Ortodonti Ana Bilim Dalı Koleksiyonu

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https://hdl.handle.net/20.500.13055/27

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Ortodonti uygulamalarında yapay zeka:Tanıdan tedavi planlamasına kanıta dayalı yaklaşım
(Vizetek Yayıncılık, 2026) Allaf, Ferdi; Doruk, Ercan Cenk
Modern diş hekimliği disiplinleri arasında dijitalleşme süreçlerine en hızlı ve dinamik entegrasyon gösteren alan kuşkusuz ortodontidir. Üç boyutlu görüntüleme modaliteleri, intraoral tarama teknolojileri, bilgisayar destekli tedavi planlama yazılımları ve şeffaf plak (aligner) sistemleri, ortodontik teşhis ve tedavi ekosistemini kökten değiştirmiştir. Bu teknolojik evrimin tepe noktasında yer alan yapay zekâ (YZ) uygulamaları, günümüzde sadece klinik iş akışlarını hızlandıran otomasyon araçları olmaktan çıkmış; klinisyene kanıta dayalı, öngörülebilir ve kişiselleştirilmiş bir karar destek mekanizması sunan temel bir unsur haline gelmiştir (Kapila ve ark., 2021).
Ortodontik tedavide pekiştirme (retansiyon): Kanıta dayalı yaklaşım
(Vizetek Yayıncılık, 2026) Sürmeli, Nazan; Doruk, Ercan Cenk
Ortodontik tedavinin başarısı yalnızca dişlerin doğru konuma getirilmesiyle değil, bu konumun zaman içinde korunmasıyla ölçülür. Aktif tedavi sona erdiğinde dişler, pekiştirme (retansiyon) olmaksızın başlangıçtaki konumlarına geri dönme, yani nüks (relaps) eğilimi gösterir. Bu nedenle retansiyon, tedavinin isteğe bağlı bir uzantısı değil, ayrılmaz bir parçasıdır.
Dijital ortodontide görüntüleme ekosistemi: CBCT, intraoral tarayıcılar ve 3D model doğruluğu
(Yaz Yayınları, 2026) Allaf, Ferdi; Allaf, Ferdi
Ortodonti, kraniyofasiyal morfolojiyi anlama çabasında uzun süre statik ve iki boyutlu (2D) verilere bağımlı kalmıştır. Geleneksel tanı, üç boyutlu biyolojik bir gerçekliği iki boyutlu gölgeler (panoramik ve sefalometrik radyografiler) ile iç yapıyı görünür kılmayan alçı modeller üzerinden yorumlama çabasıydı; klinisyenin bilişsel yükü, teknolojik yetersizliği telafi eden asıl araçtı (Halazonetis, 2005). Günümüzde bu süreç veriye dayalı nesnel bir simülasyona dönüşmüştür: kron yüzeyleri intraoral tarayıcılarla mikron düzeyinde, kök ve iskeletsel anatomi CBCT ile milimetrik hassasiyette yakalanır; bu verilerin entegrasyonu tanıyı statik bir "anlık kayıt" olmaktan çıkarıp sonuçların öngörülebildiği bir "dijital ikiz" modeline taşır (Plooij ve diğerleri, 2011).
Erişkin maksiller ekspansiyonda dijital yaklaşımlar: Marpe ve sarpe’de planlamadan kılavuza
(Yaz Yayınları, 2026) Özcan, Mustafa
Dar üst çene, ortodontide en sık rastlanan iskeletsel uyumsuzluklardan biridir. Posterior çapraz kapanış, sıkışık bir damak kemeri, diş çapraşıklığı ve kimi zaman daralmış bir burun hava yolu, hepsi aynı temel soruna işaret eder: maksilla transvers yönde yetersizdir. Çocukluk ve erken ergenlikte bu sorunun çözümü görece kolaydır, çünkü orta hattaki damak suturu (midpalatal sutur) henüz açıktır ve hızlı üst çene genişletmesi (rapid maxillary expansion, RME) suturu nispeten az dirençle ayırarak gerçek bir iskeletsel genişleme sağlar.
