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Jasmina Opacic1, Georgios Kanavakis2, Demetrios Halazonetis2

  • 1Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.

Journal of Dentistry
|July 2, 2026
PubMed
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Two-dimensional (2D) facial photographs show significant discrepancies compared to 3D scans for assessing soft-tissue profiles. Individual variability means 2D images may be insufficient for precise orthodontic diagnosis and treatment planning.

Area of Science:

  • Orthodontics
  • Medical Imaging
  • Facial Analysis

Background:

  • Accurate assessment of facial soft-tissue profiles is crucial in orthodontics.
  • Traditional two-dimensional (2D) photographs are commonly used but may lack precision.
  • Three-dimensional (3D) imaging offers a more accurate reference standard.

Purpose of the Study:

  • To evaluate the accuracy of 2D facial soft-tissue profile lines derived from standard clinical photographs.
  • To compare these 2D profiles against reference profiles generated from 3D facial imaging.
  • To determine the clinical relevance of discrepancies found between 2D and 3D profile assessments.

Main Methods:

  • Analysis of pre-existing 2D and 3D facial photographs from 160 orthodontic patients.
  • Generation of true facial profile lines from 3D images using an automated midsagittal plane.
Keywords:
Data accuracyfacegeometric morphometricsmidsagittal planephotographythree-dimensional imagingtwo-dimensional imaging

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  • Tracing of corresponding profile lines on 2D photographs and analysis using geometric morphometrics and Procrustes distances.
  • Evaluation of the influence of patient age and sex on profile discrepancies.

    • Main Results:

    • Statistically significant differences (P < 0.001) were observed between 2D-derived and 3D reference profiles.
    • Median discrepancy was 0.75 mm, with the largest errors in the lip region.
    • Individual variability was considerable; 35.2% of measurements exceeded ±1 mm and 8.2% exceeded ±2 mm.
    • Errors were more pronounced in males and younger subjects.

    Conclusions:

    • 2D facial photographs exhibit statistically significant and clinically relevant inaccuracies compared to 3D-based profiles.
    • While average errors are small, considerable individual variability necessitates caution for precise assessments.
    • Routine 2D photographs may be inadequate for accurate individual-level soft-tissue profile analysis in orthodontics.