Asymmetry In Children Research Articles

Cortical thickness lateralization and its relation to language abilities in children

The humans’ brain asymmetry is observed in the early stages of life and known to change further with age. The developmental trajectory of such an asymmetry has been observed for language, as one of the most lateralized cognitive functions. However, it remains unclear how these age-related changes in structural asymmetry are related to changes in language performance. We collected longitudinal structural magnetic resonance imaging data of children from 5 to 6 years to investigate structural asymmetry development and its linkage to the improvement of language comprehension abilities. Our results showed substantial changes of language performance across time, which were associated with changes of cortical thickness asymmetry in the triangular part of the inferior frontal gyrus (IFG), constituting a portion of Broca’s area. This suggests that language improvement is influenced by larger cortical thinning in the left triangular IFG compared to the right. This asymmetry in children’s brain at age 5 and 6 years was further associated with the language performance at 7 years. To our knowledge, this is the first longitudinal study to demonstrate that children’s improvement in sentence comprehension seems to depend on structural asymmetry changes in the IFG, further highlighting its crucial role in language acquisition.

EMG-Based Characterization of Walking Asymmetry in Children with Mild Hemiplegic Cerebral Palsy.

Hemiplegia is a neurological disorder that is often detected in children with cerebral palsy. Although many studies have investigated muscular activity in hemiplegic legs, few EMG-based findings focused on unaffected limb. This study aimed to quantify the asymmetric behavior of lower-limb-muscle recruitment during walking in mild-hemiplegic children from surface-EMG and foot-floor contact features. sEMG signals from tibialis anterior (TA) and gastrocnemius lateralis and foot-floor contact data during walking were analyzed in 16 hemiplegic children classified as W1 according to Winter’ scale, and in 100 control children. Statistical gait analysis, a methodology achieving a statistical characterization of gait by averaging surface-EMG-based features, was performed. Results, achieved in hundreds of strides for each child, indicated that in the hemiplegic side with respect to the non-hemiplegic side, W1 children showed a statistically significant: decreased number of strides with normal foot-floor contact; decreased stance-phase length and initial-contact sub-phase; curtailed, less frequent TA activity in terminal swing and a lack of TA activity at heel-strike. The acknowledged impairment of anti-phase eccentric control of dorsiflexors was confirmed in the hemiplegic side, but not in the contralateral side. However, a modified foot-floor contact pattern is evinced also in the contralateral side, probably to make up for balance requirements.

Gait asymmetry and rating of perceived exertion: How are they influenced by carrying a backpack and pulling a trolley?

Carrying a backpack and pulling a school trolley have been previously related to changes in spatiotemporal gait parameters. Analyze gait asymmetry and rating of perceived exertion carrying a backpack and pulling a trolley with different loads. Fifteen students from an elementary school (aged 10.1 ± 1.7 years) participated in this study. The participants walked with no bag, and carrying a backpack or pulling a trolley, both with 10%, 15% and 20% of the participant's body weight (BW). A 3D motion capture system was used to analyze the spatiotemporal gait variables. Then, the ratios, symmetry angles and gait asymmetry of the step length, swing time, and stance time were analyzed. Furthermore, the rating of perceived exertion was recorded. None of the asymmetry parameters were significantly different between those who carried a backpack and those who pulled a trolley. In the backpack condition, the ratings of perceived exertion were higher among participants in the 20% BW (2.07 ± 2.09, p = 0.003) and 10% BW (0.27 ± 0.59, p = 0.004) conditions compared to those in the control condition (0.07 + 0.26). Pulling a trolley did not significantly increase the perceived exertion ratings. Carrying a backpack and pulling a trolley from 10% - 20% BW did not induce gait asymmetry in children. The use of the school trolley required less subjective effort than carrying a backpack with the same loads.

Aberrant Interhemispheric Functional Organization in Children with Dyskinetic Cerebral Palsy.

