Angular Asymmetries of the Human Face

Purpose: The determination of an acceptable occlusal plane is essential for the development of esthetic prosthodontic restorations. However, since most faces are not symmetric, a method was developed for measuring facial angular asymmetry, ie, the divergence from the vertical or horizontal of the line joining the midpoint of the intercanthal line and the philtrum of the lip, the interpupillary line, the intermeatal line, the lip commissure line, and the intercuspid line. Materials and Methods: Standardized frontal images (mouth closed, smiling, and biting on a wooden spatula) of 100 subjects were taken using a digital camera. These images were downloaded into a computer, and the angles between the various facial lines and the horizontal were measured. The subjects were grouped by sex, age, and history of trauma and orthodontic treatment. Results: No statistically significant differences were found between the mean values for each group. Conclusion: Asymmetry of the face can be measured using digital camera imaging and computer analysis. A range of facial asymmetries that can influence the choice of occlusal plane during prosthodontic treatment exists. Thus, the use of an occlusal plane parallel to the ala tragus and interpupillary lines, as often advocated by prosthodontists, may result in less than ideal esthetics in the final restoration.