{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:07:24Z","timestamp":1780067244752,"version":"3.54.0"},"reference-count":54,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives:<\/jats:title>\n To use three-dimensional (3D) mirroring and surface-to-surface techniques to determine any differences in mandibular functional unit shape and morphology between the crossbite side and non-crossbite side in adult patients with posterior unilateral crossbite who had not received any corrective treatment for malocclusion.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n Cone-beam computed tomography (CBCT) records from 24 consecutive adult white patients (mean age, 27.5 years; range 22.6\u201339.7 years; 14 women and 10 men) seeking treatment for maxillary transverse deficiency were assessed in this study. The control group comprised CBCT scans from age- and sex-matched patients. Segmentation masks were generated to obtain 3D surface mesh models of the mandibles and analyze the six skeletal functional units, which were further analyzed with reverse engineering software.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Statistically significant differences in the mean surface distance when comparing the study sample and the control sample were found at the condylar process, mandibular ramus, angular process (\n P<\/jats:italic>\n \u2264 .0001), and alveolar process (\n P<\/jats:italic>\n \u2264 .01); no statistically significant differences were found for the coronoid process, the chin, and the mandibular body (\n P<\/jats:italic>\n \u2265 .5).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The condylar, angular, and alveolar processes plus the mandibular ramus appear to play a more dominant role than did the body, the coronoid, and the chin units in the asymmetry of the mandible in patients with unilateral crossbite.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/081718-607.1","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T15:17:49Z","timestamp":1556032669000},"page":"590-596","source":"Crossref","is-referenced-by-count":25,"title":["Three-dimensional analysis of mandibular functional units in adult patients with unilateral posterior crossbite: A cone beam study with the use of mirroring and surface-to-surface matching techniques"],"prefix":"10.2319","volume":"89","author":[{"given":"Rosalia","family":"Leonardi","sequence":"first","affiliation":[{"name":"Professor and Chair, Director of Master's Degree in Orthodontics, Department of Orthodontics, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Muraglie","sequence":"additional","affiliation":[{"name":"Research Fellow, Department of Orthodontics, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orazio","family":"Bennici","sequence":"additional","affiliation":[{"name":"Private Practice, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costanza","family":"Cavallini","sequence":"additional","affiliation":[{"name":"Research Fellow, Department of Radiology, Oncology and Anatomy Pathology, La Sapienza University, Azienda Ospedaliera Policlinico Umberto I, Rome, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Concetto","family":"Spampinato","sequence":"additional","affiliation":[{"name":"Professor, Department of Computer and Telecommunications Engineering, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-89-4-590-b01","series-title":"Am J Orthod","first-page":"491","article-title":"Posterior cross-bites in the deciduous and mixed dentitions","volume":"56","author":"Kutin \n G,","year":"1969","unstructured":"Kutin \n G, \n \n \n Hawes \n RR. \n \n \n Posterior cross-bites in the deciduous and mixed dentitions. Am J Orthod. 1969;56:491\u2013504."