{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:04:21Z","timestamp":1792271061228,"version":"4.4.0"},"reference-count":28,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To investigate the perception of facial asymmetry in young adults to identify the amounts of chin asymmetry that can be regarded as normal and may benefit from correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Three-dimensional (3D) images of 56 individuals of mixed ethnicity were obtained and used to produce average 3D images of male and female faces. Distortion was then applied to these average faces using a 3D graphics package to simulate different amounts of chin point asymmetry. Five observer groups (lay individuals, dental students, dental care professionals, dental practitioners, and orthodontists) assessed timed presentations of 3D images, rating them as \u201cnormal,\u201d \u201cacceptable,\u201d or \u201cwould benefit from correction.\u201d Time-to-event analysis was used to assess the level of chin asymmetry perceived as normal and beneficial for correction for each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The factors influencing the perception of facial asymmetry were the degree of asymmetry and the observer group. Direction of the asymmetry and gender of the assessed individual did not affect the perception of asymmetry, except in the 4- to 6-mm distortion range. The gender of the observer had no influence on perception. There were statistically significant differences in the amounts of asymmetry that the laypeople and orthodontists considered to be normal (5.6 \u00b1 2.7\u00a0mm and 3.6 \u00b1 1.5\u00a0mm, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and felt would benefit from surgical correction (11.8 \u00b1 4.0\u00a0mm and 9.7 \u00b1 3.0\u00a0mm, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      \u200a=\u200a .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Perception of asymmetry is affected by the amount of asymmetry and the observer group, with orthodontists being more critical.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/120213-888.1","type":"journal-article","created":{"date-parts":[[2014,3,27]],"date-time":"2014-03-27T09:41:56Z","timestamp":1395913316000},"page":"957-965","source":"Crossref","is-referenced-by-count":46,"title":["The perception of facial asymmetry using 3-dimensional simulated images"],"prefix":"10.2319","volume":"84","author":[{"given":"Grainne","family":"McAvinchey","sequence":"first","affiliation":[{"name":"Postgraduate Student, School of Dentistry, University of Birmingham, Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fay","family":"Maxim","sequence":"additional","affiliation":[{"name":"Undergraduate Student, School of Visual Communication. Birmingham City University, Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Nix","sequence":"additional","affiliation":[{"name":"Statistician, School of Medicine, Cardiff University, Cardiff, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Djordjevic","sequence":"additional","affiliation":[{"name":"Research Fellow, Department of Orthodontics, School of Dentistry, Cardiff University, Cardiff, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rognvald","family":"Linklater","sequence":"additional","affiliation":[{"name":"Consultant Orthodontist, School of Dentistry, University of Birmingham, Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Landini","sequence":"additional","affiliation":[{"name":"Professor, School of Dentistry, University of Birmingham, Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"angl-86-03-08-b01","year":"2010","unstructured":"Oxford Dictionaries.\n          Oxford:  Oxford University Press;  2010."},{"key":"angl-86-03-08-b02","series-title":"Angl Orthod","first-page":"43","article-title":"Skeletal asymmetry in aesthetically pleasing faces","volume":"61","author":"Peck\n              BS,","year":"1991","unstructured":"Peck\n              BS, \n            \n              Peck\n              L, \n            \n              Kataja\n              M. \n          \n          Skeletal asymmetry in aesthetically pleasing faces.  Angl Orthod.  1991; 61: 43\u2013 48."},{"key":"angl-86-03-08-b03","series-title":"Angl Orthod","first-page":"231","article-title":"Social and psychological implications of dentofacial disfigurement","volume":"40","author":"Macgregor\n              F.","year":"1970","unstructured":"Macgregor\n              F. \n          \n          Social and psychological implications of dentofacial disfigurement.  Angl Orthod.  1970; 40: 231\u2013 233."},{"key":"angl-86-03-08-b04","series-title":"J Adv Nurs","first-page":"4443","article-title":"Altered body image: appearance-related concerns of people with visible disfigurement","volume":"48","author":"Rumsey\n              N,","year":"2004","unstructured":"Rumsey\n              N, \n            \n              Clarke\n              A, \n            \n              White\n              P, \n            \n              Wyn-Williams\n              M, \n            \n              Garlick\n              W. \n          \n          Altered body image: appearance-related concerns of people with visible disfigurement.  