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13 Cephalometrics-1

The document provides an overview of cephalometrics, a radiographic technique used in orthodontics for diagnosis and treatment planning by analyzing cephalograms. It covers definitions, types of cephalograms, technical aspects, tracing techniques, and various anatomical landmarks essential for cephalometric analysis. Additionally, it highlights the importance of cephalometrics in evaluating skeletal and dental abnormalities, predicting growth changes, and aiding in research.

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0% found this document useful (0 votes)
8 views34 pages

13 Cephalometrics-1

The document provides an overview of cephalometrics, a radiographic technique used in orthodontics for diagnosis and treatment planning by analyzing cephalograms. It covers definitions, types of cephalograms, technical aspects, tracing techniques, and various anatomical landmarks essential for cephalometric analysis. Additionally, it highlights the importance of cephalometrics in evaluating skeletal and dental abnormalities, predicting growth changes, and aiding in research.

Uploaded by

Beast Gaming
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CEPHALOMETRICS

Department of Orthodontics & Dentofacial Orthopaedics


Learning Objective
BASIC KNOWLEDGE OF VARIOUS CEPHALOGRAM USED IN
ORTHODONTICS
TO BE ACCUSTOMED TO THE PROCESS OF CEPHALOMETRIC
TRACINGS
TO IDENTIFY DIFFERENT LANDMARKS ON A CEPHALOGRAM
Contents

INTRODUCTION
DEFINITIONS
TECHNICAL ASPECTS
USES OF CEPHALOGRAM
TRACING SUPPLIES & EQUIPMENT
TRACING TECHNIQUE
CEPHALOMETRIC LANDMARKS
COMMONLY USED LINES AND PLANES DESCRIBED IN THE LATERAL
PROJECTION
DEFINITION

CEPHLO means head and METRIC means measurement.

Cephalometric Analysis is a collection of data intended to compress as much of


information from the cephalogram into a usable form for diagnosis, treatment
planning and/or assessment of treatment effects.

According to moyer, cephalometrics is a radiographic technique for abstracting


the human head into a geometric shape.

TYPES OF CEPHALOGRAMS
1. Lateral cephalogram
2. Frontal or anteroposterior cephalogram.
3. Oblique cephalogram.
TECHNICAL ASPECT…
The cephalostat consists of:
1. Two ear rods.
2. Orbital pointer.
3. Forehead clamp.
• The distance between the
X-Ray source and the
mid-saggital plane of
patient is fixed at
5 feet(152.4cm).
USES …
1. Helps in orthodontic diagnosis.
2. Classification of skeletal and dental abnormalities.
3. Establishing facial type.
4. Treatment planning.
5. Evaluation of the results.
6. Predicting growth related changes.
7. Study changes associated with surgical treatment.
8. Valuable aid in research.
TRACING SUPPLIES AND EQUIPMENTS:

The following items are recommended for tracing a headfilm.


1. A lateral cephalogram, the usual dimensions of which are 8x10 inches.
2. Acetate matte tracing paper (0.003 inches thick, 8x10 inches).
3. A sharp 3H drawing pencil or a very fine felt-tipped pen.
4. Masking tape.
5. View box.
6. A protractor.
TRACING TECHNIQUE

Tracing should be systematic. One should begin with a general


inspection of the cephalogram and then locate and identify standard
landmarks. This is followed by tracing the anatomic structures in a
logical sequence, and finally constructing derived landmarks and lines.
STEPWISE TRACING
TECHNIQUE
Step 1
• Draw at least two plus
shaped crosses on the top
right and left corners of the
radiograph. These are
drawn away from any
landmarks and are used to
orient the tracing over the
radiograph.
Step 2
• Trace the soft tissue profile,
external cranium, and the
cervical vertebrae.
Step 3
• These are followed by the
tracing of the cranial base,
internal border of cranium,
frontal sinus, and ear rods
(Moorrees recommends
abandoning porion and instead
using the superior border of the
head of condyle to define FH).
Step 4
• Maxilla and related structures
including the key ridges (which
represent the zygomatic
processes of the maxillary bone)
and pterygomaxillary fissures are
then traced.
• The nasal floor is also traced
along with the anterior and
posterior nasal spines. The first
molar and the most anteriorly
placed maxillary incisor (including
its root) are also traced.
Step 5
• Finally the mandible, including the
symphysis, the lower border of the
mandible, the condyles and the
coronoid processes is traced.
• The first molars and the most
anteriorly placed incisor tooth
including its root are to be traced.
The mandibular canal may be
traced and is at times used for
super-positioning serial
radiographs
CEPHALOMETRIC LANDMARKS..
• Anatomical landmarks:-Actual anatomic structures of the skull.

• Derived landmarks:-Obtained secondarily from anatomic structures


in a cephalogram.

• Landmarks can also be classified as hard and soft tissue


landmarks.
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
UNILATERAL LANDMARKS

NASION (Na):
The frontonasal suture at its most
superior point on the curve at the bridge
of the nose.

