We aimed to describe facial directional asymmetry (DA) in individuals with different manifestations of laterality. Due to the overlap between brain and face development, a relationship between the manifestation of brain laterality and DA is hypothesised. These findings could clarify the relationship between the brain and facial phenotype and help to plan facial or oral motor rehabilitation. The DA of 163 healthy individuals was assessed by two complementary 3D methods: landmark and polygonal surface analysis using colour-coded maps. Handedness was assessed using the Edinburgh Handedness Inventory, while chewing side and eye preferences were self-reported. The results showed a similar DA pattern regardless of sex and laterality (the right-sided protrusion of the forehead, nose, lips, and chin) and a slightly curved C-shape of the midline in landmark analysis. A relationship between lateralized behaviours and DA was found only in males, in females the DA pattern was more homogenous. Right-handed individuals and right-side chewers showed a protrusion of the right hemiface. Males, left-handed and left-side chewers, manifested a protrusion of the left lateral hemiface. We suggest that these specific differences in males may be due to their typically higher level of brain asymmetry. No apparent relationship was found between eyedness and DA.

Department of Anatomy Faculty of Medicine in Hradec Králové Charles University Šimkova 870 500 03 Hradec Králové Czech Republic

Department of Biology and Medical Genetics 2nd Faculty of Medicine Charles University and Motol University Hospital 5 Úvalu 84 150 06 Prague 5 Czech Republic

Department of Histology and Embryology 3rd Faculty of Medicine Charles University Ruská 2411 100 00 Prague 10 Czech Republic

Department of Plastic Surgery 1st Faculty of Medicine and Bulovka Hospital Charles University Kateřinská 32 121 08 Prague 2 Czech Republic

Esthé Clinic Na Příkopě 17 110 00 Prague Czech Republic

Laboratory of 3D Imaging and Analytical Methods Department of Anthropology and Human Genetics Faculty of Science Charles University Viničná 7 128 00 Prague 2 Czech Republic

Zobrazit více v PubMed

Silbernagl, S. et al. Atlas Fyziologie člověka: překlad 8. německého vydání (Grada Publishing, 2016).

Borod, J. C., Caron, H. S. & Koff, E. Asymmetry of facial expression related to handedness, footedness, and eyedness: a quantitative study. Cortex17, 381–390 (1981). PubMed

Dane, Ş., Ersöz, M., Gümüştekin, K., Polat, P. & Daştan, A. Handedness differences in widths of right and left craniofacial regions in healthy young adults. Percept. Mot. Skills98, 1261–1264 (2004). PubMed

Měšťák, J. Estetické Operace nosu v klinické Praxi (Grada Publishing, a.s., 2020).

Papadatou-Pastou, M. et al. Human handedness: a meta-analysis. Psychol. Bull.146, 481–524 (2020). PubMed

Nissan, J., Gross, M. D., Shifman, A., Tzadok, L. & Assif, D. Chewing side preference as a type of hemispheric laterality. J. Rehabilit.31, 412–416 (2004). PubMed

Tiwari, S., Nambiar, S. & Unnikrishnan, B. Chewing side preference - impact on facial symmetry, dentition and temporomandibular joint and its correlation with handedness. J. Orofac. Sci.9, 22 (2017).

Lindell, A. Elsevier,. Lateralization of the expression of facial emotion in humans. In: Progress in Brain Research vol. 238 249–270 (2018). PubMed

Ocklenburg, S. & Güntürkün, O. Language and the left hemisphere. In: The Lateralized Brain 87–121 (Elsevier), 10.1016/B978-0-12-803452-1.00004-7. (2018).

Akabalieva, K. V. Combined foot and eye dominance scale as a useful tool for the assessment of lateralization. Eur. Psychiatr.66, S1064–S1064 (2023).

Marcucio, R., Hallgrimsson, B. & Young, N. M. Facial morphogenesis. In: Current Topics in Developmental Biology115 299–320 (Elsevier, 2015). PubMed PMC

Tripi, G. et al. Cranio-facial characteristics in children with autism spectrum disorders (ASD). JCM8, 641 (2019). PubMed PMC

Moore, K. L., Persaud, T. V. N. & Torchia, M. G. The developing human: Clinically oriented embryology (Saunders/Elsevier, 2008).

Moore, K. L., Persaud, T. V. N. & Torchia, M. G. Before we are born: Essentials of embryology and birth defects (Elsevier, 2016).