Şeffaf plaklarla diş hareketinin öngörülebilirliği: Kanıta dayalı yaklaşım
(Vizetek Yayıncılık, 2026) Özcan, Mustafa; Doruk, Ercan Cenk
Şeffaf plak sistemleri son yıllarda ortodontik tedavinin en hızlı gelişen alanlarından biri hâline gelmiş ve dijital ortodonti kavramının klinik pratiğe entegrasyonunda önemli rol oynamıştır. Başlangıçta yalnızca hafif çapraşıklıkların düzeltilmesi amacıyla kullanılan bu sistemler, günümüzde daha kompleks maloklüzyonların yönetiminde de değerlendirilebilmektedir. Dijital modelleme teknolojileri, bilgisayar destekli üretim sistemleri, optimize ataşman tasarımları ve gelişmiş termoplastik materyaller sayesinde şeffaf plak tedavisinin biyomekanik kapasitesi önceki dönemlere göre belirgin şekilde genişlemiştir. Buna bağlı olarak çekimli tedaviler, açık kapanış olguları, distalizasyon protokolleri ve büyüme-gelişim dönemindeki bireylerde aligner kullanımına yönelik ilgi artmıştır.
Investigation of effects of hybrid hyrax-mentoplate treatment in high-angle class III patients: A three-dimensional, retrospective study
(Wiley, 2026) Yıldırım, Gamze; Önem Özbilen, Elvan; Özdemir, Fulya
Objective: This retrospective study evaluated three-dimensional effects of hybrid hyrax-mentoplate (HH-M) orthopaedic treat-ment in high-angle Class III individuals using Cone Beam Computed Tomography (CBCT) images.Materials and Methods: Pre-treatment (T0) and post-treatment (T1) CBCTs of 17 fully compliant high-angle Class III patients(7 males, 10 females, age: 11.7 ± 1.32 years, treatment duration: 12.62 ± 1.7 months) treated with HH-M were analysed. T0 andT1 CBCTs were superimposed from the cranial base using artificial intelligence-based AMASSS module of the 3D Slicer version5.8.1 software (www.slicer.org). Linear and angular changes were analysed in the sagittal, vertical and transverse planes, along-side three-dimensional landmark displacements and volumetric airway measurements. Significance level was set at p < 0.05.Results: Significant increases occurred in SNA, ANB and Occlusal Plane (OP) to Mandibular Plane (MP) angle (p < 0.001,p < 0.001, p = 0.001, respectively), while Sella-Nasion to OP and Palatal Plane (PP) to OP decreased (p = 0.008, p = 0.008, re-spectively). Vertical linear measurements remained stable (p > 0.05). All transverse linear measurements increased (p < 0.05).Upper Molar (UM) to PP, Upper Incisor to PP, Lower Incisor to MP and overjet have significantly increased (p < 0.001, p = 0.018,p = 0.048, p < 0.001, respectively). Overbite remained unchanged (p > 0.05). Nasopharynx (p = 0.008) and Middle Pharynx(p = 0.003) volumes significantly increased.Conclusion: Despite the significant alterations observed in OP and UM-PP, this technique effectively managed to maintain over-all vertical skeletal dimensions without inducing a significant change in other facial height parameters and enhanced the airwayvolume. Significant expansion occurred across maxillary, nasal and zygomatic levels. HH-M represents an effective orthopaedictreatment approach for high-angle Class III patients.
Does thermoforming setup affect thickness in thermoplastic orthodontic appliances? A comparison of single vs. dual-model fabrication
(MDPI Publishing, 2026) Allaf, Ferdi; Arslan, Meriç; Özcan, Mustafa; Erdem, Buket
Thermoforming remains the predominant fabrication route for clear thermoplastic orthodontic appliances, yet it reduces and redistributes sheet thickness, which governs force delivered to teeth. Simultaneous thermoforming of two models may reduce fabrication time and material waste; however, its effect on final appliance thickness has not been evaluated. This in vitro study compared appliance thickness after thermoforming over a single model or two models simultaneously, using ten commercial aligner brands with different polymer composition and initial thickness. Thickness was measured with a digital caliper at anterior, canine and posterior sites, and analyzed using three-way ANOVA with Tukey post hoc tests. A significant three-way interaction (measurement point × number of models × brand; p < 0.001) was found. Significant single- versus dual-model differences emerged in some brand–region combinations; in most, dual-model appliances were thicker than single-model appliances. Four brands showed no significant difference at any site. Within the limits of this study, simultaneous fabrication of two appliances in a single thermoforming cycle produced appliances with thicknesses comparable to, and often slightly greater than, those fabricated over a single model. Simultaneous thermoforming maintained comparable appliance thickness and may improve manufacturing efficiency.
