title: Face symmetry assessment abilities: Clinical implications for diagnosing asymmetry.
abstract: BACKGROUND
  An accurate assessment of face symmetry is necessary for the development of a dentofacial diagnosis in orthodontics, and an understanding of individual differences in perception of face symmetry between patients and providers is needed to facilitate successful treatment.
  
  
  METHODS
  Orthodontists, general dentists, and control participants completed a series of tasks to assess symmetry. Judgments were made on pairs of upright faces (similar to the longitudinal assessment of photographic patient records), inverted faces, and dot patterns. Participants completed questionnaires regarding clinical practice, education level, and self-confidence ratings for symmetry assessment abilities.
  
  
  RESULTS
  Orthodontists showed expertise compared with controls (P <0.001), whereas dentists showed no advantage over controls. Orthodontists performed better than dentists, however, in only the most difficult face symmetry judgments (P = 0.006). For both orthodontists and dentists, accuracy increased significantly when assessing symmetry in upright vs inverted faces (t = 3.7, P = 0.001; t = 2.7, P = 0.02, respectively).
  
  
  CONCLUSIONS
  Orthodontists showed expertise in assessing face symmetry compared with both laypersons and general dentists, and they were more accurate when judging upright than inverted faces. When using accurate longitudinal photographic records to assess changing face symmetry, orthodontists are likely to be incorrect in less than 15% of cases, suggesting that assistance from some additional technology is infrequently needed for diagnosis.
authors.affiliation: Proffit fellow, Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC. Electronic address: tatejackson@unc.edu.
authors.forename: Tate H
authors.initials: TH
authors.lastname: Jackson
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Mitroff
authors.forename: Kait
authors.initials: K
authors.lastname: Clark
authors.forename: William R
authors.initials: WR
authors.lastname: Proffit
authors.forename: Jessica Y
authors.initials: JY
authors.lastname: Lee
authors.forename: Tung T
authors.initials: TT
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003815:Dentists / Q000523:psychology; D005145:Face / Q000033:anatomy & histology*; D005146:Facial Asymmetry / Q000175:diagnosis*; D005260:Female; D005792:General Practice, Dental / Q000193:education; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D009970:Orthodontics / Q000193:education; D010781:Photography; D011930:Reaction Time; D012649:Self Concept; D014796:Visual Perception / Q000502:physiology; D055815:Young Adult