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Spatially-dense three-dimensional analysis of the midfacial skeletal shape asymmetry in skeletal Class III patients
Guangpu Zhao1, Xinyu Su1, Aonan Wen2
1Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory for Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
Introduction:
This study aimed to analyze midfacial skeletal shape asymmetry in skeletal Class III patients using a three-dimensional spatially-dense method.
Methods:
Sixty skeletal Class III patients' cone-beam computed tomography images were retrospectively enrolled and divided into three groups according to occlusal plane inclination (OPI) and mandibular lateral deviation (MD). A spatially-dense template of the anterior outer surface of the midfacial skeleton was established and validated. Through template registration, a large number of homologous quasi-landmarks of the midfacial skeleton were automatically identified. After robust superimposition of the original and mirror images, the root-mean-square error was calculated as the asymmetry index (AI). Color-coded maps were generated to visually display the location and magnitude of the asymmetry.
Results:
The median overall midfacial skeletal AIs of group 1 (with OPI and MD), group 2 (with MD without OPI), and group 3 (without OPI or MD) were 1.55, 1.27, and 1.19, respectively. The overall AI of group 1 was significantly higher than that of group 2 (P < .05) and group 3 (P < .01). Within group 1, the AI of the alveolar process was significantly higher than that of other regions.
Conclusions:
The three-dimensional spatially-dense method allows quantitative and visual analysis of shape asymmetry of the midfacial skeleton. Skeletal Class III patients with occlusal plane inclination and mandibular lateral deviation exhibit a significantly greater degree of midfacial skeletal asymmetry, with the alveolar process identified as the main asymmetric site of their midfacial skeleton.
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