Diş hareketini hızlandırma yöntemlerine kanıta dayalı yaklaşım
(Efe Akademi Yayınları, 2026) Arslan, Meriç; Eratilla, Veysel
Ortodontik tedavi, bireylerin fonksiyonlarını ve estetiklerini iyileştirerek hayat kalitelerini arttırmayı amaçlar. Sabit ortodontik tedaviler olgu karmaşıklık derecesine göre değişmekle beraber yaklaşık 2-3 yıl süren uzun bir tedavi süreci gerektirir. Bu süre; çürük, dişeti çekilmesi, kök rezorpsiyonu ve hasta uyumunun azalması gibi sorunları da beraberinde getirir. Erişkin hastaların çoğu ortodontik tedavi sürelerinin daha kısa olmasını istemekte ve ortodontik tedaviye ihtiyaç duymalarına rağmen tedavi sürelerinin uzunluğu sebebiyle çoğu zaman tedaviye başlamaktan vazgeçmektedirler. Bu nedenle ortodontik diş hareketini hızlandırarak tedavi süresini kısaltmak, ortodontinin araştırma alanlarından biri haline gelmiştir (Alikhani ve ark., 2013; Oral ve ark., 2017).
Ortodontik tedaviye bağlı kök rezorpsiyonu: Kanıta dayalı yaklaşım
(Vizetek Yayıncılık, 2026) Arslan, Meriç; Doruk, Ercan Cenk
Ortodontik tedaviye bağlı kök rezorpsiyonu, ortodontik diş hareketinin büyük ölçüde kaçınılmaz ve istenmeyen bir yan etkisidir. Histolojik düzeyde dişlerin neredeyse tamamını etkileyebilirken, radyografik olarak olguların %48-66'sında hafif-orta düzeyde görülür. Tedavi gerektirecek şiddette (apikal kök uzunluğunun dörtte birinden fazla veya 4 mm'yi aşan) rezorpsiyon ise olguların yalnızca %1-5'inde ortaya çıkmaktadır. (Weltman ve ark., 2010).
Fonksiyonel ortodonti uygulamasında kanıta dayalı uygulamalar
(Vizetek Yayıncılık, 2026) Erdem, Buket; Doruk, Ercan Cenk
Sınıf II maloklüzyon, büyüme çağındaki bireylerde en sık karşılaşılan iskeletsel anomalilerden biridir ve olguların önemli bir bölümünde mandibular retrognatiyle ilişkilidir. Kalıcı dentisyonda küresel ortalama görülme sıklığı yaklaşık %19,5 olup Kafkas popülasyonlarında en yüksek prevalans bildirilmektedir (Alhammadi ve ark., 2018). Görülme sıklığı popülasyona göre farklılık göstermekle birlikte Amerika, Asya ve Avrupa'da yaklaşık %25 olduğu bildirilmekte; Afrika popülasyonlarında ise belirgin biçimde daha düşük seyrettiği rapor edilmektedir (Lombardo ve ark., 2020).
Impression precision after hydrogen peroxide sterilization of scanner sleeves
(Springer Nature Link, 2026) Yılmaz, Berza; Arslan, Meriç; Kayasaroğlu, Damla Nur; Arslan, Elif Dilara; Sunal Aktürk, Ezgi
Introduction The iTero Element (Align Technologies, San Jose, CA, USA) is a widely used intraoral scanning device, and its protective sleeves for the scanning head are provided for single use. This condition puts the clinical management budget under financial strain and creates a disadvantage for managing environmental waste. The objective of our research was to assess how repeated sterilization of disposable scan head covers with hydrogen peroxide affected the precision of digital impressions. Methods Intraoral scans were carried out using the iTero Element 5D scanner on 26 patients. Hydrogen peroxide was used to sterilize the sleeves for 45min at 45 °C. The sterilization procedure was repeated between the second, third, and fourth intraoral scans. Each tooth was given a score based on the color change between the first and fourth scans, which were superimposed using the iTero TimeLapse technology. The OrthoCAD® software (Align Technologies) was also used to measure the intercanine, interpremolar, and intermolar distances, as well as the mesiodistal dimensions of all the teeth between the first molars. Results No statistically significant difference was found between the mesiodistal dimensions of the teeth and the interca nine, interpremolar, and intermolar distances between the 1st and 4th scans. There was no correlation between the mean differences of the mesiodistal dimensions of the teeth obtained with the 1st and 4th scans and TimeLapse scores. Conclusion After sterilization with hydrogen peroxide, the repeatability of digital measurements of the protective sleeves of the intraoral scanner was not adversely affected, and their clinical performance was maintained.
