{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:26:04Z","timestamp":1792805164456,"version":"4.5.0"},"reference-count":57,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Southern Association of Orthodontics","award":["2022"],"award-info":[{"award-number":["2022"]}]},{"name":"University of Kentucky Resident Fellowship Award","award":["2021"],"award-info":[{"award-number":["2021"]}],"id":[{"id":"https:\/\/ror.org\/02k3smh20","id-type":"ROR","asserted-by":"crossref"}]},{"name":"University of Kentucky Resident Fellowship Award","award":["2024"],"award-info":[{"award-number":["2024"]}],"id":[{"id":"https:\/\/ror.org\/02k3smh20","id-type":"ROR","asserted-by":"crossref"}]},{"name":"University of Kentucky E. Preston Hicks Professor Endowment (JKH), U.S. National Science Foundation","award":["2131940"],"award-info":[{"award-number":["2131940"]}],"id":[{"id":"https:\/\/ror.org\/021nxhr62","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["2022-06620_VR"],"award-info":[{"award-number":["2022-06620_VR"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: There is a growing interest among practitioners in employing artificial intelligence (AI) to enhance the precision and efficiency of diagnostic methods. The objective of this study is to assess the precision of an AI-based method for facial asymmetry assessment using 3D facial images. Methods: The study included 130 patients (84 female, 46 male), analyzing 3D facial images from the Vectra\u00ae M3 imaging system using both manual and AI-based methods. Seven bilateral facial landmarks were identified for manual analysis, calculating the asymmetry index for facial symmetry assessment. An AI-based program was developed to automate the identification of the same landmarks and calculate the asymmetry index. The reliability of the manual measurements was assessed using intraclass correlation coefficients (ICC) with 95% confidence intervals (CI). Precision of automated landmark identification was compared to the manual method. Results: The ICCs for the manual measurements demonstrated moderate to excellent reliability, both within raters (ICC = 0.62\u20130.99) and between raters (ICC = 0.72\u20130.96) each calculated with 95% CI. Agreement was observed between the manual and automated methods in calculating the asymmetry index for five landmarks. There was a statistically significant difference between the two methods in determining the asymmetry index for alare (median: 2.05 mm manual vs. 1.54 mm automated, p = 0.0056) and cheilion (median: 2.77 mm manual vs. 2.30 mm automated, p = 0.0081). Conclusions: The AI-based method provides efficient and comparable precision of facial asymmetry analysis using 3D images. The disagreement observed between the two methods can be addressed through further improvement and training of the automated software. This innovative approach opens doors to significant advancements in both research and clinical orthodontics.<\/jats:p>","DOI":"10.3390\/jcm14207172","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T10:12:29Z","timestamp":1760523149000},"page":"7172","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Precision Assessment of Facial Asymmetry Using 3D Imaging and Artificial Intelligence"],"prefix":"10.3390","volume":"14","author":[{"given":"Mohamed","family":"Adel","sequence":"first","affiliation":[{"name":"Department of Orthodontics, College of Dentistry, Texas A&M University, 3302 Gaston Avenue, Room 719, Dallas, TX 75246, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie Jo","family":"Hunt","sequence":"additional","affiliation":[{"name":"Private Practice, 5 Overlook Dr #6, Amherst, NH 03031, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Pigman College of Engineering, University of Kentucky, Lexington, KY 40506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9117-5508","authenticated-orcid":false,"given":"James K.","family":"Hartsfield","sequence":"additional","affiliation":[{"name":"Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY 40508, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0179-3941","authenticated-orcid":false,"given":"Hugo","family":"Reyes-Centeno","sequence":"additional","affiliation":[{"name":"Department of Anthropology, College of Arts and Sciences, University of Kentucky, Lexington, KY 40508, USA"},{"name":"Swedish Collegium for Advanced Study, Linneanum, Villav\u00e4gen 6c, SE-752 36 Uppsala, Sweden"},{"name":"Center for the Human Past-Uppsala & Stockholm Universities, Evolutionary Biology Centre, Norbyv\u00e4gen 18A, 752 36 Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia S.","family":"Beeman","sequence":"additional","affiliation":[{"name":"Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY 40508, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1715-8221","authenticated-orcid":false,"given":"Tarek","family":"Elshebiny","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Sharab","sequence":"additional","affiliation":[{"name":"Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, KY 40508, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0889-5406(94)70038-9","article-title":"Associations of mandibular and facial asymmetries\u2014A review","volume":"106","author":"Pirttiniemi","year":"1994","journal-title":"Am. 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