Objective
The importance of early diagnosis and intervention for pediatric malocclusion has been accentuated. With 3D image avoiding unnecessary radiation, it holds the potential to evaluate facial features in school-aged population.

Material and Methods
Students aged 9 to 10 were recruited. We performed 3D stereophotogrammetry of the participants’ head annually. 37 recognizable anatomical landmarks were identified for linear, angular, and asymmetric analyses.

Results
This study included 139 healthy Taiwanese children (mean age: 9.13), which 74 had class I occlusion, 50 had class II malocclusion, and 15 had class III malocclusion. Class III group had lower soft-tissue convexity (p = 0.01) than class II group. The boys with class II malocclusion had greater dimensions in the anteroposterior position of the mid-face (p = 0.024). A smaller labiomental angle was noted in the class II group compared with the class I group (p = 0.046). Overall asymmetry showed no significance (p > 0.05). Heat maps of the 3D models exhibited asymmetry in the mid-face of class II group and in the lower face of class III group.

Conclusions
Based on malocclusion type, children exhibited distinct facial traits early on. Asymmetry was noted in facial areas with relatively prominent soft-tissue features among different malocclusion types.