Does lip change following premolar extraction differ in patients with high and normal vertical growth patterns?
(Galenos Publishing House, 2026) Erdem, Buket; Başal, Ece; Emir, Büşra
Objective: To evaluate the relationship between incisor retraction and upper and lower lip repositioning in patients with high and normal vertical growth patterns (NVP), and to assess whether vertical growth pattern influences soft tissue changes following extraction treatments. Methods: Pre- and post-treatment lateral cephalograms of 79 patients who underwent extraction of two or four first premolars were analyzed. Patients were divided into a [high vertical pattern (HVP); Frankfort-mandibular plane angle (FMA) >30°, n=49] and a NVP; 22< FMA ≤30°, n=30) group. Horizontal and vertical changes in the lips, labiomental fold, and lip strain were measured, and correlations between these changes and incisor movements were assessed. Results: Upper lip retraction was greater in the HVP group (2.86 mm, p<0.05) than in the NVP group (1.97 mm, not significant). Upper lip height decreased significantly in both groups, with a slightly greater decrease in the NVP group (p<0.001). Upper lip strain decreased in both groups, especially in the HVP group (p<0.001). Incisor retraction was strongly correlated with upper-lip changes in both groups, and with lower-lip and labiomental-fold repositioning in the NVP group. Conclusion: Soft tissue response to incisor retraction varies with vertical growth pattern, with greater upper lip retraction in HVP patients. Vertical growth patterns should be considered for optimal soft tissue outcomes.
Evaluation of mesiodistal tip accuracy in mandibular anterior teeth following incisor extraction with clear aligners
(Elsevier, 2025) Erdem, Buket; Özcan, Mustafa; Şar, Çağla
Introduction: Single mandibular incisor extraction is sometimes necessary in clear aligner treatment, yet the accuracy of mesiodis tal tooth positioning in such cases remains unclear. This retro spective study evaluates the discrepancy between predicted and achieved mesiodistal movements of the remaining mandibular an terior teeth in Invisalign (Align Technology, Santa Clara, CA) treat ments. Additionally, it examines the effects of aligner attachments and change frequency on movement accuracy. Material and Methods: A total of 40 Invisalign patients with single mandibular incisor extraction were retrospectively analyzed. Geomagic Control X (3D Systems, Rock Hill, SC) was used to mea sure pretreatment positions, predicted movements, and achieved outcomes. Predicted and actual mesiodistal tip movements were compared. Results: Regression analysis revealed significant discrepancies (P < 0.001) between predicted and achieved mesiodistal movements for both incisors and canines. Only 70% of the predicted incisor tip movement (R² = 0.4171) and 60% of the predicted canine tip move ment (R² = 0.5789) were achieved. Neither the number of aligners, change protocol (1-week vs. 2-week), nor attachments significantly affected accuracy (P > 0.05). However, incisors were less likely than canines to follow the predicted movement direction (P = 0.025). Conclusion: A significant discrepancy exists between predicted and achieved mesiodistal movements after single mandibular in cisor extraction with Invisalign. The number of aligners, wear dura tion, and attachments do not significantly influence accuracy. Fur ther research is needed to optimize treatment planning and im prove predictability in clear aligner therapy.
Comparative evaluation of deep learning models for the classification of impacted maxillary canines on panoramic radiographs
(MDPI Publishing, 2026) Tokatlı, Nazlı; Erdem, Buket; Özcan, Mustafa; Turan Maviş, Begüm; Şar, Çağla; Özdemir, Fulya
Background/Objectives: The early and accurate identification of impacted teeth in the maxilla is critical for effective dental treatment planning. Traditional diagnostic methods relying on manual interpretation of radiographic images are often time-consuming and subject to variability. Methods: This study presents a deep learning-based approach for automated classification of impacted maxillary canines using panoramic radiographs. A comparative evaluation of four pre-trained convolutional neural network (CNN) architec tures—ResNet50, Xception, InceptionV3, and VGG16—was conducted through transfer learning techniques. In this retrospective single-center study, the dataset comprised 694 an notated panoramic radiographs sourced from the archives of a university dental hospital, with a mildly imbalanced representation of impacted and non-impacted cases. Models were assessed using accuracy, precision, recall, specificity, and F1-score. Results: Among the tested architectures, VGG16 demonstrated superior performance, achieving an accuracy of 99.28% and an F1-score of 99.43%. Additionally, a prototype diagnostic interface was developed to demonstrate the potential for clinical application. Conclusions: The findings underscore the potential of deep learning models, particularly VGG16, in enhancing diag nostic workflows; however, further validation on diverse, multi-center datasets is required to confirm clinical generalizability.
