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Dentofacial Self-Perception and Social Perception of Adults with Unilateral Cleft Lip and Palate

Dentofaziale Selbst- und Fremdwahrnehmung erwachsener Patienten mit unilateralen Lippen-Kiefer-Gaumen-Spalten

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Abstract

Objective

The aim of this study was to investigate the influence of facial asymmetry on how an adult population with unilateral cleft lip and palate (CLP) perceived themselves and were perceived by others.

Patients and Methods

3D facial data of 30 adult patients with cleft lip and palate (CLP) was scanned and standardized extra- and intraoral photographs were taken. The measured degree of 3D asymmetry was computed for the entire face, midface and lower face. Subjective estimates regarding facial symmetry, attractiveness as well as satisfaction and a desire or indication for further treatment were surveyed by means of a questionnaire filled out by patients and an assessment group (10 orthodontists, 10 oral and maxillofacial (OM) surgeons, 15 laypersons).

Results

The study’s results show that the largest degree of asymmetry was found in the midface of CLP patients. The vast majority of the patients were dissatisfied with their facial appearance, and patients, experts and laypersons expressed great interest in and a need of correction. We observed tangible incongruence between how the patients perceived their own faces and how others perceived them.

Conclusions

Asymmetry, especially in the midface, appears to detract from how facial appearance is self-perceived and perceived by others, which explains the primary desire for or need of nose correction. The self-perception of patients affected by CLP does not correlate with objective results or how others perceive them. Clinicians should be open to adult patients’ requests for correction, but the patient‘s self-perception should also be critically explored.

Zusammenfassung

Ziel

Ziel der Studie war es, den Einfluss der fazialen Asymmetrie auf die Selbst- und Fremdwahrnehmung bei Erwachsenen mit einseitiger Lippen-Kiefer-Gaumen-(LKG-)Spalte, nach Behandlungsabschluss zu untersuchen.

Patienten und Methodik

Von 30 erwachsenen Patienten mit LKG-Spalte wurden 3-D-Gesichtsdaten erhoben sowie standardisierte extra- und intraorale Fotografien angefertigt. Der gemessene 3-D-Asymmetriegrad wurde von dem gesamten Gesicht, dem Mittel- und dem Untergesicht berechnet. Subjektive Einschätzungen bezüglich der fazialen Symmetrie, Attraktivität sowie Zufriedenheit und weitere/r Behandlungswunsch/-indikation wurden mittels Fragebogen von den Patienten und einer Beurteilergruppe (10 Kieferorthopäden, 10 MKG-Chirurgen, 15 Laien) erhoben.

Ergebnisse

Die Ergebnisse der Studie zeigen, dass der größte Anteil der Asymmetrie im Mittelgesicht bei Patienten mit LKG-Spalte zu finden war. Der weitaus größte Teil der Patienten war unzufrieden mit dem fazialen Erscheinungsbild, und es bestand ein hoher Korrekturwunsch bzw. -bedarf vonseiten der Patienten, Experten und Laien. Eine deutliche Inkongruenz konnte zwischen der fazialen Selbstwahrnehmung des Spaltträgers und der Fremdwahrnehmung nachgewiesen werden.

Schlussfolgerungen

Insbesondere eine Asymmetrie im Mittelgesicht scheint die Fremd- und Selbstwahrnehmung des fazialen Aussehens negativ zu beeinflussen, wodurch sich der Korrekturwunsch bzw. -bedarf primär nach einer Nasenkorrektur erklären lässt. Patienten mit LKG-Spalten verfügen über eine Selbstwahrnehmung, die nicht mit den objektiven Ergebnissen bzw. der Fremdwahrnehmung korreliert. Der Kliniker sollte den Korrekturwünschen des erwachsenen Patienten offen gegenüberstehen, jedoch auch das Selbstbild des Patienten kritisch hinterfragen.

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Authors and Affiliations

  1. Department of Orthodontics, Julius Maximilian University, Würzburg, Germany

    Angelika Stellzig-Eisenhauer

  2. Department of Orthodontics, Dental Clinic of the Medical Faculty, Pleicherwall 2, 97070, Wuerzburg, Germany

    Philipp Meyer-Marcotty

Authors
  1. Philipp Meyer-Marcotty
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  2. Angelika Stellzig-Eisenhauer
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Corresponding author

Correspondence to Philipp Meyer-Marcotty.

Additional information

Initial results were presented at the 81st Annual Scientific Congress of the German Orthodontic Society (DGKFO) in Cologne, November 12–16, 2008.

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Meyer-Marcotty, P., Stellzig-Eisenhauer, A. Dentofacial Self-Perception and Social Perception of Adults with Unilateral Cleft Lip and Palate. J Orofac Orthop 70, 224–236 (2009). https://doi.org/10.1007/s00056-009-8813-9

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