Introduction: Skeletal Class III patients often present a major facial asymmetry. In the
current investigation, a quantitative method to assess 3D facial asymmetry was applied
to an orthognathic surgery patient to quantify possible postsurgical modifications.
Methodology: Soft-tissue facial scans of a 20-year-old man with skeletal Class III,
candidate to orthognathic surgery, were collected in the pre-surgery stage and 6, 12, 24
months post-surgery with a stereophotogrammetric system. Soft tissue asymmetry was
calculated in the facial thirds according to a published protocol (J Craniomaxillofac Surg
2017;45(1):76-81), and the relevant time-related modifications described. The results
were also compared to normal values from a group of 23 control subjects (10 men, 13
women, mean age 26) by using z-scores.
Results: The longitudinal analysis of the soft-tissue facial asymmetry showed a marked
difference in the analysed time points: orthognathic surgery did reduce facial symmetry
in the present patient. The comparison between the patient and the control subjects
by using z-scores highlighted a clear difference in all-time points: the patient with facial
dysmorphia had a higher degree of asymmetry than healthy subjects.
Conclusion: The measurements of soft-tissue facial asymmetry using 3D optical
digitisers can provide clinically useful information. The graphical representation of
results can help in the patient’s understanding of the treatment phases, thus increasing
compliance
