Dentofacial Asymmetry — Challenges and Perspectives

A special issue of Symmetry (ISSN 2073-8994). This special issue belongs to the section "Life Sciences".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 38359

Special Issue Editors


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Guest Editor
Department of Maxillofacial Orthopedics and Orthodontics, Faculty of Dentistry, Wroclaw Medical University, 26 Krakowska St., 50425 Wroclaw, Poland
Interests: dentofacial anomalies; dentistry
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Guest Editor
Department of Oral Pathology, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
Interests: molecular biology; IVF
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Guest Editor
Faculty of Dental Medicine, University of Porto, Rua Dr. Manuel Pereira da Silva, 4200-393 Porto, Portugal
Interests: craniofacial growth; corrosion; orthodontics

Special Issue Information

Dear Colleagues,

This Special Issue is concerned with facial asymmetries and asymmetrical diseases and syndromes that are observed within the orofacial region. Facial asymmetry corresponds to many medical conditions and is a multidisciplinary problem.

Facial asymmetry is often related to congenital problems. Among them the most common are clefts and syndromes influencing the orofacial area. The common facial asymmetry syndromes include Goldenhar syndrome, Klippel–Feil syndrome, and Romberg Parry syndrome, among many others.

Facial asymmetry is also often considered in the context of general aesthetics—plastic surgery, restorative dentistry, and orthodontics. This topic is very important as we want to look prettier and younger. This aspect may relate to the fields of aesthetic dentistry as well as biostimulation, botox, and hyaluronic acid use in the treatment of facial asymmetry.

Facial asymmetry is also related to neurological conditions that are related to facial palsy, especially after stroke or due to tumors that may affect the facial region. It may also be related to orofacial surgery—that is, asymmetry due to tumor treatment or as a side effect of the treatment.

Submit your paper and select the Journal “Symmetry” and the Special Issue “Dentofacial Asymmetry — Challenges and Perspectives” via MDPI submission system. Our papers will be published on a rolling basis and we will be pleased to receive your submission once you have finished it.

Dr. Anna Paradowska-Stolarz
Dr. Irena Duś-Ilnicka
Prof. Dr. Maria Cristina Pollmann
Guest Editors

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Keywords

  • Dentofacial anomalies
  • Cleft lip and/or palate
  • Temporomandibular joint
  • Dental anomalies

Published Papers (8 papers)