The effects of light and vibration on the correction of lower incisor crowding with aligners
(Galenos Publishing House, 2025) Özcan, Mustafa; Nalbantgil, Didem
Objective: To compare the effects of low-frequency vibration (LFV), photobiomodulation (PBM), and their combination (HOT) on the rate of mandibular incisor alignment during clear aligner therapy. Methods: This retrospective study included 89 patients treated with a single clear aligner system for mild-to-moderate mandibular anterior crowding. Patients were assigned to four groups: control (n=19), LFV (n=26), PBM (n=21), and HOT (n=23). LFV [30 Hz, 0.25 N (≈25 g)] and PBM (850 nm, 16×5 mm LEDs, ≈9.5 J/cm2 ) devices were used daily for 20 minutes in relevant groups. The primary outcome was the change in Little’s Irregularity Index at baseline (T0), 28 days (T1), 48 days (T2), and 62 days (T3). Statistical analyses included one-way ANOVA, repeated measures ANOVA, and Pearson’s correlation. Results: The HOT group showed significantly greater crowding reduction compared to all other groups (p<0.05). LFV and PBM alone were not significantly different from the control. Within-group analysis revealed significant reductions in all groups over time, with the HOT group showing consistent improvements at each interval. Correlation analyses revealed no significant associations between device usage or aligner wear time and crowding reduction. Conclusion: Combining LFV and PBM during clear aligner therapy produced greater short-term acceleration of mandibular incisor alignment than either modality alone. Further randomized controlled trials are warranted to confirm long-term efficacy and safety.
Comparative analysis of artificial intelligence chatbots in orthodontic emergency scenarios: ChatGPT-3.5, ChatGPT-4.0, Copilot, and Gemini
(EH Angle Education and Research Foundation, 2026) Erdem, Buket; Özcan, Mustafa; Şar, Çağla
Objectives To evaluate and compare the accuracy of four AI chatbots, ChatGPT-3.5, ChatGPT-4.0, Copilot, and Gemini, in response to orthodontic emergency scenarios. Materials and Methods Forty frequently asked questions related to orthodontic emergencies were posed to the chatbots. These questions were categorized as fixed orthodontic treatment, clear aligner treatment, eating and oral hygiene, pain and discomfort, general concerns, retention, and sports and travel. The responses were evaluated by three orthodontic experts using a five-point Likert scale, and statistical analysis was conducted to assess variations in accuracy across chatbots. Results Statistical analysis revealed significant differences among the chatbots. Gemini and ChatGPT-4.0 demonstrated the highest accuracy in response to orthodontic emergencies, followed by Copilot, whereas ChatGPT-3.5 had the lowest accuracy scores. Additionally, the “Fixed Orthodontic Treatment” category showed a statistically significant difference (P = .043), with Gemini outperforming the other chatbots in this category. However, no statistically significant differences were found in other categories. Conclusions AI chatbots show potential in providing immediate assistance for orthodontic emergencies, but their accuracy varies across different models and question categories.
The impact of female orthodontists in 21st century research: A bibliometric analysis of the 1000 most cited articles (2000−2023)
(W.B. Saunders, 2025) Şar, Çağla; Erdem, Buket; Eğlenen, Merve Nur; Koçak, Murat; Germeç-Çakan, Derya
The involvement of female orthodontists in academic research has markedly increased in the 21st century. This bibliometric analysis evaluates the 1000 most-cited orthodontic articles to assess the influence of female ortho dontists in research between the years 2000−2023. A total of 677 publications featuring at least one female ortho dontic author were identified, with 54 % being first-written by women and 4.58 % produced only by female contributions. Forty-eight percent of these publications were published in the American Journal of Orthodontics and Dentofacial Orthopedics. The United States ranked first in publications, followed by Brazil and Italy, with the University of Michigan being the most productive institution. Research trends have transitioned from root resorp tion and skeletal growth in earlier years to artificial intelligence and digital technologies in more recent times.