J Adv Nurs.  2004; 48: 4443\u2013 4453."},{"key":"angl-86-03-08-b05","series-title":"Evolution Hum Behav","first-page":"417","article-title":"Facial symmetry and judgements of apparent health. Support for a \u201cgood genes\u201d explanation of the attractiveness-symmetry relationship","volume":"22","author":"Jones\n              BC,","year":"2001","unstructured":"Jones\n              BC, \n            \n              Little\n              AC, \n            \n              Penton-Voak\n              IS, \n            \n              Tiddeman\n              BP, \n            \n              Burt\n              DM, \n            \n              Perrett\n              DI. \n          \n          Facial symmetry and judgements of apparent health. Support for a \u201cgood genes\u201d explanation of the attractiveness-symmetry relationship.  Evolution Hum Behav.  2001; 22: 417\u2013 429."},{"key":"angl-86-03-08-b06","series-title":"Proc Biol Sci","first-page":"39","article-title":"Self-perceived attractiveness influences human female preferences for sexual dimorphism and symmetry in male faces","volume":"268","author":"Little\n              AC,","year":"2001","unstructured":"Little\n              AC, \n            \n              Burt\n              DM, \n            \n              Penton-Voak\n              IS, \n            \n              Perrett\n              DI. \n          \n          Self-perceived attractiveness influences human female preferences for sexual dimorphism and symmetry in male faces.  Proc Biol Sci.  2001; 268: 39\u2013 44."},{"issue":"1","key":"angl-86-03-08-b07","series-title":"Arch Facial Plast Surg","first-page":"14","article-title":"Threshold of visual perception of facial asymmetry in a facials paralysis model","volume":"13","author":"Chu\n              EA,","year":"2011","unstructured":"Chu\n              EA, \n            \n              Farraq\n              TY, \n            \n              Ishii\n              LE, \n            \n              Byrne\n              PJ. \n          \n          Threshold of visual perception of facial asymmetry in a facials paralysis model.  Arch Facial Plast Surg.  2011; 13( 1): 14\u2013 19."},{"key":"angl-86-03-08-b08","series-title":"Three-Dimensional Imaging for Orthodontics and Maxillofacial Surgery","first-page":"126","article-title":"Averaging facial images","author":"Zhurov\n              A,","year":"2010","unstructured":"Zhurov\n              A, \n            \n              Richmond\n              S, \n            \n              Kau\n              CH, \n            \n              Toma\n              A. \n          \n          Averaging facial images.  InKauCH, RichmondS, eds.  Three-Dimensional Imaging for Orthodontics and Maxillofacial Surgery.  London:  Wiley-Blackwell;  2010: 126\u2013 144."},{"key":"angl-86-03-08-b09","series-title":"Biometrics","first-page":"159","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis\n              J,","year":"1977","unstructured":"Landis\n              J, \n            \n              Koch\n              G. \n          \n          The measurement of observer agreement for categorical data.  Biometrics.  1977; 33: 159\u2013 174."},{"issue":"5","key":"angl-86-03-08-b10","series-title":"Eur J Orthod","first-page":"517","article-title":"The influence of dental to facial midline discrepancies on dental attractiveness ratings","volume":"21","author":"Johnston\n              CD,","year":"1999","unstructured":"Johnston\n              CD, \n            \n              Burden\n              DJ, \n            \n              Stevenson\n              MR. \n          \n          The influence of dental to facial midline discrepancies on dental attractiveness ratings.  Eur J Orthod.  1999; 21( 5): 517\u2013 522."},{"key":"angl-86-03-08-b11","series-title":"Eur J Orthod","first-page":"647","article-title":"Three-dimensional perception of facial asymmetry","volume":"33","author":"Meyer-Marcotty\n              P,","year":"2011","unstructured":"Meyer-Marcotty\n              P, \n            \n              Stellzig-Eisenhauer\n              A, \n            \n              Bareis\n              U, \n            \n              Hartmann\n              J, \n            \n              Kochel\n              J. \n          \n          Three-dimensional perception of facial asymmetry.  Eur J Orthod.  2011; 33: 647\u2013 653."},{"key":"angl-86-03-08-b12","series-title":"Br J Oral Maxillofac Surg","first-page":"32","article-title":"A cost-utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony","volume":"41","author":"Cunningham\n              SJ,","year":"2003","unstructured":"Cunningham\n              SJ, \n            \n              Sculpher\n              M, \n            \n              Sassi\n              F, \n            \n              Manca\n              A. \n          \n          A cost-utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony.  Br J Oral Maxillofac Surg.  2003; 41: 32\u2013 35."