title: Mandibular asymmetry: a proposal of radiographic analysis with public domain software.
abstract: OBJECTIVE
  This preliminary study aimed to propose a new analysis of digital panoramic radiographs for a differential diagnosis between functional and morphological mandibular asymmetry in children with and without unilateral posterior crossbite.
  
  
  METHODS
  Analysis is based on linear and angular measurements taken from nine anatomic points, demarcated in sequence directly on digital images. A specific plugin was developed as part of a larger public domain image processing software (ImageJ) to automate and facilitate measurements. Since panoramic radiographs are typically subject to magnification differences between the right and left sides, horizontal linear measurements were adjusted for greater accuracy in both sides by means of a Distortion Factor (DF). In order to provide a preliminary assessment of proposed analysis and the developed plugin, radiographs of ten patients (5 with unilateral posterior crossbite and 5 with normal occlusion) were analyzed.
  
  
  RESULTS
  Considerable divergence was found between the right and left sides in the measurements of mandibular length and position of condyles in patients with unilateral posterior crossbite in comparison to individuals with normal occlusion.
  
  
  CONCLUSIONS
  Although there are more effective and accurate diagnostic methods, panoramic radiography is still widespread, especially in emerging countries. This study presented initial evidence that the proposed analysis can be an important resource for planning early orthodontic intervention and, thus, avoid progression of asymmetries and their consequences.
authors.forename: Alexandre Durval
authors.initials: AD
authors.lastname: Lemos
authors.forename: Cintia Regina Tornisiello
authors.initials: CR
authors.lastname: Katz
authors.forename: Mônica Vilela
authors.initials: MV
authors.lastname: Heimer
authors.forename: Aronita
authors.initials: A
authors.lastname: Rosenblatt
mesh_terms: D059925:Anatomic Landmarks / Q000000981:diagnostic imaging; D002508:Cephalometry / Q000379:methods; D002648:Child; D003724:Dental Arch / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005146:Facial Asymmetry / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008310:Malocclusion / Q000000981:diagnostic imaging; D008334:Mandible / Q000000981:diagnostic imaging; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D008336:Mandibular Diseases / Q000000981:diagnostic imaging*; D008437:Maxilla / Q000000981:diagnostic imaging; D017150:Public Sector; D019252:Radiography, Dental, Digital / Q000379:methods; D011862:Radiography, Panoramic / Q000379:methods*
keywords: Imaging diagnosis; Mandible; Panoramic radiography