Perception of maxillary dental midline shift in asymmetric faces

Purpose: The purpose of this article is to determine whether certain facial asymmetries (nose and chin) have an impact on the perception of the maxillary dental midline shift. Materials and methods: From a digitally created symmetric facial model (SFM) constructed in a previous study, a new asymmetric facial model (AFM) was created, with nose and chin deviated to the same side. Modifications were made on the AFM for shifts in the maxillary dental midline in both directions, resulting in a total of eight different images. Through a web survey, 112 randomly selected laypersons were asked to evaluate each image according to their own personal beauty and esthetic criteria using a visual Likert scale. Results: 1 mm of dental midline shift to the left of the AFM was not noticed; 1 mm of dental midline shift to the right of the AFM had a negative impact on perception of facial attractiveness; 2 and 3 mm of dental midline shift to left or right of the AFM had a negative impact on perception of facial attractiveness. Conclusions: Facial asymmetries such as nose and chin inclinations have an impact on the perception of maxillary dental midline shift. Direction of dental midline shift can be a major factor in this perception.