Title: Simplified Posteroanterior Cephalometric Analysis Reveals Four Classifications of Craniofacial Asymmetry
Kay Chung (Presenter)
Temple University Kornberg School of Dentistry
James Sciote, Temple University Kornberg School of Dentistry
Romain Nicot, University of Lille
Gwénaël Raoul, University of Lille
Joel Ferri, University of Lille
Jeffrey Godel, Temple University Kornberg School of Dentistry
Elizabeth Spannhake, Temple University Kornberg School of Dentistry
Objectives: To develop an uncomplicated and reliable posteroanterior (PA) cephalometric analysis to distinguish subclassifications of craniofacial asymmetry and to explore the severity and prevalence of TMD in asymmetric patients.
Methods: After exploring different PA cephalometric analyses such as Grummon’s, Oslo’s and Rickett’s analysis which evaluate mandibular and maxillary asymmetry, we constructed six PA cephalometric measurements to distinguish four groups of craniofacial symmetry. One hundred twenty-one dentofacial deformity subjects were diagnosed as symmetric or subclassified into four asymmetric groups based on the following six measurements: 1-occlusal plane tilt, 2-maxillary canting, 3-menton deviation, 4-mandibular width to midsagittal plane, 5-mandibular width to menton, and 6-ramal height. TMD examination diagnosis based on the Research Diagnostic Criteria for TMD, and jaw pain and function (JPF) patient self-reporting questionnaire were also analyzed to investigate the presence and severity of TMD.
Results: Significant cephalometric differences were found between the symmetric and asymmetric groups (p<0.0001), and within the asymmetric groups with varying significance for each measurement (Table 1). Four types of craniofacial asymmetry were: group 1 - mandibular body asymmetry only, group 2 - mandibular body and ramus asymmetry, group 3 - atypical asymmetry with menton deviation to the side with longer ramus, and group 4 - severe asymmetry with maxillary canting. TMD symptoms for asymmetric patients were significantly higher (JPF=7) than symmetric patients (JPF=2) before treatment, and groups 2 and 3 had better prognosis 1 year after treatment (Table 2).
Conclusions: PA cephalometric analysis using the six measurements described in this study is efficient and reliable. This analysis can distinguish asymmetric patients into four distinct groups and can aid in identifying probability and response to treatment for TMD conditions.