},{"key":"i0003-3219-89-4-590-b02","series-title":"Compend Contin Educ Dent","first-page":"1051","article-title":"Posterior crossbites in children","volume":"17","author":"Zhu \n JF,","year":"1996","unstructured":"Zhu \n JF, \n \n \n Crevoisier \n R, \n \n \n King \n DL, \n \n \n Henry \n R, \n \n \n Mills \n CM. \n \n \n Posterior crossbites in children. Compend Contin Educ Dent. 1996;17:1051\u20131054, 1056, 1058."},{"key":"i0003-3219-89-4-590-b03","series-title":"Am J Orthod Dentofacial Orthop","first-page":"513","article-title":"and positional asymmetries of young children with functional unilateral posterior crossbite","volume":"120","author":"Pinto \n AS,","year":"2001","unstructured":"Pinto \n AS, \n \n \n Buschang \n PH, \n \n \n Throckmorton \n GS, \n \n \n Chen P. \n Morphological\n \n \n and positional asymmetries of young children with functional unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 2001;120:513\u2013520."},{"key":"i0003-3219-89-4-590-b04","series-title":"J Oral Rehabil","first-page":"59","article-title":"Functional changes after early treatment of unilateral posterior cross-bite associated with mandibular shift: a systematic review","volume":"43","author":"Tsanidis \n N,","year":"2016","unstructured":"Tsanidis \n N, \n \n \n Antonarakis \n GS, \n \n \n Kiliaridis \n S. \n \n \n Functional changes after early treatment of unilateral posterior cross-bite associated with mandibular shift: a systematic review. J Oral Rehabil. 2016;43:59\u201368."},{"key":"i0003-3219-89-4-590-b05","series-title":"Angle Orthod","first-page":"253","article-title":"Three-dimensional evaluation of facial asymmetry in association with unilateral functional crossbite in the primary, early, and late mixed dentition phases","volume":"83","author":"Primozic \n J,","year":"2013","unstructured":"Primozic \n J, \n \n \n Perinetti \n G, \n \n \n Richmond \n S, \n \n \n Ovsenik \n M. \n \n \n Three-dimensional evaluation of facial asymmetry in association with unilateral functional crossbite in the primary, early, and late mixed dentition phases. Angle Orthod. 2013;83:253\u2013258."},{"key":"i0003-3219-89-4-590-b06","series-title":"J Orofac Orthop","first-page":"371","article-title":"A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition\u2013occlusal and skeletal characteristics of significance in predicting the long-term outcome","volume":"63","author":"Thilander \n B,","year":"2002","unstructured":"Thilander \n B, \n \n \n Lennartsson \n B. \n \n \n A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition\u2013occlusal and skeletal characteristics of significance in predicting the long-term outcome. J Orofac Orthop. 2002;63:371\u2013383."},{"key":"i0003-3219-89-4-590-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"6","article-title":"Transverse skeletal and dental asymmetry in adults with unilateral lingual posterior crossbite","volume":"127","author":"Langberg \n BJ,","year":"2005","unstructured":"Langberg \n BJ, \n \n \n Arai \n K, \n \n \n Miner \n RM. \n \n \n Transverse skeletal and dental asymmetry in adults with unilateral lingual posterior crossbite. Am J Orthod Dentofacial Orthop. 2005;127:6\u201315; discussion 15\u201316."},{"key":"i0003-3219-89-4-590-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"394","article-title":"An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite","volume":"107","author":"O'Byrn \n BL,","year":"1995","unstructured":"O'Byrn \n BL, \n \n \n Sadowsky \n C, \n \n \n Schneider \n B, \n \n \n BeGole \n EA. \n \n \n An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 1995;107:394\u2013400."