Background Hemispheric asymmetry is one fundamental principle of neuronal organization. Interhemispheric connectivity and lateralization of intrinsic networks in the resting-state brain demonstrate the interhemispheric functional organization and can be affected by disease processes. This study aims to investigate the interhemispheric organization in children with dyskinetic cerebral palsy (DCP) based on resting-state functional MRI (fMRI). Methods 24 children with DCP and 20 healthy children were included. Voxel-mirrored homotopic connectivity (VMHC) was calculated to detect the interhemispheric connectivity, and the lateralization of the resting-state networks was performed to examine the asymmetry of the intrinsic networks of brain. Results Decreased interhemispheric connectivity was found at visual, motor, and motor-control related regions in children with DCP, while high cognitive related networks including the central executive network, the frontoparietal network, and the salience network represented decreased asymmetry in children with DCP. Abnormal VMHC in visual areas, as well as the altered lateralization in inferior parietal lobule and supplementary motor area, showed correlation with the gross motor function and activities of daily living in children with DCP. Conclusion These findings indicate that the interhemispheric functional organization alteration exists in children with DCP, suggesting that abnormal interhemispheric interaction may be a pathophysiological mechanism of motor and cognitive dysfunction of CP.

Characteristics for Functional Brain Asymmetry of Children With Pseudobulbar Dysartria

The article raises important problem of the causes of functional brain asymmetry and interhemispheric interaction of children with pseudobulbar dysarthria. The left hemisphere is dominant in relation to speech function for the absolute majority of people. Therefore, the physiological process for forming distribution of functions between hemispheres in ontogeny is important not only from the point of the correct speech development as the highest mental function but also reflects on the wide spectrum of psyche features, perception and cognitive processes, adaptive capabilities of the organism, control over involuntary behavior. There are 40 children with a normal speech development and with a clinical diagnosis of ‘pseudobulbar dysarthria’, determine a lateral phenotype, calculate coefficients of functional asymmetry, and the most common types of violations identify of higher cortical functions. Confirmed information on the prevalence for the right hemispheric dominance among children with speech disorders. The most common types of violations in higher cortical functions are the failure of phonemic analysis and auditory memory.
 Keywords: functional asymmetry, interhemispheric actions, children, pseudobulbar dysarthria

The ontogeny of intent-based normative judgments.

When evaluating norm transgressions, children begin to show some sensitivity to the agent's intentionality around preschool age. However, the specific developmental trajectories of different forms of such intent-based judgments and their cognitive underpinnings are still largely unclear. The current studies, therefore, systematically investigated the development of intent-based normative judgments as a function of two crucial factors: (a) the type of the agent's mental state underlying a normative transgression, and (b) the type of norm transgressed (moral versus conventional). In Study 1, 5- and 7-year-old children as well as adults were presented with vignettes in which an agent transgressed either a moral or a conventional norm. Crucially, she did so either intentionally, accidentally (not intentionally at all) or unknowingly (intentionally, yet based on a false belief regarding the outcome). The results revealed two asymmetries in children's intent-based judgments. First, all age groups showed greater sensitivity to mental state information for moral compared to conventional transgressions. Second, children's (but not adults') normative judgments were more sensitive to the agent's intention than to her belief. Two subsequent studies investigated this asymmetry in children more closely and found evidence that it is based on performance factors: children are able in principle to take into account an agent's false belief in much the same way as her intentions, yet do not make belief-based judgments in many existing tasks (like that of Study 1) due to their inferential complexity. Taken together, these findings contribute to a more systematic understanding of the development of intent-based normative judgment.

Objective PET study of glucose metabolism asymmetries in children with epilepsy: Implications for normal brain development.

Clinical interpretation of cerebral positron emission tomography with 2-deoxy-2[F-18]fluoro-d-glucose (FDG-PET) images often relies on evaluation of regional asymmetries. This study was designed to establish age-related variations in regional cortical glucose metabolism asymmetries in the developing human brain. FDG-PET scans of 58 children (age: 1-18 years) were selected from a large single-center pediatric PET database. All children had a history of epilepsy, normal MRI, and normal pattern of glucose metabolism on visual evaluation. PET images were analyzed objectively by statistical parametric mapping with the use of age-specific FDG-PET templates. Regional FDG uptake was measured in 35 cortical regions in both hemispheres using an automated anatomical labeling atlas, and left/right ratios were correlated with age, gender, and epilepsy variables. Cortical glucose metabolism was mostly symmetric in young children and became increasingly asymmetric in older subjects. Specifically, several frontal cortical regions showed an age-related increase of left > right asymmetries (mean: up to 10%), while right > left asymmetries emerged in posterior cortex (including portions of the occipital, parietal, and temporal lobe) in older children (up to 9%). Similar trends were seen in a subgroup of 39 children with known right-handedness. Age-related correlations of regional metabolic asymmetries showed no robust gender differences and were not affected by epilepsy variables. These data demonstrate a region-specific emergence of cortical metabolic asymmetries between age 1-18 years, with left > right asymmetry in frontal and right > left asymmetry in posterior regions. The findings can facilitate correct interpretation of cortical regional asymmetries on pediatric FDG-PET images across a wide age range.

