Comparative Assessment of Vertical Facial Asymmetry Using Posteroanterior Cephalogram and Orthopantomogram

Objective: The aim of this study was to assess and correlate the asymmetry indices in maxillary and mandibular regions derived from posteroanterior (PA) cephalogram and standardized digital orthopantomogram (OPG).

Material and methods: Out of 1080 patients evaluated, 31 subjects with gross facial asymmetry were selected who required PA cephalogram for diagnosis of facial asymmetry and a routine OPG was also taken. Asymmetry indices were calculated from bilateral linear measurements. Distortion factor was also calculated in horizontal and vertical directions for both the radiographs.

Results: From the evaluated parameters, Condyle had the highest asymmetry index, while maxilla had the lowest asymmetry index. The asymmetry indices were not statistically significantly different between the two radiographs. All indices except corpus index were highly significantly positively correlated between standardized digital OPG and PA cephalogram.

Conclusion: Standardized digital OPG can be used to calculate the right-left difference for both maxilla and posterior mandible, based on asymmetry indices derived from vertical parameters for preliminary diagnosis.


Niraj Hirpara, Sandhya Jain, Vyoma Shah Hirpara and Pratik R Punyani

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