},{"key":"i0003-3219-89-4-590-b09","series-title":"Eur J Orthod","first-page":"22","article-title":"Comparison of the mandibular hinge axis in adult patients with facial asymmetry with and without posterior unilateral crossbite","volume":"37","author":"Takada \n J,","year":"2015","unstructured":"Takada \n J, \n \n \n Miyamoto \n JJ, \n \n \n Yokota \n T, \n \n \n Ono \n T, \n \n \n Moriyama \n K. \n \n \n Comparison of the mandibular hinge axis in adult patients with facial asymmetry with and without posterior unilateral crossbite. Eur J Orthod. 2015;37:22\u201327."},{"key":"i0003-3219-89-4-590-b10","series-title":"Eur J Orthod","first-page":"638","article-title":"Association between posterior crossbite, skeletal, and muscle asymmetry: a systematic review","volume":"38","author":"Iodice \n G,","year":"2016","unstructured":"Iodice \n G, \n \n \n Danzi \n G, \n \n \n Cimino \n R, \n \n \n Paduano \n S, \n \n \n Michelotti \n A. \n \n \n Association between posterior crossbite, skeletal, and muscle asymmetry: a systematic review. Eur J Orthod. 2016;38:638\u2013651."},{"key":"i0003-3219-89-4-590-b11","series-title":"Aust Orthod J","first-page":"11","article-title":"An evaluation of condylar and ramal vertical asymmetry in adolescents with unilateral and bilateral posterior crossbite using cone beam computed tomography (CBCT)","volume":"30","author":"Halicioglu \n K,","year":"2014","unstructured":"Halicioglu \n K, \n \n \n Celikoglu \n M, \n \n \n Yavuz \n I, \n \n \n Sekerci \n AE, \n \n \n Buyuk \n SK. \n \n \n An evaluation of condylar and ramal vertical asymmetry in adolescents with unilateral and bilateral posterior crossbite using cone beam computed tomography (CBCT). Aust Orthod J. 2014;30:11\u201318."},{"key":"i0003-3219-89-4-590-b12","series-title":"Braz Oral Res","first-page":"49","article-title":"Evaluation of mandibular condyles in children with unilateral posterior crossbite","volume":"29","author":"Illipronti-Filho \n E,","year":"2015","unstructured":"Illipronti-Filho \n E, \n \n \n Fantini \n SM, \n \n \n Chilvarquer \n I. \n \n \n Evaluation of mandibular condyles in children with unilateral posterior crossbite. Braz Oral Res. 2015;29:49."},{"key":"i0003-3219-89-4-590-b13","series-title":"Angle Orthod","first-page":"966","article-title":"Mandibular asymmetry in unilateral and bilateral posterior crossbite patients using cone-beam computed tomography","volume":"81","author":"Veli \n I,","year":"2011","unstructured":"Veli \n I, \n \n \n Uysal \n T, \n \n \n Ozer \n T, \n \n \n Ucar \n FI, \n \n \n Eruz \n M. \n \n \n Mandibular asymmetry in unilateral and bilateral posterior crossbite patients using cone-beam computed tomography. Angle Orthod. 2011;81:966\u2013974."},{"key":"i0003-3219-89-4-590-b14","series-title":"Angle Orthod","first-page":"95","article-title":"The role of the functional matrix in mandibular growth","volume":"38","author":"Moss \n ML,","year":"1968","unstructured":"Moss \n ML, \n \n \n Rankow \n RM. \n \n \n The role of the functional matrix in mandibular growth. Angle Orthod. 1968;38:95\u2013103."},{"key":"i0003-3219-89-4-590-b15","series-title":"Dentomaxillofac Radiol","first-page":"351","article-title":"Comparison of two methods for quantitative assessment of mandibular asymmetry using cone beam computed tomography image volumes","volume":"40","author":"AlHadidi \n A,","year":"2011","unstructured":"AlHadidi \n A, \n \n \n Cevidanes \n LH, \n \n \n Mol \n A, \n \n \n Ludlow \n J, \n \n \n Styner \n M. \n \n \n Comparison of two methods for quantitative assessment of mandibular asymmetry using cone beam computed tomography image volumes. Dentomaxillofac Radiol. 2011;40:351\u2013357."