Hepper, P. G., Mccartney, G. R. & Shannon, E. A. Lateralised behaviour in first trimester human foetuses. Neuropsychologia36, 531–534 (1998). PubMed

Francks, C. Exploring human brain lateralization with molecular genetics and genomics. Ann. N. Y. Acad. Sci.1359, 1–13 (2015). PubMed

Geschwind, N., Galaburda, A. M. Cerebral lateralization: Biological mechanisms, associations, and pathology: I. A hypothesis and a program for research. Arch. Neurol.42, 428 (1985). PubMed

Hammond, P. et al. Face–brain asymmetry in autism spectrum disorders. Mol. Psychiatry13, 614–623 (2008). PubMed

Lindell, A. K. & Hudry, K. Atypicalities in cortical structure, handedness, and functional lateralization for language in autism spectrum disorders. Neuropsychol. Rev.23, 257–270 (2013). PubMed

Johnston, V. S. Mate choice decisions: the role of facial beauty. Trends Cogn. Sci.10, 9–13 (2006). PubMed

Quist, M. C. et al. Sociosexuality predicts women’s preferences for symmetry in men’s faces. Arch. Sex. Behav.41, 1415–1421 (2012). PubMed

Klingenberg, C. Analyzing fluctuating asymmetry with geometric morphometrics: concepts, methods, and applications. Symmetry7, 843–934 (2015).

Meyer-Marcotty, P., Stellzig-Eisenhauer, A., Bareis, U., Hartmann, J. & Kochel, J. Three-dimensional perception of facial asymmetry. Eur. J. Orthod.33, 647–653 (2011). PubMed

Harnádková, K., Kočandrlová, K., Kožejová Jaklová, L., Dupej, J. & Velemínská, J. The effect of sex and age on facial shape directional asymmetry in adults: a 3D landmarks-based method study. PLoS ONE18, e0288702 (2023). PubMed PMC

Pazdera, J. Základy Ústní a Čelistní Chirurgie (Olomouc, 2013).

Katsube, M. et al. Analysis of facial skeletal asymmetry during foetal development using µCT imaging. Orthod. Craniofac. Res.22, 199–206 (2019). PubMed PMC

Hood, C. A., Bock, M., Hosey, M. T., Bowman, A. & Ayoub, A. F. Facial asymmetry – 3D assessment of infants with cleft lip & palate. Int. J. Paed Dent.13, 404–410 (2003). PubMed

Babczyńska, A., Kawala, B. & Sarul, M. Genetic factors that affect asymmetric mandibular growth—A systematic review. Symmetry14, 490 (2022).

Windhager, S. et al. Variation at genes influencing facial morphology are not associated with developmental iImprecision in human faces. PLoS ONE9, e99009 (2014). PubMed PMC

Carstens, M. H. D. F. R. & Cheilorhinoplasty The role of developmental field reassignment in the management of facial asymmetry and the airway in the complete cleft deformity. In: The Embryologic Basis of Craniofacial Structure (ed Carstens, M. H.) 1563–1642 (Springer International Publishing), 10.1007/978-3-031-15636-6_19. (2023).

Klingenberg, C. P. et al. Prenatal alcohol exposure alters the patterns of facial asymmetry. Alcohol44, 649–657 (2010). PubMed PMC

Harastani, M., Benterkia, A., Zadeh, F. M. & Nait-Ali, A. Methamphetamine drug abuse and addiction: effects on face asymmetry. Comput. Biol. Med.116, 103475 (2020). PubMed

Kaur, M., Garg, R. K. & Singla, S. Analysis of facial soft tissue changes with aging and their effects on facial morphology: a forensic perspective. Egypt. J. Forensic Sci.5, 46–56 (2015).

Linden, O. E., He, J. K., Morrison, C. S., Sullivan, S. R. & Taylor, H. O. B. The relationship between age and facial asymmetry. Plast. Reconstr. Surg.142, 1145–1152 (2018). PubMed

Sajid, M., Taj, I. A. & Bajwa, U. I. Ratyal, N. I. The role of facial asymmetry in recognizing age-separated face images. Comput. Electr. Eng.54, 255–270 (2016).

