CHEPALOMETRI

MUHAMAD FAIK
 CEPHALOMETRI
C E P H A L O M E T R I ADALAH TEKNIK RADIOGRAFI UNTUK MENCARI HUBUNGAN
YA N G B E N A R D A R I G I G I G E L I G I D A N S T R U K T U R T U L A N G M U K A YA N G L A I N , B A I K
SECARA EXTRA CRANIAL MAUPUN INTRA CRANIAL.
C E P H A L O M E T R I M E R U PA K A N S U AT U TEKNIK MENGABSTRASIKAN K E PA L A
M A N U S I A YA N G K O M P L E K K E D A L A M S K E M A G E O M T E R I .
P A D A A W A L N Y A P E M E R I K S A A N I N I M E N G G U N A K A N B A H A N K O N T R A S B E R U P A
B A R I U M YA N G D I O L E S K A N D I WA J A H A G A R D A PAT M E M P E R L I H AT K A N B ATA S
S O F T T I S S U E N YA
T E T A P I PA D A S A AT I N I K E B A N YA K A N P E M O T R E TA N C H E PA L O M E T R I T I D A K
M E N G G U N A K A N P E S AWAT R A D I O G R A F I B I A S A T E TA P I M E N G G U N A K A N P E S AWAT
PA N O R A M I C YA N G D I L E N G K A P I D E N G A N A K S E S O R I S U N T U K P E M E R I K S A A N
C H E PA L O M E T R I . I N I D I A N G G A P L E B I H B A I K K A R E N A T I D A K P E R L U M E N G G U N A N
B A H A N K O N T R A S L A G I D A N G A M B A R A N N YA P U N L E B I H D E TA I L .
D A R I C E P H A L O G R A M D I P E R O L E H A N A L I S A C E P H A L O M E T R I D I M A N A S T R U K T U R
A N AT O M I N YA D I T U N J U K K A N O L E H T I T I K 2 L A N D M A R K YA N G D A PAT D I J A D I K A N
I N D I K A S I B E N T U K D A N H U B U N G A N L O K A S I K U R VA .
C E P H A L O M E T R I MEMBANTU DALAM DIAGNOSA S K E L E TA L , D E N TA L DAN
JARINGAN LUNAK YA N G DITUNJUKKAN OLEH KERUSAKAN D EN TO -FA SIA L
PA S I E N .
K E G U N A A N A N A L I S A C E P H A L O M E T R I PA D A PA S I E N B E D A H O R T H O N D O N T I K
T I D A K H A N YA M E L I P U T I P E N G U K U R A N G I G I G E L I G I YA N G H A R M O N I S D E N G A N
P O L A S K E L E TA L YA N G S E S U A I , T E TA P I J U G A H A R U S D A PAT M E N G E VA L U A S I
POSISI TU L AN G FASIA L D A N A NA L ISA K O N TU R JA R IN G AN L UN A K .
C E P H A L O M E T R I M E M P U N YA I B E B E R A PA KEGUNAAN A N TA R A
LAIN :
1. MEMPELAJARI PERTUMBUHAN DAN PERKEMBANGAN DARI CRANIO FACIAL.
2. UNTUK MELAKUKAN DIAGNOSA/ANALISA KELAINAN CRANIO FACIAL.
MENGETAHUI FAKTOR PENYEBAB MALOKLUSI SEPERTI KETIDAKSEIMBANGAN
STRUKTUR TULANG MUKA
3. UNTUK MEMPELAJARI TYPE FACIAL.
RELASI RAHANG DAN POSISI GIGI BERHUBUNGAN ERAT DENGAN TYPE FASIAL
4. UNTUK MERENCANAKAN PERAWATAN ORTHODENTI.
5. UNTUK EVALUASI KASUS KASUS YANG TELAH DIRAWAT.
6 UNTUK ANALISA FUNGSIONAL
GERAKAN MANDIBULA DAPAT DIKETAHUI DENGAN MEMBANDINGKAN POSISI
KONDILUS PADA SEFALOGRAM DENGAN MULUT TERBUKA DAN POSISI
ISTIRAHAT
7. RISET.
 TEKNIK PEMERIKSAAN CEPHALOMETRI
 PERSIAPAN ALAT
 A. CEPHALOMETER ATAU CEPHALOSTAT
(Terdiri dari penahan kepala, ear rods u/ memastikan posisi kepala sdh sesuai prosedur, grid)
 B. PESAWAT X- RAY, PANORAMIC YANG DILENGKAPI ASESORIS CEPHALOMETRI
DENGAN KAPASITAS MENCAPAI 125 KVP DAN 150 MA
 C. KASET 18x30 atau 24x30 CM
 TEKNIK RADIOGRAFI
 1. LATERAL
 2. POSTERO ANTERIOR
 3. OBLIQUE.
AD.1. LATERAL
POSISI PASIEN : DUDUK/BERDIRI AGAK OBLIK
POSISI OBYEK: KEPALA DIFIKSASI DENGAN CEPHALOSTAT, DUA TELINGA
SETINGGI EAR RODS. MUKA SEBELAH KIRI DEKAT DENGAN
KASET.
BIDANG MSP // KASET, PUSAT BERKAS SINAR TEPAT PADA SUMBU
TRANSMEATAL (EAR ROAD). FHP (FRANKURT HORIZONTAL
PLANE) SEJAJAR LANTAI.
 AD.2. POSTERO ANTERIOR
 POSISI PASIEN : DUDUK ATAU BERDIRI
POSISI OBYEK : KEPALA TRUE P.A. DAN TEGAK,
TUBE DIROTASI 90° SEHINGGA
ARAH
SINAR X TEGAK LURUS SUMBU
TRANSMEATAL. KEPALA TIDAK
BOLEH MENUNDUK ATAU
MENENGADAH KARENA AKAN
TERJADI DISTORSI SEHINGGA
PENGUKURAN PADA ARAH
VERTIKAL TIDAK COCOK LAGI.
FAKTOR EKSPOSI : KV =50 -60, mAs=25-40,S=2-2,5
FFD = 152,4 CM, OFD = 3 – 4 INCHI
 AD.3 OBLIQUE.
 POSISI PASIEN : DUDUK
POSISI OBYEK : KEPALA ROTASI 45° DAN 135°, ARAH
SINAR DARI POSTERIOR SEHINGGA
ANTARA KEDUA MANDIBULAE NOTCH
TIDAK SUPERPOSISI.
ANALISA CEPHALOMETRI :
A.GUNAKAN TEKNIK YANG SUDAH DITETAPKAN ,UNTUK
MENGURANGI MAGNIFIKASI DAN DISTORSI.
B.GUNAKAN NILAI RATA–RATA CEPHALOMETRI YANG
SESUAI DENGAN RASNYA.
KETERBATASAN/KEKURANGAN DARI CEPHALOMETRI.
1. KESALAHAN YANG SERING DILAKUKAN ADALAH :
POSISI PASIEN TIDAK BENAR, WAKTU PENYINARAN TIDAK
CUKUP, PENENTUAN JARAK FFD/OFD KURANG TEPAT.
2. PEMBESARAN /MAGNIFIKASI DAN DISTORSI
 MAKIN BESAR JARAK SUMBER SINAR X TERHADAP
KASET MAKA MAGNIFIKASI MAKIN BERKURANG,
 DAN DISTORSI BERKURANG APABILA ARAH SINAR //
DENGAN KASET.
 SEMAKIN DEKAT JARAK KASET KE OBYEK MAKA
AKAN SEMAKIN KECIL TERJADI MAGNIFIKASI.
POSISI PASIEN
Dikenal 2 macam sefalometer, yaitu:
a. Broadbent-Bolton, digunakan 2 tabung sinar X dan 2
pemegang kaset, sehingga objek tidak perlu bergerak
atau berubah apabila akan dibuat
penyinaran/proyeksi lateral atau antero-posterior.
b. Higley, terdiri dari 1 tabung sinar X, 1 pemegang
kaset dan sefalometernya dapat berputar sedemikian
rupa sehingga objek dapat diatur dalam beberapa
macam proyeksi yang diperlukan. Sefalometer
modern pada umumnya adalah jenis ini yaitu
Rotating type.
 REFERENSI SEFALOMETRI RADIOGRAFIK

