Asimmetrie Cranio-Facciali In Soggetti Non Sindromici: Segno Isolato O Sistemico?

CRANIO-FACIAL ASYMMETRY IN NON-SYNDROMIC ORTHODONTIC SUBJECTS: ISOLATED OR SYSTEMIC SIGN? Castellano M. Sapienza University of Rome, Department of Dentistry and Maxillo-Facial Surgery, Dir.: A. Polimeni. Orthognatodontic Department, Dir.: E. Barbato. Post-graduate school of Orthognatodontic Dir.: G. Galluccio. Aim: to compare orthodontic patients presenting symmetric malocclusion and malocclusion + craniofacial asymmetry not referable to syndromes and an asymmetrical feature in other body’s areas. To test the possible influence of the pattern malocclusion + asymmetry on the posture of the patient through study with rasterstereography (Formetric 4D, Diers). Materials and methods: At the Orthodontics Department of Dentistry of Sapienza University of Rome, were evaluated patients affected by symmetrical malocclusion and malocclusion + mild to moderate non sindromic craniofacial asymmetry. Patients undergone to a clinical and X-Ray evaluation. In order to assess the presence of asymmetries in other areas of the body, a multidisciplinary assessment was made which included the development of a method for the measurement of XR-hand wrist, comparing right and left hand on an anterior-posterior single radiogram. Evaluation of differences in postural pattern among patients was performed using rasterestereographic evaluation, an optical contact-free photogrammetric method. The analysis included sagittal and frontal back shape measurements. Results: We analyzed 40 hand-wrist radiographs on which tracks of soft and hard tissue were drawn manually. A statistically significant difference between the right and left hand was found in some variable (i.e. M2-M4R-M2-M4L p=0.0095; right-sided laterality vs. hand-wrist parameters: difference fpdx – fpsx (p=0.0260); Wider right hemi-face vs. hand-wrist parameters: difference fpdx – fpsx (p=0.0175) and difference URdx – Ursx (p=0.0494); Right-handed vs. hand-wrist parameters: difference fpdx – fpsx (p=0.0302) and difference Wdx – Wsx (p=0.0458). Moreover, we analyzed data by 61 patients using statistical analysis to detect differences on variables measured by rasterstereography, related to the symmetric malocclusion or malocclusion + mild to moderate craniofacial asymmetry. The result shows a statistically significant difference of Pelvic torsion parameter (NV= 0-1,9° by Harzmann) in subjects with Class II skeletal malocclusion + asymmetry. Conclusions: The findings should help the orthodontist to point out patients with malocclusion + mild to moderate non syndromic craniofacial asymmetry, in order to make an appropriate diagnosis and to draft an appropriate treatment plan that may involves a multidisciplinary approach, including postural evaluation.