Anatomical References for the Study of 3D Facial Photographs: A Scoping Review and Proposed Preliminary Framework for Comprehensive Facial Evaluation.

Background/Objectives: Facial deformities compromise craniofacial aesthetics and functionality. Maxillofacial surgery and orthodontics require meticulous planning utilizing tomography and clinical photography. Although tomography provides precise information about bony structures, it has limitations in evaluating soft tissues. Three-dimensional photography emerges as a complementary alternative; however, there is limited information regarding morphological facial analysis in three dimensional (3D) images. Methods: A scoping review was conducted according to PRISMA-ScR guidelines and the Joanna Briggs Institute methodological framework. The MEDLINE (PubMed), Scopus, SciELO, and Web of Science databases were searched for studies published between 2017 and 2025 evaluating the use of 3D facial photography in orthodontics, orthognathic surgery, maxillofacial surgery, and related craniofacial applications. Two independent reviewers performed study selection and data extraction, with disagreements resolved by a third reviewer. Anatomical landmarks and facial measurements were descriptively synthesized according to facial regions and measurement type. Results: Out of 79 initially identified articles, 18 observational studies examining 3D facial photographs were included. Consequently, the "3D FullFace A" tool was developed, incorporating 13 midline points and 12 bilateral points, enabling 18 linear and 28 angular measurements for comprehensive facial analysis. Conclusions: Available evidence suggests that 3D facial photography is a promising tool for orthognathic surgical planning. Key advances identified include reliable stereophotogrammetric landmark identification, quantification of soft-tissue changes following orthognathic and orthodontic treatment, and characterization of facial asymmetry and proportionality.