Wysong, A., Joseph, T., Kim, D., Tang, J. Y. & Gladstone, H. B. Quantifying soft tissue loss in facial aging: a study in women using magnetic resonance imaging. Dermatol. Surg.39, 1895–1902 (2013). PubMed

Albert, A. M., Ricanek, K. & Patterson, E. A review of the literature on the aging adult skull and face: implications for forensic science research and applications. Forensic Sci. Int.172, 1–9 (2007). PubMed

Alford, R. & Alford, K. F. Sex differences in asymmetry in the facial expression of emotion. Neuropsychologia19, 605–608 (1981). PubMed

Claes, P. et al. Sexual dimorphism in multiple aspects of 3D facial symmetry and asymmetry defined by spatially dense geometric morphometrics: spatially dense sexual dimorphism in 3D facial shape. J. Anat.221, 97–114 (2012). PubMed PMC

Martinez-Gomis, J. et al. Relationship between chewing side preference and handedness and lateral asymmetry of peripheral factors. Arch. Oral Biol.54, 101–107 (2009). PubMed

Ocklenburg, S. & Güntürkün, O. Handedness and other behavioral asymmetries. In: The Lateralized Brain 123–158 (Elsevier), 10.1016/B978-0-12-803452-1.00005-9. (2018).

McManus, C. Cerebral polymorphisms for lateralisation: modelling the genetic and phenotypic architectures of multiple functional modules. Symmetry14, 814 (2022).

Vingerhoets, G. Phenotypes in hemispheric functional segregation? Perspectives and challenges. Phys. Life Rev.30, 1–18 (2019). PubMed

Szaflarski, J. P., Holland, S. K., Schmithorst, V. J. & Byars, A. W. fMRI study of language lateralization in children and adults. Hum. Brain Mapp.27, 202–212 (2006). PubMed PMC

Hausmann, M. et al. Sex differences in oral asymmetries during wordrepetition. Neuropsychologia36, 1397–1402 (1998). PubMed

Budisavljevic, S., Castiello, U. & Begliomini, C. Handedness and white matter networks. Neuroscientist27, 88–103 (2021). PubMed

Howells, H. et al. Frontoparietal tracts linked to lateralized hand preference and manual specialization. Cereb. Cortex28, 1–13 (2018). PubMed PMC

Özener, B., Palin, C., Kürkçüoğlu, A., Ertuğrul, B. & Zağyapan, R. Analysis of facial directional asymmetry in extremehanded young males and females. Eurasian J. Anthropol. 96–101 (2011).

KelesL, P., Díyarbakirli, S., Tan, M. & Tan, Ü. Facial asymmetry in right- and left-handed men and women. Int. J. Neurosci.91, 147–159 (1997). PubMed

Varela, J. M. F. et al. A comparison of the methods used to determine chewing preference. J. Oral Rehabilit.30, 990–994 (2003). PubMed

Khamnei, S. et al. Manifestation of hemispheric laterality in chewing side preference and handedness. Bioimpacts9, 189–193 (2019). PubMed PMC

Jiang, H. et al. Analysis of brain activity involved in chewing-side preference during chewing: an fMRI study. J. Oral Rehabilit.42, 27–33 (2015). PubMed

Heikkinen, E. V., Vuollo, V., Harila, V., Sidlauskas, A. & Heikkinen, T. Facial asymmetry and chewing sides in twins. Acta Odontol. Scand.80, 197–202 (2022). PubMed

Nascimento, G. K. B. O. et al. Preferência De lado mastigatório e simetria facial em laringectomizados totais: estudo clínico e eletromiográfico. Rev. CEFAC15, 1525–1532 (2013).

Bourassa, D. C. Handedness and eye-dominance: a Meta-analysis of their relationship. Laterality1, 5–34 (1996). PubMed

Shah, C. T., Nguyen, E. V. & Hassan, A. S. Asymmetric eyebrow elevation and its association with ocular dominance. Ophthalmic Plast. Reconstr. Surg.28, 50–53 (2012). PubMed

Severt, T. & Proffit, W. The prevalence of facial asymmetry in the dentofacial deformities population at the University of North Carolina. Int. J. Adult Orthodon Orthognath Surg.12, (1997). PubMed

Azuma, T. et al. New method to evaluate sequelae of static facial asymmetry in patients with facial palsy using three-dimensional scanning analysis. Auris Nasus Larynx49, 755–761 (2022). PubMed

Golshah, A., Hajiazizi, R., Azizi, B. & Nikkerdar, N. Assessment of the asymmetry of the lower jaw, face, and palate in patients with unilateral cleft lip and palate. Contemp. Clin. Dent.13, 40 (2022). PubMed PMC

Haraguchi, S., Iguchi, Y. & Takada, K. Asymmetry of the face in orthodontic patients. Angle Orthod.78, 421–426 (2008). PubMed