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Research

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12 pages, 3794 KiB  
Article
The Loss of Symmetry in Unilateral Bony Syngnathia: Case Report and Literature Review
by Vito Crincoli, Roberto Cortelazzi, Corrado De Biase, Angela Pia Cazzolla, Alessandra Campobasso, Mario Dioguardi, Maria Grazia Piancino, Luigi Mattia and Mariasevera Di Comite
Symmetry 2022, 14(10), 2008; https://doi.org/10.3390/sym14102008 - 25 Sep 2022
Cited by 2 | Viewed by 1165
Abstract
Congenital syngnathia is a very rare condition of unknown etiology with multiple clinical manifestations due to different combinations of bony or soft tissue adhesions between the mandible and maxilla. It shares possible association with other congenital anomalies in the head and neck region, [...] Read more.
Congenital syngnathia is a very rare condition of unknown etiology with multiple clinical manifestations due to different combinations of bony or soft tissue adhesions between the mandible and maxilla. It shares possible association with other congenital anomalies in the head and neck region, or with other syndromes. The aims of the present work were: (1) to perform a literature review on bony syngnathia in order to obtain a general framework on epidemiology and management protocol; (2) to describe a case of a two-year-old boy with a left unilateral bony fusion treated with a distraction protocol of three months. Original articles were searched through PubMed, Cochrane Central database and Embase with a cut-off date of June 2022. In total, 94 articles were identified through database searching. After 39 exclusions, 55 articles were included in the review process. Eighty-seven cases of bony syngnathia have been reported from 1936 to 2022, and different classifications have been suggested in terms of location, extension, functional outcomes and management protocol. Complications may range from feeding difficulty to aspiration pneumonia and respiratory arrest. Early surgery is generally required to release the ankylosis and to establish good mandible function. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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10 pages, 1785 KiB  
Article
Symmetry and Asymmetry of the Antegonial Notch
by Grzegorz Mączka, Michał Jerzy Kulus, Joanna Grzelak, Maciej Dobrzyński, Tomasz Staniowski, Katarzyna Skośkiewicz-Malinowska and Paweł Dąbrowski
Symmetry 2022, 14(8), 1558; https://doi.org/10.3390/sym14081558 - 28 Jul 2022
Cited by 1 | Viewed by 3897
Abstract
The symmetry of a human organism’s structure is an expression of the general law of development regarding organic life. Assessing the symmetry of the face and its individual components is one of the most important factors when it comes to the overall assessment [...] Read more.
The symmetry of a human organism’s structure is an expression of the general law of development regarding organic life. Assessing the symmetry of the face and its individual components is one of the most important factors when it comes to the overall assessment of a patient’s stomatognathic system and is essential in the planning of orthodontic and prosthetic treatment. The aim of this study is to assess the symmetry of the occurrence and the measurement parameters of the pre-angular notch of the mandible. The study included computed tomography scans of 187 patients who all exhibited a visible pre-angular notch in the mandible. There was a noticeable and measurable asymmetry in the length of the angle of the notches as well as in the area of the notch angles. The differentiation of the right- and left-side measurements points to the existence of a fluctuating asymmetry. Other measurements which describe the pre-angular notch of the lower jaw do not show asymmetry. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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12 pages, 1076 KiB  
Article
Subjective and Objective Evaluation of the Symmetry of Maxillary Incisors among Residents of Southwest Poland
by Paulina Chrapla, Anna Paradowska-Stolarz and Katarzyna Skoskiewicz-Malinowska
Symmetry 2022, 14(6), 1257; https://doi.org/10.3390/sym14061257 - 17 Jun 2022
Cited by 8 | Viewed by 1853
Abstract
Dental aesthetics is an essential factor affecting people’s psychosocial wellbeing. One of the most critical components of an aesthetic smile is symmetry within the dentition. Dentists and orthodontists, unlike laypersons, are critical in assessing dental aesthetics. This study aimed to evaluate the accuracy [...] Read more.
Dental aesthetics is an essential factor affecting people’s psychosocial wellbeing. One of the most critical components of an aesthetic smile is symmetry within the dentition. Dentists and orthodontists, unlike laypersons, are critical in assessing dental aesthetics. This study aimed to evaluate the accuracy of patients’ assessment of the symmetry of their maxillary incisors and some factors that influence it. The study was conducted on 83 participants aged from 11 to 39 years. First, the participants filled out a questionnaire to obtain patients’ opinions of the symmetry of their upper incisors. This stage was followed by an intraoral examination, during which we used a digital caliper to measure the width of four maxillary incisors. The data were entered into STATISTICA v. 13.3. The following conclusions were drawn from the study. First, the respondents were generally able to determine the asymmetry of the incisors. Second, among the maxillary incisors, the participants defined the symmetry of maxillary central incisors more accurately than the maxillary lateral incisors. The cut-off value for incisor asymmetry noticeable to a layperson is 0.2 mm for maxillary medial incisors and 0.55 for maxillary lateral incisors. Third, we found no dependence of the accuracy of the assessment of incisor asymmetry on the age of the subjects; however, in our study group, the age range (spread) was not significant, so further studies are recommended. Finally, results concerning the relationship with gender showed that males assess the level of symmetry of their maxillary incisors more accurately than females. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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10 pages, 809 KiB  
Article
Does Sex, Skeletal Class and Mandibular Asymmetry Affect Tooth Length and Asymmetry in Tooth Length?
by Maciej Warnecki, Małgorzata Żak, Klaudia Szkoda-Poliszuk, Beata Kawala and Michał Sarul
Symmetry 2022, 14(5), 1069; https://doi.org/10.3390/sym14051069 - 23 May 2022
Cited by 1 | Viewed by 1376
Abstract
Introduction: The aim of our cross-sectional study is to determine whether there is a link between sex, skeletal class and mandibular asymmetry in orthodontic patients, with tooth length and asymmetry in tooth length on contralateral sides of the mandible. Methods: As the source [...] Read more.
Introduction: The aim of our cross-sectional study is to determine whether there is a link between sex, skeletal class and mandibular asymmetry in orthodontic patients, with tooth length and asymmetry in tooth length on contralateral sides of the mandible. Methods: As the source for relevant data to answer this question, 3D cone-beam tomography (CBCT) images of a total of 95 future orthodontic patients were retrospectively selected from private practice records and were analyzed. The CBCT images were part of routine orthodontic diagnosis. Patients were divided into three groups (Class I, Class III with asymmetry and Class III without asymmetry) based on skeletal variables assessed on orthodontic cephalometric images and frontal photos of the face. Three null hypotheses were developed, and a series of statistical tests was performed in order to support or reject them. Results: We have established that there exists a sexual dimorphism in some of the teeth’s lengths in our sample. Furthermore, we failed to find a link between mandibular asymmetry and asymmetry in tooth length. We have also found a link between skeletal class and tooth length differences in some of the analyzed measurements. Conclusions: Computational models used to design orthodontic appliances and to plan orthodontic treatment should be more individualized to consider a patient’s sex and skeletal class. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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16 pages, 193538 KiB  
Article
The Practitioner’s Eye: The Ricketts Technique Elements in Non-Extraction Treatment Camouflaging Skeletal Class III with Bite Asymmetry—A Case Series Presentation
by Jaroslaw Iwanicki, Beata Kawala and Joanna Lis
Symmetry 2022, 14(2), 316; https://doi.org/10.3390/sym14020316 - 04 Feb 2022
Viewed by 2846
Abstract
The study presents four cases of camouflage treatment of skeletal Class III with occlusal asymmetry in adult patients. Cephalometric analysis was performed using two different reference lines, S-N and FH. The treatment was carried out without the use of additional fixed appliances, no [...] Read more.
The study presents four cases of camouflage treatment of skeletal Class III with occlusal asymmetry in adult patients. Cephalometric analysis was performed using two different reference lines, S-N and FH. The treatment was carried out without the use of additional fixed appliances, no extraoral elastics for maxillary protection, and no extraction of teeth in the mandible. In addition to the characteristic elements and archwires taken from the Ricketts technique, NiTi, TMA, Wilcock archwires, Class III asymmetric intraoral elastic and criss-cross as well as individualized biomechanical systems were used. It has been proven that mild and moderate skeletal Class III with occlusal asymmetry can be treated with orthodontic camouflage, without additional fixed appliances for expansion or protraction of the maxilla. Moreover, it has been shown that it is possible to effectively treat this defect without extracting the teeth in the mand. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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14 pages, 6715 KiB  
Article
Prevalence and Characteristic of Oral Mucosa Lesions
by Małgorzata Radwan-Oczko, Iga Sokół, Katarzyna Babuśka and Joanna E. Owczarek-Drabińska
Symmetry 2022, 14(2), 307; https://doi.org/10.3390/sym14020307 - 02 Feb 2022
Cited by 8 | Viewed by 10928
Abstract
(1) Background: Oral mucosa lesions (OMLs) are diagnosed worldwide in any population, age or gender, but in varied prevalence. OMLs can be found in each site of the oral mucosa; for some of them, it is characteristic to have a bilateral/symmetrical or unilateral/nonsymmetrical [...] Read more.
(1) Background: Oral mucosa lesions (OMLs) are diagnosed worldwide in any population, age or gender, but in varied prevalence. OMLs can be found in each site of the oral mucosa; for some of them, it is characteristic to have a bilateral/symmetrical or unilateral/nonsymmetrical mucosal manifestation. The knowledge about its prevalence in varied populations can be useful from a clinical point of view. The aim of this study is to assess the prevalence of OMLs in patients attending outpatient dental clinic; (2) Retrospective analysis of 2747 patients’ oral cavity medical charts, who referred to oral pathology outpatient clinic. The type of diagnosed oral lesion, sex and age were evaluated. p ≤ 0.05 was considered statistically significant; (3) Results: In this study, the overall prevalence of oral mucosal lesions was found to be higher in older than younger patients. In our study, the age median was the highest in patients with xerostomia, burning mouth syndrome, angular cheilitis and oral candidiasis. The youngest median age was observed in patients with aphthae, mucocele and gingival enlargement. The higher OMLs frequency was related with the female gender. (4) It is important for clinicians to be familiar not only with distinctive features, which sometimes may not be clear, but also with linking the occurrence of OMLs with the gender and age. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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Review

