Biological predictors of mandibular asymmetries in children with mixed dentition

The objective was to investigate the severity of skeletal mandibular asymmetry in children with mixed dentition and other factors associated with asymmetry.

The study was cross sectional, with stratified sampling according to malocclusion type consisting of 205 subjects with mixed dentition (median 10, interquartile range 9-11 years). There were 59 subjects presenting Class II/1, 77 Class II/2, and 69 Class III. The mandibular asymmetry has been estimated from orthopantomograms using the Habets' method and the dental maturation by Demirjian's method. The sagittal skeletal relationship and facial growth pattern were assessed from lateral cephalograms.

Asymmetries in general, were not rare and were more present in the condylar height rather than in the height of the ramus. The highest severity of condylar asymmetry was in Class II/2 subjects (median of asymmetry index 7.3; 64% subjects exhibiting moderate and severe asymmetry), while the Class III subjects exhibited the highest severity of both ramus and total height asymmetry (2.1; 13% and 2.0; 15%, respectively). Multiple logistic regression unveiled male gender as the only predictor of moderate or significant overall asymmetry. Dental age, the difference between dental and chronological age, and facial growth pattern were not significant predictors of asymmetries.

Overall, asymmetries in mixed dentition cannot be considered rare; however, no strong relationships between asymmetry and observed biological factors were found.