A Comparison of Radiographic, Photographic and Anthropometric Assessments of Craniofacial Asymmetry

Abstract

A series of 56 orthodontic patients from the ages of 9 to 48 were involved in a prospective study on craniofacial asymmetry at Indiana University Department of Oral Facial Development. Each of the 56 individuals had fourteen bilateral anthropometric facial measurements made which were used to quantify asymmetry based on the anthropometric technique. Standard orthodontic records were taken and routine clinical exams were performed. Fourteen bilateral landmarks similar to the anthropometric landmarks were identified and measured from posterior-anterior cephalometric radiographs. Asymmetry scores for each individual were calculated using the same mathematical method as with the anthropometric data. The correlation of the two methods was calculated statistically using Pearson Product Correlation Coefficient. In addition, 26 clinicians evaluated the same patients from frontal photographs and gave each individual an overall score based on his or her apparent asymmetry. These average scores from the examiners were compared statistically to the total asymmetry scores from both the radiographic and the anthropometric data. The hypothesis was that the anthropometric data and the radiographic data would be more closely correlated with each other than either would be with the photographic data (examiner's scores). Data in this study support the hypothesis. Although some significant correlations exist between radiographic and anthropometric methods, the correlation is not high. Neither of the methods shows a correlation with the photographic data. Different measurement techniques measure different aspects of asymmetry with different errors associated with it, and clinical decisions based only on one method must be interpreted with caution.