},{"key":"angl-86-03-08-b13","series-title":"J Oral Maxillofac Surg","first-page":"192","article-title":"Assessing the influence of asymmetry affecting the mandible and chin point on perceived attractiveness in the orthognathic patient, clinician and layperson","volume":"70","author":"Naini\n              F,","year":"2012","unstructured":"Naini\n              F, \n            \n              Donaldson\n              AN, \n            \n              McDonald\n              F, \n            \n              Cobourne\n              M. \n          \n          Assessing the influence of asymmetry affecting the mandible and chin point on perceived attractiveness in the orthognathic patient, clinician and layperson.  J Oral Maxillofac Surg.  2012; 70: 192\u2013 206."},{"key":"angl-86-03-08-b14","series-title":"Am J Orthod Dentofac Orthop","first-page":"168.e1","article-title":"Impact of facial asymmetry in visual perception: A 3-dimensional data analysis","volume":"137","author":"Meyer-Marcotty\n              P,","year":"2010","unstructured":"Meyer-Marcotty\n              P, \n            \n              Alpers\n              GW, \n            \n              Gerdes\n              ABM, \n            \n              Stellzig-Eisenhauer\n              A. \n          \n          Impact of facial asymmetry in visual perception: A 3-dimensional data analysis.  Am J Orthod Dentofac Orthop.  2010; 137: 168.e1\u2013 168.e8."},{"key":"angl-86-03-08-b01","year":"2010","unstructured":"Oxford Dictionaries.\n          Oxford:  Oxford University Press;  2010."},{"key":"angl-86-03-08-b02","series-title":"Angl Orthod","first-page":"43","article-title":"Skeletal asymmetry in aesthetically pleasing faces","volume":"61","author":"Peck\n              BS,","year":"1991","unstructured":"Peck\n              BS, \n            \n              Peck\n              L, \n            \n              Kataja\n              M. \n          \n          Skeletal asymmetry in aesthetically pleasing faces.  Angl Orthod.  1991; 61: 43\u2013 48."},{"key":"angl-86-03-08-b03","series-title":"Angl Orthod","first-page":"231","article-title":"Social and psychological implications of dentofacial disfigurement","volume":"40","author":"Macgregor\n              F.","year":"1970","unstructured":"Macgregor\n              F. \n          \n          Social and psychological implications of dentofacial disfigurement.  Angl Orthod.  1970; 40: 231\u2013 233."},{"key":"angl-86-03-08-b04","series-title":"J Adv Nurs","first-page":"4443","article-title":"Altered body image: appearance-related concerns of people with visible disfigurement","volume":"48","author":"Rumsey\n              N,","year":"2004","unstructured":"Rumsey\n              N, \n            \n              Clarke\n              A, \n            \n              White\n              P, \n            \n              Wyn-Williams\n              M, \n            \n              Garlick\n              W. \n          \n          Altered body image: appearance-related concerns of people with visible disfigurement.  J Adv Nurs.  2004; 48: 4443\u2013 4453."},{"key":"angl-86-03-08-b05","series-title":"Evolution Hum Behav","first-page":"417","article-title":"Facial symmetry and judgements of apparent health. Support for a \u201cgood genes\u201d explanation of the attractiveness-symmetry relationship","volume":"22","author":"Jones\n              BC,","year":"2001","unstructured":"Jones\n              BC, \n            \n              Little\n              AC, \n            \n              Penton-Voak\n              IS, \n            \n              Tiddeman\n              BP, \n            \n              Burt\n              DM, \n            \n              Perrett\n              DI. \n          \n          Facial symmetry and judgements of apparent health. Support for a \u201cgood genes\u201d explanation of the attractiveness-symmetry relationship.  Evolution Hum Behav.  2001; 22: 417\u2013 429."},{"key":"angl-86-03-08-b06","series-title":"Proc Biol Sci","first-page":"39","article-title":"Self-perceived attractiveness influences human female preferences for sexual dimorphism and symmetry in male faces","volume":"268","author":"Little\n              AC,","year":"2001","unstructured":"Little\n              AC, \n            \n              Burt\n              DM, \n            \n              Penton-Voak\n              IS, \n            \n              Perrett\n              DI. \n          \n          Self-perceived attractiveness influences human female preferences for sexual dimorphism and symmetry in male faces.  Proc Biol Sci.  2001; 268: 39\u2013 44."},{"issue":"1","key":"angl-86-03-08-b07","series-title":"Arch Facial Plast Surg","first-page":"14","article-title":"Threshold of visual perception of facial asymmetry in a facials paralysis model","volume":"13","author":"Chu\n              EA,","year":"2011","unstructured":"Chu\n              EA, \n            \n              Farraq\n              TY, \n            \n              Ishii\n              LE, \n            \n              Byrne\n              PJ. \n          \n          Threshold of visual perception of facial asymmetry in a facials paralysis model.  