1. Titik-titik antropometri
Tanda-tanda penting pada sefalometri radiografik adalah titik-titik yang dapat digunakan sebagai petunjuk dalam
pengukuran atau untuk membentuk suatu bidang. Titik-titik tersebut antara lain:
a. Nasion (Na/N) : titik paling anterior sutura frontonasalis pada bidang sagital tengah ujung tulang
b. Spina nasalis anterior (ANS) : spina nasalis anterior, pada bidang tengah
c. Subspinal (A) : titik paling dalam antara spina nasalis anterior dan Prosthion
d. Prosthion (Pr) : titik paling bawah dan paling anterior prosessus alveolaris maksila, pada bidang tengah, antara gigi
insisivus sentral atas
e. Insisif superior (Is) : ujung mahkota paling anterior gigi insisivus sentral atas
f. Insisif inferior (Ii) : ujung mahkota paling anterior gigi insisivus sentral bawah
g. Infradental (Id) : titik paling tinggi dan paling anterior prosessus alveolaris mandibula, pada bidang tengah, antara
gigi insisivus sentral bawah
h. Supramental (B) : titik paling dalam antara Infradental dan pogonion
i. Pogonion (Pog/Pg) : titik paling anterior tulang dagu, pada bidang tengah
j. Gnathion (Gn) : titik paling anterior dan paling inferior dagu
k. Menton (Me) : titik paling inferior dari simfisis atau titik paling bawah dari mandibula
l. Sela tursika (S) titik tengah fossa hipofisial
m. Spina nasalis posterior (PNS) : titik perpotongan dari perpanjangan dinding anterior fossa pterigopalatina dan dasar
hidung
n. Orbital (Or) : titik yang paling bawah pada tepi bawah tulang orbita/infra orbital
o. Gonion (Go) : titik perpotongan garis singgung margin posterior ramus assenden dan basis mandibula
p. Porion (Po) : titik paling luar dan paling superior ear rod/titik tertinggi pada tepi MAE