Rohrich, R. J., Villanueva, N. L., Small, K. H. & Pezeshk, R. A. Implications of facial asymmetry in rhinoplasty. Plast. Reconstr. Surg.140, 510–516 (2017). PubMed

WHO. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch. Intern. Med.158, 1855 (1998). PubMed

Kočandrlová, K., Dupej, J., Hoffmannová, E. & Velemínská, J. Three-dimensional mixed longitudinal study of facial growth changes and variability of facial form in preschool children using stereophotogrammetry. Orthod. Craniofac. Res.24, 511–519 (2021). PubMed

Velemínská, J. et al. Three-dimensional analysis of modeled facial aging and sexual dimorphism from juvenile to elderly age. Sci. Rep.12, 21821 (2022). PubMed PMC

Guo, K. et al. Precise maxillofacial soft tissue reconstruction: a combination of cone beam computed tomography and 3dMD photogrammetry system. Heliyon10, e32513 (2024). PubMed PMC

Schwarz, M. et al. Body mass index is an overlooked confounding factor in existing clustering studies of 3D facial scans of children with autism spectrum disorder. Sci. Rep.14, 9873 (2024). PubMed PMC

Technology, I. N. U. S. Inc. Rapidform (INUS Technology, Inc, 2006).

Dupej, J. & Krajíček, V. Morphome3cs. (2023).

Klingenberg, C. P. MorphoJ: an integrated software package for geometric morphometrics. (2011). PubMed

Bonferroni, C. E. Teoria Statistica delle classi e calcolo delle probabilit `a. Pubblicazioni Del. R Istituto Superiore Di Scienze Economiche E Commerciali Di Firenze 3–62 (1936).

von Cramon-Taubadel, N., Frazier, B. C. & Lahr, M. M. The problem of assessing landmark error in geometric morphometrics: theory, methods, and modifications. Am. J. Phys. Anthropol.134, 24–35 (2007). PubMed

Dupej, J., Krajíček, V., Velemínská, J. & Pelikán, J. Statistical mesh shape analysis with nonlandmark nonrigid registration (2014).

Myronenko, A. Xubo Song. Point set registration: coherent point drift. IEEE Trans. Pattern Anal. Mach. Intell.32, 2262–2275 (2010). PubMed

Krajíček, V., Dupej, J., Velemínská, J. & Pelikán, J. Morphometric analysis of mesh asymmetry. J. WSCG (2012).

Oldfield, R. C. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia9, 97–113 (1971). PubMed

Ferrario, V. F., Sforza, C., Miani, A. & Serrao, G. A three-dimensional evaluation of human facial asymmetry. J. Anat.186 (Pt 1), 103–110 (1995). PubMed PMC

Roosenboom, J. et al. SNPs Associated with testosterone levels influence human facial morphology. Front. Genet.9, 497 (2018). PubMed PMC

Rogers, L. J. Manual bias, behavior, and cognition in common marmosets and other primates. In: Progress in Brain Research vol. 238 91–113 Elsevier, (2018). PubMed

Bigoni, L., Krajíček, V., Sládek, V., Velemínský, P. & Velemínská, J. Skull shape asymmetry and the socioeconomic structure of an early medieval central European society. Am. J. Phys. Anthropol.150, 349–364 (2013). PubMed

Kertesz, A., Black, S. E., Polk, M. & Howell, J. Cerebral asymmetries on magnetic resonance imaging. Cortex22, 117–127 (1986). PubMed

Rentería, M. E. & Cerebral Asymmetry A quantitative, multifactorial, and plastic brain phenotype. Twin Res. Hum. Genet.15, 401–413 (2012). PubMed

Launonen, A. M. et al. A longitudinal study of facial asymmetry in a normal birth cohort up to 6 years of age and the predisposing factors. Eur. J. Orthod.45, 396–407 (2023). PubMed PMC

Hun, K. D., Park, K. R., Chung, K. J. & Kim, Y. H. The relationship between facial asymmetry and nasal septal deviation. J. Craniofac. Surg.26, 1273–1276 (2015). PubMed

Dane, Ş. et al. Relations among hand preference, craniofacial asymmetry, and ear advantage in young subjects. Percept. Mot. Skills95, 416–422 (2002). PubMed

Yorita, G. J., Melnick, M., Opitz, J. M. & Reynolds, J. F. Cleft lip and handedness: a study of laterality. Am. J. Med. Genet.31, 273–280 (1988). PubMed