Arch Facial Plast Surg.  2011; 13( 1): 14\u2013 19."},{"key":"angl-86-03-08-b08","series-title":"Three-Dimensional Imaging for Orthodontics and Maxillofacial Surgery","first-page":"126","article-title":"Averaging facial images","author":"Zhurov\n              A,","year":"2010","unstructured":"Zhurov\n              A, \n            \n              Richmond\n              S, \n            \n              Kau\n              CH, \n            \n              Toma\n              A. \n          \n          Averaging facial images.  InKauCH, RichmondS, eds.  Three-Dimensional Imaging for Orthodontics and Maxillofacial Surgery.  London:  Wiley-Blackwell;  2010: 126\u2013 144."},{"key":"angl-86-03-08-b09","series-title":"Biometrics","first-page":"159","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis\n              J,","year":"1977","unstructured":"Landis\n              J, \n            \n              Koch\n              G. \n          \n          The measurement of observer agreement for categorical data.  Biometrics.  1977; 33: 159\u2013 174."},{"issue":"5","key":"angl-86-03-08-b10","series-title":"Eur J Orthod","first-page":"517","article-title":"The influence of dental to facial midline discrepancies on dental attractiveness ratings","volume":"21","author":"Johnston\n              CD,","year":"1999","unstructured":"Johnston\n              CD, \n            \n              Burden\n              DJ, \n            \n              Stevenson\n              MR. \n          \n          The influence of dental to facial midline discrepancies on dental attractiveness ratings.  Eur J Orthod.  1999; 21( 5): 517\u2013 522."},{"key":"angl-86-03-08-b11","series-title":"Eur J Orthod","first-page":"647","article-title":"Three-dimensional perception of facial asymmetry","volume":"33","author":"Meyer-Marcotty\n              P,","year":"2011","unstructured":"Meyer-Marcotty\n              P, \n            \n              Stellzig-Eisenhauer\n              A, \n            \n              Bareis\n              U, \n            \n              Hartmann\n              J, \n            \n              Kochel\n              J. \n          \n          Three-dimensional perception of facial asymmetry.  Eur J Orthod.  2011; 33: 647\u2013 653."},{"key":"angl-86-03-08-b12","series-title":"Br J Oral Maxillofac Surg","first-page":"32","article-title":"A cost-utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony","volume":"41","author":"Cunningham\n              SJ,","year":"2003","unstructured":"Cunningham\n              SJ, \n            \n              Sculpher\n              M, \n            \n              Sassi\n              F, \n            \n              Manca\n              A. \n          \n          A cost-utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony.  Br J Oral Maxillofac Surg.  2003; 41: 32\u2013 35."},{"key":"angl-86-03-08-b13","series-title":"J Oral Maxillofac Surg","first-page":"192","article-title":"Assessing the influence of asymmetry affecting the mandible and chin point on perceived attractiveness in the orthognathic patient, clinician and layperson","volume":"70","author":"Naini\n              F,","year":"2012","unstructured":"Naini\n              F, \n            \n              Donaldson\n              AN, \n            \n              McDonald\n              F, \n            \n              Cobourne\n              M. \n          \n          Assessing the influence of asymmetry affecting the mandible and chin point on perceived attractiveness in the orthognathic patient, clinician and layperson.  J Oral Maxillofac Surg.  2012; 70: 192\u2013 206."},{"key":"angl-86-03-08-b14","series-title":"Am J Orthod Dentofac Orthop","first-page":"168.e1","article-title":"Impact of facial asymmetry in visual perception: A 3-dimensional data analysis","volume":"137","author":"Meyer-Marcotty\n              P,","year":"2010","unstructured":"Meyer-Marcotty\n              P, \n            \n              Alpers\n              GW, \n            \n              Gerdes\n              ABM, \n            \n              Stellzig-Eisenhauer\n              A. \n          \n          Impact of facial asymmetry in visual perception: A 3-dimensional data analysis.  Am J Orthod Dentofac Orthop.  2010; 137: 168.e1\u2013 168.e8."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/84\/6\/article-p957.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/84\/6\/article-p957.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/84\/6\/article-p957.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:40:58Z","timestamp":1780069258000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/84\/6\/article-p957.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11]]},"references-count":28,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.2319\/120213-888.1","relation":{},"ISSN":["0003-3219","1945-7103"],"issn-type":[{"value":"0003-3219","type":"print"},{"value":"1945-7103","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11]]}}}