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15 pages, 501 KiB  
Review
Facial Asymmetry: A Narrative Review of the Most Common Neurological Causes
by Justyna Chojdak-Łukasiewicz and Bogusław Paradowski
Symmetry 2022, 14(4), 737; https://doi.org/10.3390/sym14040737 - 04 Apr 2022
Cited by 3 | Viewed by 11979
Abstract
Symmetry of the face is one of the most important features for the perception of attractiveness. Asymmetry of the face means that the right and left sides of the face are not identical. Subclinical facial asymmetry is very common in the general population. [...] Read more.
Symmetry of the face is one of the most important features for the perception of attractiveness. Asymmetry of the face means that the right and left sides of the face are not identical. Subclinical facial asymmetry is very common in the general population. Most people have some slight facial asymmetry, and this is the normal biological situation in humans. Abnormalities from soft tissue, dental, and skeletal elements lead to facial asymmetry. Asymmetry has many causal factors, and its aetiology includes both congenital and acquired conditions. Neurological facial asymmetry is scarcely addressed in the dental literature. In this narrative review, we focus on the most common neurological causes of facial asymmetry. From a neurological point of view, facial asymmetry can result from disturbances of the cranial nerves, developmental disorders, or myopathies. In the broad range of differential diagnostics of facial asymmetry, neurological abnormalities should be taken into consideration. The treatment must be related to the underlying cause. Complete knowledge of the aetiological factors and the character of the asymmetry plays a crucial role in formulating a treatment plan. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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Other

