Is There a Need for Greater Emphasis on Clinical Facial Analysis than Cephalometrics & 3D Software Solutions in the Diagnosis and Treatment Planning of Patients with Dentofacial Deformities?

J Maxillofac Oral Surg. 2023 Dec;22(4):820-826. doi: 10.1007/s12663-023-02022-2. Epub 2023 Nov 4.

Abstract

Purpose: This study is designed to evaluate the need for a greater emphasis on clinical facial analysis over cephalometrics in the diagnosis and treatment planning of patients with dentofacial deformities.

Materials and method: A predetermined questionnaire study was designed to get the thought process of surgeons and consultants involved in orthognathic surgery from various parts of southern India. Two hundred and twenty-eight maxillofacial consultants were involved in the survey. Demographic information, type of professional practice, preferred tool in the diagnosis & treatment planning: Cephalometrics or 3D software solutions and flaw in the available tools were evaluated.

Results: The results of this study revealed that only 36.8% of the consultants felt that cephalometrics is the prime tool and 73.3% of the consultants felt that 3D software solutions were superior to cephalometrics in the diagnosis and treatment planning of patients with dentofacial deformities. However, 46% of the consultants preferred facial analysis as the prime tool with cephalometrics as an adjunct. Pertaining to the clinical outcome of their treated cases of dentofacial deformities, 61.8% of the consultants felt the need to address additional cosmetic issues following an orthognathic procedure. It was observed that 92.1% of the participants felt the need for greater emphasis on clinical facial analysis than cephalometrics.

Conclusion: Human faces should always be evaluated taking into consideration the various esthetic units of the face. Performing corrective jaw surgery merely based on cephalometric values inevitably fails to address the various other innate imbalances of the face. Hence, cephalometric data should only be considered as an adjunct to clinical judgment in the diagnosis and treatment planning of dentofacial deformities.

Keywords: 3D software solutions; Cephalometrics; Dentofacial deformity; Facial analysis; Oral and maxillofacial surgeon; Orthodontist.