Acquired Facial, Maxillofacial, and Oral Asymmetries—A Review Highlighting Diagnosis and Management

From Filters to Scalpels-Understanding Perceptions of Facial Asymmetry: An AAFPRS Survey

Facial asymmetries can significantly affect patient satisfaction post-surgery. Social media can impact a patient's perception of their asymmetries. To gather insights into the practices, perceptions, and approaches concerning facial asymmetry among facial plastic surgeons. The aim of this study was to understand the impact of social media on perceptions of facial asymmetry. This is an American Academy of Facial Plastic and Reconstructive Surgeons (AAFPRS) survey consisting of 46 questions that sought to understand facial plastic surgeons' perceptions of facial asymmetry, their consultation process, their patients' perspectives on their own facial asymmetries, and patient satisfaction. The survey was distributed to 1,269 members of AAFPRS across community hospitals, private practices, and academic hospitals. Sixty-seven members completed the survey. The survey revealed that 31% (21) of surgeons face challenges in managing patient expectations regarding facial asymmetry. In addition, 12% (8) of surgeons felt that patients did not initially recognize their own asymmetries. Eighty-seven percent (58) of surgeons emphasize the natural occurrence of asymmetry during consultations to set realistic expectations. This study emphasizes the need for thorough patient education during initial consultations to align expectations with achievable outcomes. Surgeons should explain the natural occurrence of asymmetry clearly and use digital imaging to show patients realistic previews of surgical results.

Role of Three-Dimensional Printing in Treatment Planning for Orthognathic Surgery: A Systematic Review

Three-dimensional (3D) printing refers to a wide range of additive manufacturing processes that enable the construction of structures and models. It has been rapidly adopted for a variety of surgical applications, including the printing of patient-specific anatomical models, implants and prostheses, external fixators and splints, as well as surgical instrumentation and cutting guides. In comparison to traditional methods, 3D-printed models and surgical guides offer a deeper understanding of intricate maxillofacial structures and spatial relationships. This review article examines the utilization of 3D printing in orthognathic surgery, particularly in the context of treatment planning. It discusses how 3D printing has revolutionized this sector by providing enhanced visualization, precise surgical planning, reduction in operating time, and improved patient communication. Various databases, including PubMed, Google Scholar, ScienceDirect, and Medline, were searched with relevant keywords. A total of 410 articles were retrieved, of which 71 were included in this study. This article concludes that the utilization of 3D printing in the treatment planning of orthognathic surgery offers a wide range of advantages, such as increased patient satisfaction and improved functional and aesthetic outcomes.

Characterizing the relationship between L-DOPA-induced-dyskinesia and psychosis-like behaviors in a bilateral rat model of Parkinson's disease

Parkinson's disease associated psychosis (PDAP) is a prevalent non-motor symptom (NMS) that significantly erodes patients' and caregivers' quality of life yet remains vastly understudied. One potential source of PDAP in late-stage Parkinson's disease (PD) is the common dopamine (DA) replacement therapy for motor symptoms, Levodopa (L-DOPA). Given the high incidence of L-DOPA-induced dyskinesia (LID) in later phases of PD, this study sought to characterize the relationship between PDAP and LID in a bilateral medial forebrain bundle 6-hydroxydopamine hydrobromide (6-OHDA) lesion rat model. To assess PDAP in this model, prepulse inhibition (PPI), a well-validated assay of sensorimotor gating, was employed. First, we tested whether a bilateral lesion alone or after chronic L-DOPA treatment was sufficient to induce PPI dysfunction. Rats were also monitored for LID development, using the abnormal involuntary movements (AIMs) test, to examine PPI and LID associations. In experiment 2, Vilazodone (VZD), a serotonin transporter (SERT) blocker and 1A receptor (5-HT_1A) partial agonist was administered to test its potential efficacy in reducing LID and PPI dysfunction. Once testing was complete, tissue was collected for high performance liquid chromatography (HPLC) to examine the monoamine levels in motor and non-motor circuits. Results indicate that bilateral DA lesions produced motor deficits and that chronic L-DOPA induced moderate AIMs; importantly, rats that developed more severe AIMs were more likely to display sensorimotor gating dysfunction. In addition, VZD treatment dose-dependently reduced L-DOPA-induced AIMs without impairing L-DOPA efficacy, although VZD's effects on PPI were limited. Altogether, this project established the bilateral 6-OHDA lesion model accurately portrayed LID and PDAP-like behaviors, uncovered their potential relationship, and finally, demonstrated the utility of VZD for reducing LID.