S Sella: Mid point of sella turcica

N Nasion: Most anterior point on fronto-
nasal suture

ANS Anterior Nasal Spine

PNS Posterior Nasal Spine

Go Gonion: Most posterior inferior point
on angle of mandible

Me Menton: Lower most point on the
mandibular symphysis

A point: Position of deepest concavity on
anterior profile of maxilla

B point: Position of deepest concavity on
anterior profile of mandibular symphysis
 REFERENSI SEFALOMETRI RADIOGRAFIK

2. Garis dan bidang referensi

Menurut Krogman dan Sassouni, dikatakan garis apabila menghubungkan 2 titik disebut bidang apabila
menghubungkan paling sedikit 3 titik.
a. Sela-Nasion (S-N) : garis yang menghubungkan Sela tursika (S) dan Nasion (N), merupakan garis
perpanjangan dari basis kranial anterior
b. Nasion-Pogonion (N-Pg) : garis yang menghubungkan Nasion (N) dan Pogonion (Pg), merupakan garis fasial
c. Y-Axis : garis yang menghubungkan sela tursika (S) dan gnathion (Gn), digunakan untuk mengetahui
arah/jurusan pertumbuhan mandibula
d. Frankfurt Horizontal Plane (FHP) : bidang yang melalui kedua porion dan titik orbital, merupakan bidang
horizontal
e. Bidang oklusal (Occlusal Plane) terdapat 2 definisi : 1. garis yang membagi dua overlapping tonjol gigi molar
pertama dan insisal overbite (Downs) 2. garis yang membagi overlapping gigi molar pertama dan gigi
premolar pertama (Steiner)
f. Bidang Palatal (Bispinal) : bidang yang melalui spina nasalis anterior (ANS) dan spina nasalis posterior (PNS)
g. Bidang Orbital (dari Simon) : bidang vertikal yang melalui titik orbital dan tegak lurus FHP
h. Bidang mandibula (mandibular plane/MP) terdapat 3 cara pembuatannya :
- bidang yang melalui gonion (Go) dan gnathion (Gn) (Steiner)
- bidang yang melalui gonion (Go) dan Menton (Me)
- bidang yang menyinggung tepi bawah mandibula dan menton (Me) (Downs)
Gambar. Titik antropometri, garis dan bidang referensi
ANALISIS SEFALOMETRI RADIOGRAFIK

Pada saat ini, analisis sefalometri dari pasien yang

dirawat ortodontik merupakan suatu kebutuhan.
Metode analisis sefalometri radiografik antara lain
dikemukakan oleh : Downs, Steiner, Rickett, Tweed,
Schwarz, McNamara dan lain-lain.
Berdasarkan metode-metode tersebut dapat
diperoleh informasi mengenai morfologi
dentoalveolar, skeletal dan jaringan lunak pada tiga
bidang yaitu sagital, transversal dan vertikal.
 KELEMAHAN SEFALOMETRIK

