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CEPHALOMETRIC ANALYSIS

DENT 657

ANALYSIS UTILIZING THE CEPHALOMETRIC TRACING


1) Describe the subjects dento-facial morphology 2) Quantitative description of morphological deviations 3) Make diagnostic and treatment planing decisions 2) Evaluate change over time - treatment induced and growth process

Morphological Description
Skeletal - horizontal and vertical x Dental - horizontal and vertical x Comparing individual subjects tracing to the ideal x Reference sample
x

Cross-sectional Longitudinal - growth studies eg. Bolton-Brush, Ann Arbor and Burlington

Cephalometric Analyses
Downs x Steiners x Tweeds x McNamaras x OSU
x

Cephalometric Evaluation
Identification of anatomic landmarks x Landmarks: stable reference structures and maxillary and mandibular skeletal and dental x Graphically relating the dento-facial elements to these reference structures x Angular and or linear measurements
x

METHODS OF CEPHALOMETRIC ANALYSIS


Two basic approaches x Metric approach - use of selected linear and angular measures x Graphic approach - overlay of individuals tracing on a reference template and visual inspection of degree of variation
x

Metric Method - Use of selected


linear and angular measures

Graphic Method - Use of a


Composite Template

GOALS OF CEPHALOMETRIC ANLYSIS


Evaluating relationships, both horizontal and vertical of 5 major functional components of the face: x the cranial base; x the maxilla; the mandible, x the maxillary and mandibular dentoalveolus
x

REFERENCE LINES
Frankforts Horizontal (porion to orbitale) x Sella - Nasion line x True horizontal plane x True vertical plane
x

Reference Lines

sella porion

nasion orbitale

SNA 82 22deg SNA 82 deg NA TO FH 90 33 NA TO FH 90 deg deg

SKELETAL HORIZONTAL MAXILLA

s FH

SNB 80 22deg SNB 80 deg N-PG TO FH N-PG TO FH 88 66deg 88 deg

SKELETAL HORIZONTAL MANDIBLE

s FH

b Pg

ANB 2222deg ANB deg

SKELETAL HORIZONTAL MAXILLA TO MANDIBLE

A B

FH TO GOGN 22 FH TO GOGN 22 55deg deg Y AXIS 59 66 Y AXIS 59 deg deg LFH 55% OF TFH LFH 55% OF TFH

SKELETAL VERTICAL

S FH

GO ME GN

INTERINCISAL INTERINCISAL 130 55deg 130 deg

DENTAL - UPPER TO LOWER INCISOR

U1 TO FH 110 U1 TO FH 110 55deg deg U1 TO NA 22deg U1 TO NA 22deg U1 TO NA 4mm U1 TO NA 4mm

DENTAL - MAXILLARY INCISOR

N FH A

L1 TO NB 25deg L1 TO NB 25deg L1 TO NB 4mm L1 TO NB 4mm L1 TO GOGN 91 L1 TO GOGN 91 6deg 6deg

DENTAL - MANDIBULAR ANTERIOR

GO

B GN

NASOLABIAL NASOLABIAL ANGLE 102 88 ANGLE 102 deg deg L.LIP TO E L.LIP TO E PLANE -2 2mm PLANE -2 2mm

SOFT TISSUE

Limitations of the Metric Method


Stable reference structures are only relatively stable x Validity of landmarks x Error in landmark identification
x

Graphic Method
Template x Changes between 2 time points
x

Superimposition Method - on the


cranial base

Maxillary and mandibular superimposition

Limitations of Cephalometric Analysis


Individual variability x Ethnic variability x Gender variability
x