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13 pages, 1022 KiB  
Systematic Review
Genetic Factors That Affect Asymmetric Mandibular Growth—A Systematic Review
by Alicja Babczyńska, Beata Kawala and Michał Sarul
Symmetry 2022, 14(3), 490; https://doi.org/10.3390/sym14030490 - 28 Feb 2022
Cited by 5 | Viewed by 2759
Abstract
Facial asymmetry is a feature that occurs to a greater or lesser extent in the general population. As its severity is usually slight, facial asymmetry may not be noticeable to the patient. However, there are cases when severe facial asymmetry not only affects [...] Read more.
Facial asymmetry is a feature that occurs to a greater or lesser extent in the general population. As its severity is usually slight, facial asymmetry may not be noticeable to the patient. However, there are cases when severe facial asymmetry not only affects the facial aesthetics by distorting facial proportions, but also contributes to problems related to the function of the stomatognathic system. The nodal signalling pathway appears to be of particular importance in the process of mandibular asymmetry, as it affects not only structures formed from the first pharyngeal arch, but also other organs, such as the heart and lungs. Following the evaluation of the available literature, the inheritance of mandibular asymmetry is a very complex and multifactorial process, and the genes whose altered expression appears to be a more important potential aetiological factor for asymmetry include PITX2, ACTN3, ENPP1 and ESR1. This systematic review attempts to systematise the available literature concerning the impact of signalling pathway disruption, including the disruption of the nodal signalling pathway, on the development of mandibular asymmetry. Full article
(This article belongs to the Special Issue Dentofacial Asymmetry — Challenges and Perspectives)
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