3D Facial Analysis in Class II Subdivision Malocclusion

Ettore Candida1
, Francesca R. Grippaudo2
, Cristiana Romeo1
, Rosita Tauro1
, Anna Blasi1
, Cristina Grippaudo1, *

1 Dental Institute, Catholic University of the Sacred Heart, Fondazione Policlinico Gemelli IRCCS. L.go A. Gemelli, 8 – 00168 Rome, Italy
2 Plastic Surgery Unit, Faculty of Medicine and Psychology, Sapienza University of Rome, Piazzale Aldo Moro, 5-00185 Rome, Italy

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 449
Abstract HTML Views: 259
PDF Downloads: 69
ePub Downloads: 51
Total Views/Downloads: 828
Unique Statistics:

Full-Text HTML Views: 276
Abstract HTML Views: 162
PDF Downloads: 42
ePub Downloads: 34
Total Views/Downloads: 514

Creative Commons License
© 2022 Candida et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Dental Dental Institute, Catholic University of the Sacred Heart, Fondazione Policlinico Gemelli IRCCS. L.go A. Gemelli, 8 – 00168 Rome, Italy; Tel: +39 3334121137;



Class II subdivision is an asymmetric condition presenting a Class I dental occlusion on one side and a Class II on the contralateral one. It presents a midline deviation that may be caused by a monolateral distalization of the mandible (type 1) or a mesialization of one side of the maxilla (type 2). The evaluation of asymmetry based on 2D radiographic records has been demonstrated to be less accurate than the one made using 3D radiographs.


The aim of this work is to evaluate the facial asymmetry in a group of patients with Class II subdivision, compared to patients in Class I without evident asymmetry, by using 3D photographs of the face.


32 young adults with Class II subdivision were compared to a group of 32 subjects with bilateral Class I molar relationship. 3D photograph of their face was acquired using a stereophotogrammetric camera (3dMDtrio System-3dMD Atlanta, GA, USA). 3D photographs were imported into the Geomagic Software to create mirror 3D photography. Independent T-tests were made to compare facial asymmetries measured on Class II subdivision group with the Class I group.


The results show that there is a statistically significant difference in landmarks location between the control group and the experimental group regarding the values measured at the level of the lips and the perioral area. The asymmetry was more marked in patients with mandibular midline deviation. This is in line with previous observations with radiographic investigations.


For a correct assessment of the asymmetry, a study of 3D photographs cannot replace an evaluation by cone beam, but it can be an important aid to estimate possible asymmetries in the perioral area and in the lip area.

Keywords: Facial asymmetry, Class II subdivision, Stereophotogrammetry, Soft tissue, Face, Malocclusion.