},{"key":"i0003-3219-89-4-590-b16","series-title":"Prog Orthod","first-page":"69","article-title":"Comparison of in vivo 3D cone-beam computed tomography tooth volume measurement protocols","volume":"15","author":"Forst \n D,","year":"2014","unstructured":"Forst \n D, \n \n \n Nijjar \n S, \n \n \n Flores-Mir \n C, \n \n \n Carey \n J, \n \n \n Secanell \n M, \n \n \n Lagravere \n M. \n \n \n Comparison of in vivo 3D cone-beam computed tomography tooth volume measurement protocols. 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Oral Surg Oral Med Oral Pathol. 1987;63:637\u2013644."},{"key":"i0003-3219-89-4-590-b20","series-title":"Am J Orthod Dentofacial Orthop","first-page":"328","article-title":"Effect of unilateral posterior crossbite on the electromyographic activity of human masticatory muscles","volume":"118","author":"Alarcon \n JA,","year":"2000","unstructured":"Alarcon \n JA, \n \n \n Martin \n C, \n \n \n Palma \n JC. \n \n \n Effect of unilateral posterior crossbite on the electromyographic activity of human masticatory muscles. Am J Orthod Dentofacial Orthop. 2000;118:328\u2013334."},{"key":"i0003-3219-89-4-590-b21","series-title":"Eur J Oral Sci","first-page":"35","article-title":"Effect of masticatory function on the internal bone structure in the mandible of the growing rat","volume":"107","author":"Bresin \n A,","year":"1999","unstructured":"Bresin \n A, \n \n \n Kiliaridis \n S, \n \n \n Strid \n KG. \n \n \n Effect of masticatory function on the internal bone structure in the mandible of the growing rat. Eur J Oral Sci. 1999;107:35\u201344."},{"key":"i0003-3219-89-4-590-b22","series-title":"Angle Orthod","first-page":"607","article-title":"Ultrasonographic thickness of the masseter muscle in growing individuals with unilateral crossbite","volume":"77","author":"Kiliaridis \n S,","year":"2007","unstructured":"Kiliaridis \n S, \n \n \n Mahboubi \n PH, \n \n \n Raadsheer \n MC, \n \n \n Katsaros \n C. \n \n \n Ultrasonographic thickness of the masseter muscle in growing individuals with unilateral crossbite. Angle Orthod. 2007;77:607\u2013611."},{"key":"i0003-3219-89-4-590-b23","series-title":"Braz Oral Res","first-page":"89","article-title":"Effects of the unilateral removal and dissection of the masseter muscle on the facial growth of young rats","volume":"23","author":"Rodrigues \n L,","year":"2009","unstructured":"Rodrigues \n L, \n \n \n Traina \n AA, \n \n \n Nakamai \n LF, \n \n \n Luz \n JG. \n \n \n Effects of the unilateral removal and dissection of the masseter muscle on the facial growth of young rats. Braz Oral Res. 2009;23:89\u201395."},{"key":"i0003-3219-89-4-590-b24","series-title":"Angle Orthod","first-page":"321","article-title":"Craniofacial change and non-change after experimental surgery in young and adult animals","volume":"58","author":"Sarnat \n BG.","year":"1988","unstructured":"Sarnat \n BG. \n \n \n Craniofacial change and non-change after experimental surgery in young and adult animals. 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Arch Oral Biol. 2016;63:22\u201331."},{"key":"i0003-3219-89-4-590-b27","series-title":"Eur J Orthod","first-page":"155","article-title":"The functional shift of the mandible in unilateral posterior crossbite and the adaptation of the temporomandibular joints: a pilot study","volume":"21","author":"Nerder \n PH,","year":"1999","unstructured":"Nerder \n PH, \n \n \n Bakke \n M, \n \n \n Solow \n B. \n \n \n The functional shift of the mandible in unilateral posterior crossbite and the adaptation of the temporomandibular joints: a pilot study. Eur J Orthod. 1999;21:155\u2013166."},{"key":"i0003-3219-89-4-590-b01","series-title":"Am J Orthod","first-page":"491","article-title":"Posterior cross-bites in the deciduous and mixed dentitions","volume":"56","author":"Kutin \n G,","year":"1969","unstructured":"Kutin \n G, \n \n \n Hawes \n RR. \n \n \n Posterior cross-bites in the deciduous and mixed dentitions. Am J Orthod. 