An Algorithm for the Assessment of Facial Asymmetry in Children With Focus on Etiology and Treatment.

Facial asymmetry is a common referral indication for craniofacial teams but has a wide range of causes. Prompt identification of etiology is critical to treatment, as medical and surgical interventions vary depending on the cause of asymmetry in each patient. A standardized diagnostic algorithm. We developed an algorithm to assist in the diagnostic evaluation of facial asymmetry with a focus on next steps for medically actionable causes.

Is tonsillectomy mandatory for asymmetric tonsils in children? A review of our diagnostic tonsillectomy practice and the literature

IntroductionDiagnostic tonsillectomy is performed to exclude malignancy. It is associated with a post-operative hemorrhage rate of 3.5%, (1) which is more dangerous in small children. No previous case series for asymmetrical tonsils have detected tonsil lymphoma.(2–6) We aimed to review our local diagnostic tonsillectomy practice. MethodThe authors reviewed the clinical notes and histological results for all diagnostic tonsillectomies carried out from June 2013 to June 2016. ResultsWe recorded data for 168 patients. There were four post-operative bleeds and one return to theatre. Bilateral tonsillectomies accounted for 152 operations (90.5%). Lymphoid hyperplasia accounted for 95% of histological diagnosis with no malignancies found. Pre-operative tonsil grading demonstrated no statistically significant association with histological tonsil weight difference (ANOVA p = 0.10). Actinomyces colonisation had little affect on tonsil weight difference when we compared patients with bilateral colonisation and no colonisation (t-test p = 0.540) and between tonsils in patients with unilateral tonsil Actinomyces colonisation (paired t-test p = 0.448). Recurrent tonsillitis was more prevalent in patients with Actinomyces colonisation than OSA/sleep disordered breathing (39% vs 15%). ConclusionA literature search yielded five smaller case series of palatine tonsil asymmetry in children with no malignancy found.(2–6) Case-control studies report tonsillar asymmetry as the most common presenting symptom (73%) in tonsillar lymphoma.(7) This enlargement usually occurs rapidly within 6 weeks with new obstructive or systemic B-type symptoms.(3) A Turkish epidemiological study found asymmetrical tonsils in 1.7% of the healthy paediatric population.(8) We therefore estimate there to be over 210,000 children with asymmetrical tonsils in the UK. With an unreliable grading system, we believe asymmetrical tonsils in isolation, unchanged for over 6 weeks may not warrant tonsillectomy.

Positive and Negative Emotionality at Age 3 Predicts Change in Frontal EEG Asymmetry across Early Childhood.

Depression is characterized by low positive emotionality (PE) and high negative emotionality (NE), as well as asymmetries in resting electroencephalography (EEG) alpha power. Moreover, frontal asymmetry has itself been linked to PE, NE, and related constructs. However, little is known about associations of temperamental PE and NE with resting EEG asymmetries in young children and whether this association changes as a function of development. In a longitudinal study of 254 three-year old children, we assessed PE and NE at age 3 using a standard laboratory observation procedure. Frontal EEG asymmetries were assessed at age 3 and three years later at age 6. We observed a significant three-way interaction of preschool PE and NE and age at assessment for asymmetry at F3-F4 electrode sites, such that children with both low PE and high NE developed a pattern of increasingly lower relative left-frontal cortical activity over time. In addition, F7-F8 asymmetry was predicted by a PE by time interaction, such that the frontal asymmetry in children with high PE virtually disappeared by age 6. Overall, these findings suggest that early temperament is associated with developmental changes in frontal asymmetry, and that the combination of low PE and high NE predicts the development of the pattern of frontal symmetry that is associated with depression.

Trajectories of frontal brain activity and socio-emotional development in children.

Asymmetric frontal brain activity is thought to reflect individual differences in approach- and avoidance-oriented motivation and emotional experience. Using a prospective longitudinal design, the authors investigated whether trajectories of frontal electroencephalogram (EEG) asymmetry in children (Mage = 6.39 years at enrollment) predicted subjective, behavioral, and autonomic indices of socioemotional processes. Resting frontal EEG activity was measured across four separate repeated assessments spanning approximately 2 years. Children's EEG asymmetry across assessments was best characterized by two trajectories: a stable right frontal asymmetry class (48.65%), and a stable left frontal asymmetry class (51.35%). At visit 4, children in the stable right frontal asymmetry displayed more avoidance-related tendencies and children in the stable left frontal asymmetry class exhibited more approach-related tendencies across social, emotional, and autonomic measures. These findings suggest that developmental patterns of resting frontal brain activity across the early school years may underlie approach- and avoidance-related motivation and predict socio-emotional processes in some children.

