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 SNA82 8222deg deg NA NATO TOFH FH90 9033 deg deg

SKELETAL HORIZONTAL MAXILLA

s FH

SNB SNB80 8022deg deg N-PG N-PGTO TOFH FH 88 8866deg deg

SKELETAL HORIZONTAL MANDIBLE

s FH

b Pg

ANB ANB2222deg deg

SKELETAL HORIZONTAL MAXILLA TO MANDIBLE

A B

FH FHTO TOGOGN GOGN22 22 55deg deg Y YAXIS AXIS59 5966 deg deg LFH LFH55% 55%OF OFTFH TFH

SKELETAL VERTICAL

S FH

GO ME GN

INTERINCISAL INTERINCISAL 130 13055deg deg

DENTAL - UPPER TO LOWER INCISOR

U1 U1TO TOFH FH110 110 55deg deg U1 U1TO TONA NA22deg 22deg U1 U1TO TONA NA4mm 4mm

DENTAL - MAXILLARY INCISOR

N FH A

L1 L1TO TONB NB25deg 25deg L1 L1TO TONB NB4mm 4mm L1 L1TO TOGOGN GOGN91 91 6deg 6deg

DENTAL - MANDIBULAR ANTERIOR

GO

B GN

NASOLABIAL NASOLABIAL ANGLE ANGLE102 10288 deg deg L.LIP L.LIPTO TOE E PLANE -2 PLANE -22mm 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