A novel approach for craniofacial symmetry evaluation: Using the midsagittal Reference line drawn from “Crista Gali” with NHP technique
Please cite this article as: Ordobazari M, Naqavi Al-Hosseini AA, Zafarmand H. A novel approach for craniofacial symmetry evaluation: Using the midsagittal Reference line drawn from “Crista Gali” with NHP technique. Novel Biomed 2013;1(2):48-53.
Background and objective: The purpose of this study was the determination of midsagittal reference line (MSL) for craniofacial asymmetry assessment by drawing a line from Crista gali parallel to the true vertical line in PA cephalometry, using Natural Head Position (NHP) technique.
Method and Materials: 60 Iranian subjects within the age range of 9-13 years old were selected for this prospective study. Patients referred for orthodontic treatment and ghad no supernumerary or missing teeth, no skeletal anomaly, or any history of orthodontic and jaw surgery with normal occlusion. Posteroanterior cephalometric radiographs (PA Ceph) were taken of all subjects with NHP technique. The midsagittal line was also traced parallel to the hanging chain from Crista gali. True horizontal line (THL) and true vertical line (TVL) were also traced from Crista gali (Cg). Using Cartesian system based upon Cg point (0~0), the craniofacial symmetry was assessed with linear, angular and proportional measurements in PA cephalogam, related to TVL and THL lines, for 10 bilateral (R&L) anatomical landmarks. The mean differences of the above measurements in left and right sides were analyzed by T- test.
Results: The proportional ratios for all left and right measurements were not statistically significant. This was true for both vertical and horizontal distances. The significant level for MSL drawn from Cg as referred to ANS (0±0.255) and Me points (0.007±0.527) was 0.002 and 0.004, respectively.
Conclusion: In posteroanterior cephalometry radiographs taken with NHP method, the MSL drawn from Crista gali is reproducible and reliable up to 96% of the times for facial symmetry diagnosis.
Fong JH, Wu HT, Huang MC, Chou YW, Chi LY, Fong Y, et al. Analysis of facial skeletal characteristics in patients with chin deviation. J Chin Med Assoc 2010;73(1): 29-34.
Grummons DC, Dappsyne MAG. A frontal asymmetry analysis. J Clin Orthod 1987;21:448-63.
Betts N, Vanarsdall L, Dexter H, Barber K, Fonseca J. Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthodon Orthognath Surg. 1995;10(2):75-96.
Aoshia O. Investigation of the facial symmetry of cases with cross bites needing surgical orthodontic treatment using posteroanteriorroentgenographiccephalometric. Nippon Kyosei 1990;9:256-62.
Grayson BH, Mccarthy G. Analyses of craniofacial asymmetry by multiplancephalometry. Am J Orthod 1983;84:217-24 .
Mongini F, Schmid W, Felliso A. A computer based assessment of structural and displacement asymmetry of the mandible. Am J Orthod 1991; 100 (1) :19-34.
Madsen DP, Sampson WJ, Townsend GC. Craniofacial reference plane variation and natural head position. Eur J Orthod 2008;30:532-40.
Primozic J, Perinetti G, Zhurov A, Richmond S, Ovsenik M. Assessment of facial asymmetry in growing subjects with a three- dimensional laser scanning system. Orthod Craniofac Res 2012;15:237-44.
Huang CS, Liu XQ, Chen YR. Facial asymmetry index in normal young adults. Orthod Craniofac Res 2013;16:97-104.
Chen CM, Lai S, Tseng YC, Lee KT. Simple technique to achieve a natural head position for cephalography.Br J Oral Maxillofac Surg 2008;46(8):677-8.
Cuccia AM, Carola C. The measurement of craniocervical posture: a simple method to evaluate head position.Int J Pediatr Otorhinolaryngol. 2009;73(12):1732-6.
Athanasiou E, Drosche H l, Bosch C. Data and patterns of transverse dentofacial structure of 6 to 15 years old children. A posteroanteriorcephalometric study. Am J Orthod 1992;101 (4) :65-
Araujo P, Wilhelm SA. Skeletal and dental arch asymmetric in individuals with normal dental occlusion. Int J Adult Orthog Surg 1994;9:111-8.
Cuccia AM, Caradonna C. The natural head position: Different
techniques of head positioning in the study of craniocervical posture. Minerva Stomatol 2009;58(11-12):601-12.