Facial Photography vs Cephalometry for Assessing Jaw Discrepancies: A Systematic Review

To systematically review studies to evaluate the correlation and agreement between facial photographic measurements and cephalometric parameters in assessing jaw discrepancy.

An extensive search was performed in PubMed, Scopus, and Web of Science to retrieve articles published from January 2015 to December 2024, and the literature search itself was conducted from 2 to 20 December 2024. The systematic review was carried out following the PRISMA 2020 guidelines. The participants, intervention, control, and outcome (PICO) framework used was as follows: (P) Orthodontic patients who underwent cephalometric and facial photographic assessment; (I): Cephalometric measurements derived from standardized 2D lateral facial photographs; (C): Cephalometric measurements obtained from lateral cephalograms; (O): Agreement between photographic and cephalometric parameters, evaluated through correlation coefficient, agreement statistics, or diagnostic accuracy measures (sensitivity/specificity); and (S): Observational correlation studies and diagnostic accuracy studies. The data extracted comprised study design, participant details, measurement parameters, and outcome statistics. Data extraction and quality appraisal were performed independently by two reviewers using the Joanna Briggs Institute (JBI) diagnostic test accuracy checklist.

A total of 83 studies were screened, of which seven studies met the inclusion criteria, comprising six cross-sectional and one prospective design. Risk of bias (ROB) assessment indicated an overall low to moderate risk. Most studies reported clear inclusion criteria and applied both index and reference tests within the same session. However, blinding of assessors was frequently unclear, introducing potential interpretation bias. Photographic measurements showed significant correlations with cephalometric parameters, with reliability highest for vertical dimensions and selected sagittal measures. Diagnostic accuracy ranged from fair to excellent. Transverse discrepancies were not assessed in any of the studies reviewed.

Standardized facial photographs can serve as a valuable adjunct in orthodontic assessment, particularly for evaluating sagittal and vertical relationships. Although facial photographs demonstrate diagnostic utility, comprehensive assessment of skeletal discrepancies continues to rely on lateral cephalograms.

Facial photography provides a practical, radiation-free tool that may enhance orthodontic diagnosis in selected contexts, especially when radiographic imaging is unavailable. Its greatest utility lies in sagittal and vertical assessment, while future integration with 3D photogrammetry and AI-based landmark detection may further improve diagnostic precision. How to cite this article: Novianty SI, Alhasyimi AA, Dewi AH, et al. Facial Photography vs Cephalometry for Assessing Jaw Discrepancies: A Systematic Review. J Contemp Dent Pract 2026;27(2):190-200.