3D Facial Analysis in Class II Subdivision Malocclusion

Background: Class II subdivision is an asymmetric condition presenting a Class I dental occlusion on one side and a Class II on the contralateral one. It presents a midline deviation that may be caused by a monolateral distalization of the mandible (type 1) or a mesialization of one side of the maxilla (type 2). The evaluation of asymmetry based on 2D radiographic records has been demonstrated to be less accurate than the one made using 3D radiographs. Objective: The aim of this work is to evaluate the facial asymmetry in a group of patients with Class II subdivision, compared to patients in Class I without evident asymmetry, by using 3D photographs of the face. Methods: 32 young adults with Class II subdivision were compared to a group of 32 subjects with bilateral Class I molar relationship. 3D photograph of their face was acquired using a stereophotogrammetric camera (3dMDtrio System-3dMD Atlanta, GA, USA). 3D photographs were imported into the Geomagic Software to create mirror 3D photography. Independent T-tests were made to compare facial asymmetries measured on Class II subdivision group with the Class I group. Results: The results show that there is a statistically significant difference in landmarks location between the control group and the experimental group regarding the values measured at the level of the lips and the perioral area. The asymmetry was more marked in patients with mandibular midline deviation. This is in line with previous observations with radiographic investigations. Conclusion: For a correct assessment of the asymmetry, a study of 3D photographs cannot replace an evaluation by cone beam, but it can be an important aid to estimate possible asymmetries in the perioral area and in the lip area.