Accuracy of Orthopantomography Versus Lateral Cephalograms in Facial Asymmetry Evaluation: A Cross-Sectional Study in Orthodontic Patients

Introduction: Facial asymmetry significantly influences orthodontic diagnosis, treatment planning, and patient satisfaction. Although three-dimensional imaging techniques such as CBCT provide comprehensive diagnostic information, their routine use is often restricted due to higher costs and radiation exposure. As a result, two-dimensional imaging modalities—primarily orthopantomograms (OPG) and lateral cephalograms (LC)—remain widely used in clinical practice. Aim & Objectives: This cross-sectional study aimed to compare the diagnostic reliability of OPG and LC in assessing skeletal facial asymmetry, focusing on linear and angular skeletal parameters measurable on both. Materials & Methods: Standardized protocols ensured consistent patient positioning to reduce distortion. Results: indicated that lateral cephalograms were more accurate in detecting midline deviations and angular skeletal discrepancies, particularly in the anteroposterior and vertical planes. On the other hand, OPGs demonstrated reasonable diagnostic utility in identifying vertical asymmetries, such as differences in ramus height, provided patient positioning was meticulously controlled. Conclusion: The study concludes that while LC is superior overall, both modalities can serve complementary roles in routine orthodontic assessment