1. Kesalahan sefalometer
Kesalahan sefalometer meliputi:
a. Kesalahan dalam pembuatan sefalogram.
Kesalahan yang sering dilakukan yaitu posisi subjek tidak benar, waktu penyinaran tidak
cukup, penentuan jarak sagital-film tidak tepat. Kesalahan ini dapat diatasi dengan
pengalaman dan teknik pemotretan yang benar.
b. Pembesaran dan distorsi.
Makin besar jarak sumber sinar X terhadap film maka semakin sejajar arah sinar X
sehingga distorsi dan pembesaran semakin kecil. Makin dekat jarak film terhadap objek
semakin kecil terjadi pembesaran. Hal ini dapat dikurangi dengan menggunakan teknik
pemotretan yang benar.
2. Kesalahan penapakan dan metode yang digunakan
a. Kesalahan penapakan pada umumnya disebabkan karena kurang terlatih atau
kurangnya pengetahuan tentang anatomi atau referensi sefalometrik. Hal ini dapat diatasi
dengan latihan-latihan dan pengalaman.
b. Kesalahan metode yang digunakan pada umumnya karena pengukuran 3 dimensi
menjadi 2 dimensi, kesalahan interpretasi perubahan akibat pertumbuhan dan perawatan.
 ANALISIS CEPHALOMETRI

Analisis cephalometrik pada radiografi cephalometrik untuk

mempelajari hubungan antara tulang dan landmark jaringan
lunak yang dapat digunakan untuk mendiagnosis kelainan
pertumbuhan wajah sebelum pengobatan, di tengah
pengobatan untuk mengevaluasi kemajuan pengobatan untuk
memastikan bahwa tujuan pengobatan telah terpenuhi.
Radiograf Cephalometrik adalah radiograf dari kepala yang
diambil dalam Cephalometer (Cephalostat) yang merupakan
perangkat fiksasi kepala yang diperkenalkan di 1931 oleh
Holly Broadbent SR. di Amerika Serikat. Cephalometer
digunakan untuk mendapatkan gambar Kraniofasial standar
pada film radiografi.
 Cephalometric landmarks
Landmark
Landmark name Comments
symbol
A point (subspinale) A Most concave point of anterior maxilla

A point–nasion–B point angle ANB Average of 2° ± 2°

anterior nasal spine ANS Anterior point on maxillary bone

Junction between inferior surface of the cranial base and the posterior border
articulare Ar
of the ascending rami of the mandible

B point (supramentale) B Most concave point on mandibular symphysis

basion Ba Most anterior point on foramen magnum

Point at the intersection of the occipital condyle and Foramen Magnum at the
Bolton point
highest notch posterior to the occipital condyle

cheilion Ch Corner of oral cavity

chresta philtri Chp Head of nasal filter
Condylion Most posterior/superior point on the condyle of mandible

dacryon dac Point of junction of maxillary bone, lacrimal bone, and frontal bone

Point at which inner ends of upper and lower eyelids meet (medial canthal
endocanthion En
point)
 Landmark
Landmark name Comments
symbol
exocanthion (synonym, Point at which outer ends of upper and lower eyelids meet (lateral canthal
Ex
ectocanthion) point)

Frontotemporal Ft Most medial point on the temporal crest

Most prominent point in the median sagittal plane between the supraorbital
Glabella G'
ridges

Point located perpendicular on mandibular symphysis midway between

Gnathion Gn
pogonion and menton

Most posterior inferior point on angle of mandible. Can also be constructed by

Gonion Go bisecting the angle formed by intersection of mandibular plane and ramus of
mandible

Posterior vertical portion and inferior curvature of left and right zygomatic
key ridges
bones

labial inferior Li Point denoting vermilion border of lower lip in midsagittal plane

labialis superior Ls Point denoting vermilion border of upper lip

Line connecting incisal edge and root apex of the most prominent mandibular
lower incisor L1
incisor

machine porion Superior-most point of the image of the ear rod

menton Me Lowest point on mandibular symphysis

nasion N Most anterior point on frontonasal suture

 Landmark
Landmark name Comments
symbol
odontale Highest point on second vertebra

opisthion Op Most posterior point of foramen magnum

orbitale Or Most inferior point on margin of orbit

pogonion Pg Most anterior point of mandibular symphysis

porion Po Most superior point of outline of external auditory meatus

posterior nasal spine PNS Posterior limit of bony palate or maxilla

pronasale (synonyms, pronasal or

Prn Soft tissue point on tip of nose
pronasion)

prosthion (supradentale, superior The most inferior anterior point on the maxillary alveolar process between the
Pr
prosthion) central incisors