Backward walking highlights gait asymmetries in children with cerebral palsy.

To investigate how early injuries to developing motor regions of the brain affect different forms of gait, we compared the spatiotemporal locomotor patterns during forward (FW) and backward (BW) walking in children with cerebral palsy (CP). Bilateral gait kinematics and EMG activity of 11 pairs of leg muscles were recorded in 14 children with CP (9 diplegic, 5 hemiplegic; 3.0-11.1 yr) and 14 typically developing (TD) children (3.3-11.8 yr). During BW, children with CP showed a significant increase of gait asymmetry in foot trajectory characteristics and limb intersegmental coordination. Furthermore, gait asymmetries, which were not evident during FW in diplegic children, became evident during BW. Factorization of the EMG signals revealed a comparable structure of the motor output during FW and BW in all groups of children, but we found differences in the basic temporal activation patterns. Overall, the results are consistent with the idea that both forms of gait share pattern generation control circuits providing similar (though reversed) kinematic patterns. However, BW requires different muscle activation timings associated with muscle modules, highlighting subtle gait asymmetries in diplegic children, and thus provides a more comprehensive assessment of gait pathology in children with CP. The findings suggest that spatiotemporal asymmetry assessments during BW might reflect an impaired state and/or descending control of the spinal locomotor circuitry and can be used for diagnostic purposes and as complementary markers of gait recovery. NEW & NOTEWORTHY Early injuries to developing motor regions of the brain affect both forward progression and other forms of gait. In particular, backward walking highlights prominent gait asymmetries in children with hemiplegia and diplegia from cerebral palsy and can give a more comprehensive assessment of gait pathology. The observed spatiotemporal asymmetry assessments may reflect both impaired supraspinal control and impaired state of the spinal circuitry.

Left-Biased Clavicle Length Asymmetry in Children and Young Adults 12 to 25 Years Old.

Management of clavicle fractures depends in part on the magnitude of shortening compared with the contralateral, intact clavicle. However, estimating prefracture length may be complicated by side-to-side asymmetry. The authors retrospectively reviewed chest radiographs using a ruler tool to measure clavicle length in 696 patients 12 to 25 years old. Absolute and relative least significant change values that represented statistically significant true biological differences were 3.54 mm and 2.44%, respectively. Length differences in which the left was greater than the right or the right was greater than the left exceeding the absolute least significant change were found in 35.2% of males and 39.8% of females. Length differences exceeding 5 mm and 10 mm were 19% and 2.6% in males and 22.6% and 0.9% in females, respectively. There was a statistically significant left bias in length difference, with a 2.1-fold and a 1.6-fold greater chance of the left being longer than the right (although usually <5 mm in actual length) in males and females, respectively. The authors concluded that small but significant left-biased length asymmetry prevailed in both sexes. Differences exceeding 10 mm were rare. Contralateral clavicles can be used to estimate prefracture length of presenting fractures with the understanding that small left-right length discrepancy is common. [Orthopedics. 2018; 41(1):e104-e109.].

The effects of low arched feet on lower limb joints moment asymmetry during gait in children: A cross sectional study

BackgroundThe prevalence of flexible flat feet in children was reported to be up to 20% in previous studies. However, the role of foot type in the development of musculoskeletal injuries is less clear, particularly in children. The purpose of this study was to investigate the differences in the joint moment asymmetry in children with flexible flat feet and healthy matched control subjects. MethodsFourteen male children with flexible flat feet and 15 healthy control subjects served as the sample of the study. Three dimensional kinematics and kinetic data were collected using a Vicon camera system and two Kistler force platforms during walking. Then between-limb asymmetry was examined for each joint moment. ResultsNormal individuals experienced higher asymmetry in the ankle eversion and the external rotation moments than the flat feet group. Asymmetry indices in the knee abduction, adduction, and the internal rotation moments in the flat feet group were higher than that in the normal group by 15%, 24% and 13%, respectively. Furthermore, in comparison of the two groups, individuals with flat feet had higher asymmetry in the hip flexion moment as well as the hip abduction moment. ConclusionsIn order to provide appropriate protocols or footwear design for male children with flat feet, clinicians need to understand that flat feet children do not have higher levels of joint moment asymmetry as compared to normal children in all joints and all planes; consequently, they must differentiate their treatments for each specific joint. However, further larger study is warranted.

