Title: 0270 - Facial Asymmetry in Children Using Three-Dimensional Images (3dMD)


Orla Carty (Presenter)
University of Liverpool

Norah Flannigan, University of Liverpool
Susana Dominguez-Gonzalez, Alder Hey Hospital
Girvan Burnside, University of Liverpool


Objectives: The primary objective was to determine the extent of facial asymmetry in a standard population of children (<16 years) from the north west of England using a landmark based approach on 3-dimensional (3dMD) images. The secondary objectives were to investigate the direction and severity of nose and chin deviation and the correlation between them, and to determine if the extent of facial asymmetry differed between genders.

Methods: This was a retrospective cross-sectional cohort study undertaken at Alder Hey Children’s Hospital. The participants were children of either gender and under 16 years of age. Images of 145 children were available. Following the application of exclusion criteria and a panel assessment to determine adequate quality, 107 images were included. A landmark based approach was used by positioning 7 mid and 8 bilateral facial landmarks and the analysis was applied using Vultus software. Intra and inter-reliability were recorded.

Results: Fifty-seven males and 50 females were included with a mean age of 7.36 years (SD 3.74). The median asymmetry indices (AI) for midfacial landmarks were all <1.10mm and for bilateral facial landmarks were all <2.60mm. Pogonion was the most asymmetric midfacial landmark (median AI 1.08mm) and cheilion was the most asymmetric bilateral facial landmark (median AI 2.56mm). A statistically significant relationship between the side of nose and chin deviation (Chi-squared p<0.001) was detected and also a significant correlation between the severity of nose and chin deviation (Pearson’s correlation coefficient=0.91). There was no significant difference in the asymmetry detected between males and females when the Mann Whitney U-test was applied.

Conclusions: In the standard population of children from the north west of England an element of facial asymmetry is present. The direction and magnitude of nose and chin deviation are highly correlated. Males and females exhibit similar levels of facial asymmetry.

Student Presenter

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: Project was completed as part of DDSc in Orthodontics at the University of Liverpool. The authors have no financial interest.