Deep-learning model for assessing difficulty in localizing impacted canines
(Elsevier, 2024) Özcan, Mustafa; Erdem, Buket; Turan, Begüm; Tokatlı, Nazlı; Şar, Çağla; Özdemir, Fulya
AIM or PURPOSE The aim of this study is to examine if an artificial intelligence algorithm can be used for identifying the bucco-palatinal position of the maxillary impacted canine from the panoramic X-rays. MATERIALS and METHOD A total of 810 panoramic x-rays were obtained from the archive of University, Faculty of Dentistry, Department of Orthodontics. X-rays included cases with unilateral/bilaterally impacted canines. We used a Convolutional Neural Network (CNN) to forecast where the impacted canines crown would be situated. CNNs excel at classifying images as they can autonomously and flexibly grasp hierarchies of features, from input images. The implementation of the proposed deep learning model has been done using the Python programming language and libraries (TensorFlow and Numpy). The dataset that was used to train the proposed model categorized into buccal, middle, and palatinal positioned samples. These samples are mainly 2D panoramic X-rays combined with clinical information about the location of the canine. The expectation from the model is to determine the location of the crown of the maxillary-impacted canine. The model's prediction of the impacted canine's location was assessed in bucco-palatinal directions. RESULTS The proposed deep learning model predicts the position of the impacted canine in the buccal, middle, or palatinal position with 68% accuracy. CONCLUSION(S) This multidisciplinary research study developed a deep learning model to automate the detection and positioning of impacted canines on panoramic dental X-rays. Lastly, further research is required to refine the model for clinical implementation and to explore its integration into routine orthodontic practice
Does vertical pattern affect lip strain in open-bite patients?: A cephalometric study
(Adıyaman University, 2024) Başal, Ece; Acar, Yasemin Bahar; Erdem, Buket
Aim: To examine effect of skeletal pattern on lip strain in open-bite, in individuals with normal and increased vertical pattern. Materials and Methods: 56 open bite patients with Normovergent (NG) and Hyperdivergent (HG) vertical patterns (Mean age: 16.57 years) underwent cephalometric analysis. Soft tissue labial, hard tissue, and dental inclinations were measured. Statistical analyses were performed using Kolmogorov Smirnov, Mann Whitney-U, and independent sample t-tests; Pearson and Spearman correlation analyses; and Linear regression analysis. Results: In HG, each degree of SN-UOP increase caused 0.371 mm increase in lower lip strain. While in NG, upper lip strain was associated with IMPA and SNB (each degree caused 0.14 mm increase and 0.207 mm decrease respectively). Conclusion: IMPA, SN-UOP and SNB were found to be the determinants of lip strain. Dental, vertical, and sagittal variables showed association with lower face.
Does facial growth pattern affect the perception of lower facial asymmetry?
(The EH Angle Education and Research Foundation Inc., 2024) Basal, Ece; Çevik, İsmail; Acar, Yasemin Bahar; Özdemir, Fulya
Objectives To investigate the influence of vertical facial type on esthetic perception of lower facial asymmetry as evaluated by orthodontists, dentists, and laypeople. Materials and Methods Three adult females were selected with normal growth patterns (NGP), vertical growth patterns (VGP), and horizontal growth patterns (HGP). Frontal photographs were made symmetric and digitally altered, rotating the lower facial third clockwise, ranging from 0° to 6° in 1° increments. A web-based survey was designed with 24 images (eight images for each model) in random order. Each image was rated using a scale ranging from 0 (unattractive) to 10 (the most attractive) by 75 orthodontists, 73 dentists, and 78 laypeople. Kruskal-Wallis test was used to determine whether differences among groups were significant. Pairwise comparisons were made with Mann-Whitney U test. The significance level was set at P = .05. Results In NGP, orthodontists and dentists could recognize slighter deviations (2°), while deviations in VGP and HGP under 3° were not recognized by all groups. Severe deviations (≥4°) were distinguished better in HGP by orthodontists and laypeople. In VGP and NGP, there was no significant difference over 4°. Conclusions Growth pattern has a significant influence on perception of lower facial asymmetry. Less severe asymmetry can be detected better in NGP. In severe degrees, increments of asymmetry can be perceived more in HGP by orthodontists and laypeople.

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