A Hierarchical Model for Autism Spectrum Disorder (HMASD)

Background: Autism spectrum disorder (ASD) is a severe behavioral disorder characterized by pervasive impairments in social in- teractions, deficits in verbal and nonverbal communication, and stereotyped, repetitive patterns of behaviors and interests. Despite recent advances in identifying some genes that may cause autism, its underlying neurological mechanisms are uncertain. ASD is best conceptualized by considering the neural systems that may be defective in autistic individuals. Objectives: Here, we aim to describe a potential Hierarchical model for ASD. This interesting presented model is based on excitatory and inhibitory characteristics of cortico-cortical networks. Methods: Jason model is one of the models applied to produce EEG in cortical areas. In this model, a cortical area is modeled with three subpopulations including: excitatory pyramidal cells (output), excitatory interneurons groups, input inhibitory interneuron groups by means of output connections (output connections are limited to cortical planes). The presented hierarchical model for autism spectrum disorder (HMASD) is based on Jason model. HMASD is a hierarchical model of cortico-cortical networks as well as an excitation/inhibition model in sensory, mnemonic, social and emotional systems. In HMASD there are three kinds of outer connections including forward, backward and lateral connections, that their power is controlled by coupling parameters. Results: HMASD raises the possibility that ASD is related to excitation/inhibition imbalance in cortico-cortical networks. HMASD parameters are possible way for quantization imbalance quality. Conclusions: The most eected parts in ASD are lateral connections of HMASD. Two-sided connections which are completely sym- metric become more active, and cause extra synchronization. On the other hand, due to special characteristic of two-sided con- nections and their ability to simulate the same phased dynamics, they cause unnatural asymmetry in children's EEG signal. These results are consistent with previous findings suggesting the association of EEG abnormalities in ASD with functional impairment of information interacted in cortical connections.

Facial Asymmetry in Children with Unicoronal Synostosis Who Have Undergone Craniofacial Reconstruction in Infancy.

Quantitatively assess 3D spatially detailed soft-tissue facial asymmetry in children who had undergone craniofacial reconstruction for Unicoronal Synostosis (UCS), and compare the facial asymmetry to control patients. It was hypothesized that there would be no significant differences in the facial asymmetry between the groups. Clinical, retrospective follow-up study. Methodological study. Primary care center. Twenty-two children with UCS were selected after review of records. isolated UCS; surgically treated for UCS within the first 19 months of life, without secondary reconstruction; and DNA analysis for the Muenke mutation. An age- and sex-matched control group was employed. The UCS group had undergone bilateral craniotomy of the frontal bone with unilateral supraorbital rim advancement. Using 3D surface scanning, a detailed map of 3D asymmetry presenting the amount of asymmetry in the sagittal, vertical, and transverse directions was calculated for six facial subregions. The facial asymmetry in the UCS group was significantly larger than in the control group for all regions, to the largest extent in the sagittal direction (level of significance: 5%). The regions with the most pronounced asymmetry were cheeks (mean: 5.45 mm; SD: 1.83 mm), forehead (mean: 5.00 mm; SD: 1.57 mm), and eyes (mean: 4.26 mm; SD: 1.44 mm). Ninety percent of the UCS patients in the study had significant facial asymmetry throughout the facial area. The study demonstrates a methodology of facial asymmetry quantification well suited for soft-tissue surgical outcome evaluations and long-term follow-up studies in patients with craniofacial anomalies.

Gait in 5-year-old children with idiopathic clubfoot: A cohort study of 59 children, focusing on foot involvement and the contralateral foot

