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CEPHALOMETRIC ANALYSIS

DENT 657
ANALYSIS UTILIZING THE
CEPHALOMETRIC TRACING
1) Describe the subject’s 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
 Dental - horizontal and vertical
 Comparing individual subject’s tracing
to the “ideal”
 Reference sample
Cross-sectional
Longitudinal - growth studies eg. Bolton-Brush,
Ann Arbor and Burlington
Cephalometric Analyses
 Down’s
 Steiner’s
 Tweed’s
 McNamara’s
 OSU
Cephalometric Evaluation
 Identificationof anatomic landmarks
 Landmarks: stable reference structures
and maxillary and mandibular skeletal
and dental
 Graphically relating the dento-facial
elements to these reference structures
 Angular and or linear measurements
METHODS OF
CEPHALOMETRIC ANALYSIS
 Two basic approaches
 Metric approach - use of selected linear
and angular measures
 Graphic approach - “overlay” of
individual’s tracing on a reference
template and visual inspection of
degree of variation
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:
 the cranial base;
 the maxilla; the mandible,
 the maxillary and mandibular dento-
alveolus
REFERENCE LINES
 Frankfort’s Horizontal (porion to
orbitale)
 Sella - Nasion line
 True horizontal plane
 True vertical plane
Reference Lines

sella nasion

porion orbitale
SNA 82 ± 2 deg
NA TO FH 90 ± 3
deg
SKELETAL HORIZONTAL -
MAXILLA

s n

FH

a
SNB 80 ± 2 deg
N-PG TO FH
SKELETAL HORIZONTAL -
88 ± 6 deg
MANDIBLE

n
s

FH

b
Pg
ANB 2 ± 2 deg

SKELETAL HORIZONTAL - MAXILLA


TO MANDIBLE

B
FH TO GOGN 22
± 5 deg
Y AXIS 59 ± 6
deg
SKELETAL VERTICAL
LFH 55% OF
TFH

FH

GO

ME GN
INTERINCISAL
130 ± 5 deg

DENTAL - UPPER TO LOWER INCISOR


U1 TO FH 110 ± 5
deg
U1 TO NA 22deg
DENTAL - MAXILLARY INCISOR
U1 TO NA 4mm

N
FH

A
L1 TO NB 25deg
L1 TO NB 4mm
DENTAL - MANDIBULAR
L1 TO GOGN 91
± 6deg ANTERIOR

GO B
GN
NASOLABIAL
ANGLE 102 ± 8
deg
L.LIP TO E
SOFT TISSUE
PLANE -2 ±2mm
Limitations of the Metric Method
 Stable reference structures are only
relatively stable
 Validity of landmarks
 Error in landmark identification
Graphic Method
 Template
 Changes between 2 time points
Superimposition Method - on the
cranial base
Maxillary and mandibular
superimposition
Limitations of Cephalometric
Analysis
 Individualvariability
 Ethnic variability
 Gender variability