1969;56:491\u2013504."},{"key":"i0003-3219-89-4-590-b02","series-title":"Compend Contin Educ Dent","first-page":"1051","article-title":"Posterior crossbites in children","volume":"17","author":"Zhu \n JF,","year":"1996","unstructured":"Zhu \n JF, \n \n \n Crevoisier \n R, \n \n \n King \n DL, \n \n \n Henry \n R, \n \n \n Mills \n CM. \n \n \n Posterior crossbites in children. Compend Contin Educ Dent. 1996;17:1051\u20131054, 1056, 1058."},{"key":"i0003-3219-89-4-590-b03","series-title":"Am J Orthod Dentofacial Orthop","first-page":"513","article-title":"and positional asymmetries of young children with functional unilateral posterior crossbite","volume":"120","author":"Pinto \n AS,","year":"2001","unstructured":"Pinto \n AS, \n \n \n Buschang \n PH, \n \n \n Throckmorton \n GS, \n \n \n Chen P. \n Morphological\n \n \n and positional asymmetries of young children with functional unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 2001;120:513\u2013520."},{"key":"i0003-3219-89-4-590-b04","series-title":"J Oral Rehabil","first-page":"59","article-title":"Functional changes after early treatment of unilateral posterior cross-bite associated with mandibular shift: a systematic review","volume":"43","author":"Tsanidis \n N,","year":"2016","unstructured":"Tsanidis \n N, \n \n \n Antonarakis \n GS, \n \n \n Kiliaridis \n S. \n \n \n Functional changes after early treatment of unilateral posterior cross-bite associated with mandibular shift: a systematic review. J Oral Rehabil. 2016;43:59\u201368."},{"key":"i0003-3219-89-4-590-b05","series-title":"Angle Orthod","first-page":"253","article-title":"Three-dimensional evaluation of facial asymmetry in association with unilateral functional crossbite in the primary, early, and late mixed dentition phases","volume":"83","author":"Primozic \n J,","year":"2013","unstructured":"Primozic \n J, \n \n \n Perinetti \n G, \n \n \n Richmond \n S, \n \n \n Ovsenik \n M. \n \n \n Three-dimensional evaluation of facial asymmetry in association with unilateral functional crossbite in the primary, early, and late mixed dentition phases. Angle Orthod. 2013;83:253\u2013258."},{"key":"i0003-3219-89-4-590-b06","series-title":"J Orofac Orthop","first-page":"371","article-title":"A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition\u2013occlusal and skeletal characteristics of significance in predicting the long-term outcome","volume":"63","author":"Thilander \n B,","year":"2002","unstructured":"Thilander \n B, \n \n \n Lennartsson \n B. \n \n \n A study of children with unilateral posterior crossbite, treated and untreated, in the deciduous dentition\u2013occlusal and skeletal characteristics of significance in predicting the long-term outcome. J Orofac Orthop. 2002;63:371\u2013383."},{"key":"i0003-3219-89-4-590-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"6","article-title":"Transverse skeletal and dental asymmetry in adults with unilateral lingual posterior crossbite","volume":"127","author":"Langberg \n BJ,","year":"2005","unstructured":"Langberg \n BJ, \n \n \n Arai \n K, \n \n \n Miner \n RM. \n \n \n Transverse skeletal and dental asymmetry in adults with unilateral lingual posterior crossbite. Am J Orthod Dentofacial Orthop. 2005;127:6\u201315; discussion 15\u201316."},{"key":"i0003-3219-89-4-590-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"394","article-title":"An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite","volume":"107","author":"O'Byrn \n BL,","year":"1995","unstructured":"O'Byrn \n BL, \n \n \n Sadowsky \n C, \n \n \n Schneider \n B, \n \n \n BeGole \n EA. \n \n \n An evaluation of mandibular asymmetry in adults with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop. 1995;107:394\u2013400."