Accuracy of RGB-D camera-based and stereophotogrammetric facial scanners: a comparative study

OBJECTIVES

This study aimed to evaluate and compare the accuracy and inter-operator reliability of a low-cost red-green-blue-depth (RGB-D) camera-based facial scanner (Bellus3D Arc7) with a stereophotogrammetry facial scanner (3dMD) and to explore the possibility of the former as a clinical substitute for the latter.

METHODS

A mannequin head was selected as the research object. In the RGB-D camera-based facial scanner group, the head was continuously scanned five times using an RGB-D camera-based facial scanner (Bellus3D Arc7), and the outcome data of each scan was then imported into CAD software (MeshLab) to reconstruct three-dimensional (3D) facial photographs. In the stereophotogrammetry facial scanner group, the mannequin head was scanned with a stereophotogrammetry facial scanner (3dMD). Selected parameters were directly measured on the reconstructed 3D virtual faces using a CAD software. The same parameters were then measured directly on the mannequin head using the direct anthropometry (DA) method as the gold standard for later comparison. The accuracy of the facial scanners was evaluated in terms of trueness and precision. Trueness was evaluated by comparing the measurement results of the two groups with each other and with that of DA using equivalence tests and average absolute deviations, while precision and inter-operator reliability were assessed using the intraclass correlation coefficient (ICC). A 3D facial mesh deviation between the two groups was also calculated for further reference using a 3D metrology software (GOM inspect pro).

RESULTS

In terms of trueness, the average absolute deviations between RGB-D camera-based and stereophotogrammetry facial scanners, between RGB-D camera-based facial scanner and DA, and between stereophotogrammetry facial scanner and DA were statistically equivalent at 0.50±0.27 mm, 0.61±0.42 mm, and 0.28±0.14 mm, respectively. Equivalence test results confirmed that their equivalence was within clinical requirements (<1 mm). The ICC for each parameter was approximately 0.999 in terms of precision and inter-operator reliability. A 3D facial mesh analysis suggested that the deviation between the two groups was 0.37±0.01 mm.

CONCLUSIONS

For facial scanners, an accuracy of <1 mm is commonly considered clinically acceptable. Both the RGB-D camera-based and stereophotogrammetry facial scanners in this study showed acceptable trueness, high precision, and inter-operator reliability. A low-cost RGB-D camera-based facial scanner could be an eligible clinical substitute for traditional stereophotogrammetry.

CLINICAL SIGNIFICANCE

The low-cost RGB-D camera-based facial scanner showed clinically acceptable trueness, high precision, and inter-operator reliability; thus, it could be an eligible clinical substitute for traditional stereophotogrammetry.

Introducing Structural Symmetry and Asymmetry Implications in Development of Recent Pharmacy and Medicine

Structural symmetry, anti-symmetry, or asymmetry represent a foundational property that, for chemical compounds, often determines their chemical and biological activity [...]

Facial Asymmetry: A Narrative Review of the Most Common Neurological Causes

Symmetry of the face is one of the most important features for the perception of attractiveness. Asymmetry of the face means that the right and left sides of the face are not identical. Subclinical facial asymmetry is very common in the general population. Most people have some slight facial asymmetry, and this is the normal biological situation in humans. Abnormalities from soft tissue, dental, and skeletal elements lead to facial asymmetry. Asymmetry has many causal factors, and its aetiology includes both congenital and acquired conditions. Neurological facial asymmetry is scarcely addressed in the dental literature. In this narrative review, we focus on the most common neurological causes of facial asymmetry. From a neurological point of view, facial asymmetry can result from disturbances of the cranial nerves, developmental disorders, or myopathies. In the broad range of differential diagnostics of facial asymmetry, neurological abnormalities should be taken into consideration. The treatment must be related to the underlying cause. Complete knowledge of the aetiological factors and the character of the asymmetry plays a crucial role in formulating a treatment plan.