Background and purpose — Idiopathic clubfoot can be bilateral or unilateral; however, most studies of gait have assessed clubfoot cases as one uniform group. The contralateral foot in children with unilateral clubfoot has shown deviations in pedobarographic measurements, but it is seldom included in studies of gait. We evaluated gait in children with idiopathic clubfoot, concentrating on foot involvement.Patients and methods — Three-dimensional gait analyses of 59 children, mean age 5.4 years, with bilateral (n = 30) or unilateral (n = 29) idiopathic clubfoot were stratified into groups of bilateral, unilateral, or contralateral feet. Age-matched controls (n = 28) were evaluated for comparison. Gait assessment included: (1) discrete kinematic and kinetic parameters, and (2) gait deviation index for kinematics (GDI) and kinetics (GDI-k).Results — No differences in gait were found between bilateral and unilateral idiopathic clubfoot, but both groups deviated when compared to controls. Compared to control feet, contralateral feet showed no deviations in discrete gait parameters, but discrepancies were evident in relation to unilateral clubfoot, causing gait asymmetries in children with unilateral involvement. However, all groups deviated significantly from control feet according to GDI and GDI-k.Interpretation — Bilateral and unilateral idiopathic clubfoot cases show the same persistent deviations in gait, mainly regarding reduced plantarflexion. Nevertheless, knowledge of foot involvement is important as children with unilateral clubfoot show gait asymmetries, which might give an impression of poorer deviations. The results of GDI/GDI-k indicate global gait adaptations of the contralateral foot, so the foot should preferably not be used as a reference for gait.

Assessing Cognition, Executive Functions, and Functional Brain Asymmetry in Children with Rett Syndrome

Background/Purpose: Rett syndrome is a heterogenous neurodevelopmental disorder and is characterized by a regression of language and psychomotor development, autism and epilepsy. In most cases, Rett syndrome is caused by mutations in the MECP2 (MIM*300005) and the FOXG1 (*164874) gene. Due to the abnormal brain development fundamental neurophysiological principles of the brain like functional asymmetry may be altered. Additionally, executive functions like inhibition, which are imminent for the adaption of behavior to the environment, may also be impaired. We chose a functional neurophysiological approach to address these questions. Methods: Children ( > 10 years) with Rett Syndrome (R1) and healthy, age-matched controls (C1) conducted two computer-based neuropsychological tests while recording a 61-channel EEG. A passive dichotic listening task (DLT) was used to assess speech processing and functional cerebral asymmetries. Response capabilities were assessed using a Go–NoGo inhibition task. Results: Using the DLT we found deviances for early perceptual-attentive event-related potentials (ERPs) in R1. For response inhibition the Go–NoGo task revealed impairments in behavior und electrophysiology (R1). Conclusion: Children with Rett syndrome exhibited altered speech perception and altered functional asymmetry of language processing. We also found impaired response inhibition in Rett patients. The tests are a first step to shed light on the cognitive effects of the developmental abnormalities specific for the Rett syndrome. Our findings may help to improve compensatory and occupational therapies and enable the development of (bio-)markers for future putative therapies. The applied ERP tests are applicable for further neurodevelopmental disorders with a low cognitive functional level and compliance.

Asymmetry in children's comprehension of raising.

This paper investigates English-speaking children's acquisition of raising constructions (e.g. John seems to Mary to be happy) and finds an asymmetric effect of NP type on their comprehension: an improvement in performance is observed when a lexical NP is raised across a pronominal experiencer (e.g. John seems to her to be happy) compared to when a pronoun is raised across a lexical NP experiencer (e.g. He seems to Mary to be happy). These results are consistent with a processing-based approach to intervention effects, which reduces children's difficulty with raising to a performance limitation, rather than a grammatical deficit.

Biological predictors of mandibular asymmetries in children with mixed dentition

Objectives: The objective was to investigate the severity of skeletal mandibular asymmetry in children with mixed dentition and other factors associated with asymmetry.Method: The study was cross sectional, with stratified sampling according to malocclusion type consisting of 205 subjects with mixed dentition (median 10, interquartile range 9–11 years). There were 59 subjects presenting Class II/1, 77 Class II/2, and 69 Class III. The mandibular asymmetry has been estimated from orthopantomograms using the Habets’ method and the dental maturation by Demirjian’s method. The sagittal skeletal relationship and facial growth pattern were assessed from lateral cephalograms.Results: Asymmetries in general, were not rare and were more present in the condylar height rather than in the height of the ramus. The highest severity of condylar asymmetry was in Class II/2 subjects (median of asymmetry index 7.3; 64% subjects exhibiting moderate and severe asymmetry), while the Class III subjects exhibited the highest severity of both ramus and total height asymmetry (2.1; 13% and 2.0; 15%, respectively). Multiple logistic regression unveiled male gender as the only predictor of moderate or significant overall asymmetry. Dental age, the difference between dental and chronological age, and facial growth pattern were not significant predictors of asymmetries.Discussion: Overall, asymmetries in mixed dentition cannot be considered rare; however, no strong relationships between asymmetry and observed biological factors were found.