Three-Dimensional Evaluation of Facial Asymmetry Among a Sample of Yemeni Population: A CBCT Study

Background and aims: Facial asymmetry is an easily identifiable observation but is of great importance for both esthetics and function. In orthodontic and surgical planning a correct assessment of facial asymmetry is therefore indispensable. Aim of the present study was to measure three-dimensional skeletal facial asymmetry in the Yemeni population using CBCT and to analyze it by skeletal class and gender. Methods: This is a retrospective study involving 62 Yemeni patients (22 males, 40 females) aged 14-40 years. Skeletal classification was according to ANB angles (Class I-III). Using the Slicer 3D software, 16 craniofacial landmarks were identified. 3D Slicer, as well as automated scripts in python was used for the determination of angular, linear and asymmetry indices. T-tests, ANOVA and Tukey post-hoc tests were performed for comparisons with significance set at p< 0.05. Results: Mean skeletal asymmetry was found to be 3.46±1.01 mm, the mandible contributing to it largely in the gonial (4.04±1.94 mm) and antegonial (3.87±1.80 mm) regions and showing the minimum deviation in the maxilla. Higher values were observed for Menton deviation, gonial index, antegonial index, and overall skeletal asymmetry in Class III than Classes I and II (p<0.05). Higher mandibular dimensions and jugal asymmetry were evident in males than in females, although the global facial asymmetry did not show any significant sexual dimorphism. Conclusions: The Yemeni population exhibited noticeable skeletal facial asymmetry where the mandible constituted the majority of it. The orthodontic assessment and surgical planning were highlighted by significant correlation between class III malocclusion and greater skeletal asymmetry. Peer Review History: Received 8 April 2026; Reviewed 4 May 2026; Accepted 10 June; Available online 15 July 2026 Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622, Giza, Egypt, gehankandeel9@yahoo.com Reviewers: Prof. Cyprian Ogbonna ONYEJI, Obafemi Awolowo University, Ile-Ife, Nigeria, conyeji@oauife.edu.ng Dr. Mahmoud Ibrahim Mostafa Elseidy, Helwan University, Egypt, mahmoud.ibrahim@pharm.helwan.edu.eg