SUPERIOR PROSTHION (SPr or PR):


The most anterior inferior point on the
maxillary alveolar process, usually found
near the cementoenamel junction of the
maxillary central incisor.
SUBSPINALE (A point):
The most posterior point on the
curve between ANS and PR. “A” point
is usually found 2mm anterior to the
apices of the maxillary central incisor.
INCISION SUPERIUS (Is):
The incisal tip of the most anterior
maxillary central incisor.
INCISON INFERIUS (Ii):
The incisal tip of the most labial
mandibular central incisor.
INFRADENTALE (Id):
The most anterosuperior point on
the mandibular process. Also termed
inferior prosthion.
Supramentale ("B" point):
The most posterior point of the bony
curvature of the mandible below
infradentale and above Pogonion. "B"
point is usually found near the apical
third of the roots of the mandibular
incisors and may be obscured during
the eruption of these teeth. When
the profile of the chin is not concave,
"B" point cannot be determined.
Menton (Me):
Menton is the lowest point on the
symphyseal outline of the chin.
Pogonion (Pog)
Pogonion is the most anterior
point on the contour of the chin.
Pogonion usually is located by a
tangent perpendicular to the
mandibular line or a tangent
dropped to the chin from nasion.

Gnathion (Gn)
The most anteroinferior point on
the lateral shadow of the chin.
Gnathion may be approximated by
the midpoint between pogonion
and menton on the contour of the
chin.
Basion (Ba)
The most inferoposterior point in
the sagittal plane on the anterior
rim of the foramen magnum—the
tip of the posterior cranial base.

Posterior Nasal Spine (PNS)


The most posterior point on the
bony hard plate in the sagittal
plane: usually the meeting point of
the inferior and superior surfaces
of the hard plate.
Anterior Nasal Spine (ANS)
Most anterior point on the bony
hard palate in sagittal plane.

Sella(S)
The center of the hypophyseal
fossa (sella tursica). It is selected
by the eye, since that procedure
has been shown to be as reliable
as a constructed center.
BOLTON POINT:

The highest point at the posterior


condylar notch of the occipital
bone.
BILATERAL LANDMARKS
Orbitale (Or)
Orbitale has been defined as the lowest point of the bony orbit. In the PA
cephalogram, each may be identified but in the lateral cephalograms, the
outlines of the orbital rims overlap. Usually, the lowest point on the
average outline is used to construct the Frankfort plane.
Gonion (Go)
Gonion is the most posteroinferior point at the angle of the mandible. It
may be determined by inspection or by bisecting the angle formed by the
junction of the ramal and mandibular lines, and extending this bisector
through the mandibular border.
Condylion (Co)
Condylion is the most
posterosuperior point on the condyle
of the mandible.

Articulare (Ar)
The intersection of the three
radiographic shadows: the inferior
surface of the cranial base and the
posterior surfaces of the necks of the
condyles of the mandible. Articulare
is systematically used for condylion
when the latter is not reliably
discernible. Displacement of the
condyle moves the articulare.
Pterygomaxillary Fissure (PTM)
A bilateral teardrop-shaped area of
radiolucency, the anterior shadow of
which is the posterior surfaces of the
tuberosities of the maxilla.

Porion
The "top" of the external auditory
meatus. Sometimes because porion
is quite unreliable, the "top“ of the
shadow of the ear rods is called
"machine porion".
COMMONLY USED LINES AND PLANES DESCRIBED IN THE
LATERAL PROJECTION
Frankfort Horizontal Plane
Used first by Downs,
it is drawn from the point
orbitale to the superiormost
point on the external
auditory meatus (Porion).

S-N Line
The S-N line represents
the anterior cranial base.
It is constructed by connecting
the points Sella Turcica and the Nasion.
Palatal Plane
The palatal plane is drawn by extending a
line from the anterior nasal spine (ANS) to
posterior nasal spine (PNS).
Occlusal Plane
It was originally described by Down as the
line connecting the molars in occlusion to
the bisector of the overbite (vertical overlap
of the incisors anteriorly). It was later
modified to be represented by the line
passing through the occlusion of the
premolars and the molars .
Mandibular Plane
Mandibular planes have been defined
by various authors based upon their
clinical experience and use in their
cephalometric analysis's.
Tweed described the mandibular
plane as a line that is a tangent to the
inferior border of the mandible.
Down considered the mandibular
plane to represent a line connecting
the points gonion and menton.
Steiner drew the mandibular plane by
joining the points Gonion and
Gnathion.
BASION-NASION PLANE:
It is a line connecting the basion and
nasion. It represents the cranial base.
Take home message
 Cephalometrics is the backbone of Orthodontic diagnosis &
Treatment Planning
 Cephalometrics includes measurements, description & appraisal of
the morphological configuration & growth changes in the skull by
ascertaining the dimensions of lines, angles & planes .
PROBABLE QUESTIONS
SAQ
1. Cephalostat
2. Horizontal Planes
3. FRANKFORT HORIZONTAL PLANE
4. MANDIBULAR PLANE ANGLE
5. FACIAL PLANE ANGLE

LAQ
• What is Cephalometrics. Describe in brief about the various landmarks
used in Cephalometrics
Thank you

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