillofac Surg. 2012; 70: 192-206.

[15]          Meyer-Marcotty P, Stellzig-Eisenhauer A, Bareis U, Hartmann J, Kochel J. Three-dimensional perception of facial asymmetry. Eur J Orthod. 2011; 33: 647-653.

[16]          Hohman MH, Kim SW, Heller ES, Frigerio A, Heaton JT, Hadlock TA. Determining the threshold for asymmetry detection in facial expressions. Laryngoscope. 2014; 124: 860-865.

[17]          Mertens I, Siegmund H, Grusser OJ. Gaze motor asymmetries in the perception of faces during a memory task. Neuropsychologia. 1993; 31: 989-998.

[18]          Jarosz KF, Bosio JA, Bloomstein R, Jiang SS, Vakharia NS, Cangialosi TJ. Perceptions of chin asymmetries among dental professionals and laypersons. Am J Orthod Dentofacial Orthop. 2018; 154: 201-212.

[19]          Pinho S, Ciriaco C, Faber J, Lenza MA. Impact of dental asymmetries on the perception of smile esthetics. Am J Orthod Dentofacial Orthop. 2007; 132: 748-753.

[20]          Kokich VO, Kokich VG, Kiyak HA. Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations. Am J Orthod Dentofacial Orthop. 2006; 130: 141-151.

[21]          Dong T, Ye N, Yuan L, Wu S, Xia L, Fang B. Assessing the Influence of Chin Asymmetry on Perceived Facial Esthetics With 3-Dimensional Images. J Oral Maxillofac Surg. 2020; S0278-2391: 30311-30316.

[22]          Chou PY, Denadai R, Chen SH, Tseng HJ, Hsu CK,  Wang SW, et al. Identifying Three-Dimensional Facial Fluctuating Asymmetry in Normal Pediatric Individuals: A Panel Assessment Outcome Study of Clinicians and Observers. Journal of Clinical Medicine. 2019; 8. DOI: 10.3390/jcm8050648.