},{"key":"i0003-3219-89-4-590-b09","series-title":"Eur J Orthod","first-page":"22","article-title":"Comparison of the mandibular hinge axis in adult patients with facial asymmetry with and without posterior unilateral crossbite","volume":"37","author":"Takada \n J,","year":"2015","unstructured":"Takada \n J, \n \n \n Miyamoto \n JJ, \n \n \n Yokota \n T, \n \n \n Ono \n T, \n \n \n Moriyama \n K. \n \n \n Comparison of the mandibular hinge axis in adult patients with facial asymmetry with and without posterior unilateral crossbite. Eur J Orthod. 2015;37:22\u201327."},{"key":"i0003-3219-89-4-590-b10","series-title":"Eur J Orthod","first-page":"638","article-title":"Association between posterior crossbite, skeletal, and muscle asymmetry: a systematic review","volume":"38","author":"Iodice \n G,","year":"2016","unstructured":"Iodice \n G, \n \n \n Danzi \n G, \n \n \n Cimino \n R, \n \n \n Paduano \n S, \n \n \n Michelotti \n A. \n \n \n Association between posterior crossbite, skeletal, and muscle asymmetry: a systematic review. Eur J Orthod. 2016;38:638\u2013651."},{"key":"i0003-3219-89-4-590-b11","series-title":"Aust Orthod J","first-page":"11","article-title":"An evaluation of condylar and ramal vertical asymmetry in adolescents with unilateral and bilateral posterior crossbite using cone beam computed tomography (CBCT)","volume":"30","author":"Halicioglu \n K,","year":"2014","unstructured":"Halicioglu \n K, \n \n \n Celikoglu \n M, \n \n \n Yavuz \n I, \n \n \n Sekerci \n AE, \n \n \n Buyuk \n SK. \n \n \n An evaluation of condylar and ramal vertical asymmetry in adolescents with unilateral and bilateral posterior crossbite using cone beam computed tomography (CBCT). Aust Orthod J. 2014;30:11\u201318."},{"key":"i0003-3219-89-4-590-b12","series-title":"Braz Oral Res","first-page":"49","article-title":"Evaluation of mandibular condyles in children with unilateral posterior crossbite","volume":"29","author":"Illipronti-Filho \n E,","year":"2015","unstructured":"Illipronti-Filho \n E, \n \n \n Fantini \n SM, \n \n \n Chilvarquer \n I. \n \n \n Evaluation of mandibular condyles in children with unilateral posterior crossbite. Braz Oral Res. 2015;29:49."},{"key":"i0003-3219-89-4-590-b13","series-title":"Angle Orthod","first-page":"966","article-title":"Mandibular asymmetry in unilateral and bilateral posterior crossbite patients using cone-beam computed tomography","volume":"81","author":"Veli \n I,","year":"2011","unstructured":"Veli \n I, \n \n \n Uysal \n T, \n \n \n Ozer \n T, \n \n \n Ucar \n FI, \n \n \n Eruz \n M. \n \n \n Mandibular asymmetry in unilateral and bilateral posterior crossbite patients using cone-beam computed tomography. Angle Orthod. 2011;81:966\u2013974."},{"key":"i0003-3219-89-4-590-b14","series-title":"Angle Orthod","first-page":"95","article-title":"The role of the functional matrix in mandibular growth","volume":"38","author":"Moss \n ML,","year":"1968","unstructured":"Moss \n ML, \n \n \n Rankow \n RM. \n \n \n The role of the functional matrix in mandibular growth. Angle Orthod. 1968;38:95\u2013103."},{"key":"i0003-3219-89-4-590-b15","series-title":"Dentomaxillofac Radiol","first-page":"351","article-title":"Comparison of two methods for quantitative assessment of mandibular asymmetry using cone beam computed tomography image volumes","volume":"40","author":"AlHadidi \n A,","year":"2011","unstructured":"AlHadidi \n A, \n \n \n Cevidanes \n LH, \n \n \n Mol \n A, \n \n \n Ludlow \n J, \n \n \n Styner \n M. \n \n \n Comparison of two methods for quantitative assessment of mandibular asymmetry using cone beam computed tomography image volumes. 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