SOFT-TISSUE FACIAL ASYMMETRY BEFORE AND AFTER ORTHOGNATHIC SURGERY: APPLICATION OF A NEW 3D PROTOCOL

What is it about?

Introduction: Skeletal Class III patients often present a major facial asymmetry. In the current investigation, a quantitative method to assess 3D facial asymmetry was applied to an orthognathic surgery patient to quantify possible postsurgical modifications. Methodology: Soft-tissue facial scans of a 20-year-old man with skeletal Class III, candidate to orthognathic surgery, were collected in the pre-surgery stage and 6, 12, 24 months post-surgery with a stereophotogrammetric system. Soft tissue asymmetry was calculated in the facial thirds according to a published protocol (J Craniomaxillofac Surg 2017;45(1):76-81), and the relevant time-related modifications described. The results were also compared to normal values from a group of 23 control subjects (10 men, 13 women, mean age 26) by using z-scores. Results: The longitudinal analysis of the soft-tissue facial asymmetry showed a marked difference in the analysed time points: orthognathic surgery did reduce facial symmetry in the present patient. The comparison between the patient and the control subjects by using z-scores highlighted a clear difference in all-time points: the patient with facial dysmorphia had a higher degree of asymmetry than healthy subjects. Conclusion: The measurements of soft-tissue facial asymmetry using 3D optical digitisers can provide clinically useful information. The graphical representation of results can help in the patient’s understanding of the treatment phases, thus increasing compliance. Keywords: face, soft tissues, orthognathic surgery, symmetry.

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