Point at junction between Ptm and foramen rotundum (at 11 o'clock from
PT point PT
Ptm)

Point at base of fissure where anterior and posterior wall meet. Anterior wall
pterygomaxillary fissure Ptm
represents posterior surface of maxillary tuberosity

registration point A reference point for superimposition of ceph tracings

sella (that is, sella turcica) S Midpoint of sella turcica

sella–nasion line SN or S-N Line from sella to nasion
 Landmark
Landmark name Comments
symbol
sella–nasion–A point angle SNA or S-N-A Average of 82 degrees with +/- of 2 degrees

sella–nasion–B point angle SNB or S-N-B Average of 80 degrees with +/- of 2 degrees

soft tissue menton Me′ Lowest point on soft tissue over mandible

soft tissue nasion N′ Point on soft tissue over nasion

soft tissue pogonion Pg′ Soft tissue over pogonion

sphenoethmoidal suture SE the cranial suture between the sphenoid bone and the ethmoid bone

stomion inferius Sti Highest midline point of lower lip

stomion superius Sts Highest midline point of upper lip

sublabialis Sl

subnasale (synonyms, subnasal or In the midline, the junction where base of the columella of the nose meets the
Sn
subnasion) upper lip

throat point Junction of inferior border of mandible and throat

Notch above the tragus of the ear where the upper edge of the cartilage
tragion T′
disappears into the skin of the face

trichion Tr Midline of hairline

A line connecting the incisal edge and root apex of the most prominent
upper incisor U1
maxillary incisor

xi point Xi An approximate point for inferior alveolar foramen

 Cephalometric Planes
Cephalometric plane Plane symbol Definition
This plane is formed by connecting ANS to PNS and is used to
palatal plane ANS-PNS
measure the vertical tilt of maxilla

This plane represents the anterior cranial base and is formed by

SN plane SN plane
projecting a plane from the sella-nasion line
Frankfort horizontal plane (Frankfurt
P-Or This plane represents the habitual postural position of the head.
horizontal plane)
This plane can be used as an alternate to Frankfort horizontal
condylar plane Co-Or
plane.
This plane passes is formed by drawing a line that touches the
functional occlusal plane FOP
posterior premolars and molars.

This plane is formed by bisecting the anterior incisors and the

Downs occlusal plane DOP
distal cusps of the most posterior in occlusion.

This plane is formed by connecting the point gonion to gnathion at

mandibular plane Go-Gn
the inferior border of the mandible.

This vertical plane is formed by connecting nasion to pogonion as

facial plane N-Pg
described in the Schudy analysis.
This plane is formed by connecting the Bolton point to nasion. This
Bolton plane Bolton Pt-N plane includes the registration point and is part of the Bolton
triangle.
 Classification of analyses

The basic elements of analysis are angles and distances. Measurements (in degrees or
millimetres) may be treated as absolute or relative, or they may be related to each other
to express proportional correlations. The various analyses may be grouped into the
following:
Angular – dealing with angles,
Linear – dealing with distances and lengths,
Coordinate – involving the Cartesian (X, Y) or even 3-D planes,
Arcial – involving the construction of arcs to perform relational analyses.
These in turn may be grouped according to the following concepts on which normal
values have been based:
Mononormative analyses: averages serve as the norms for these and may be
arithmetical (average figures) or geometrical (average tracings). E.g. Bolton Standards.
Multinormative: for these a whole series of norms are used, with age and sex taken
into account, e.g. Bolton Standards.
Correlative: used to assess individual variations of facial structure to establish their
mutual relationships, e.g. the Sassouni arcial analysis.
 Cephalometric angles

According to the Steiner analysis:

ANB (A point, nasion, B point) indicates whether the skeletal relationship
between the maxilla and mandible is a normal skeletal class I (+2
degrees), a skeletal Class II (+4 degrees or more), or skeletal class III (0 or
negative) relationship.
SNA (sella, nasion, A point) indicates whether or not the maxilla is
normal, prognathic, or retrognathic.
SNB (sella, nasion, B point) indicates whether or not the mandible is
normal, prognathic, or retrognathic.
SNA and SNB is important to determine what type of intervention (on
maxilla, mandible or both) is appropriate. These angles, however are
influenced also by the vertical height of the face and a possible abnormal
positioning of nasion. By using a comparative set of angles and distances,
measurements can be related to one another and to normative values to
determine variations in a patient’s facial structure.
 Steiner analysis
Name Description Normal Standard Deviation
Skeletal
SNA (°) Sella-Nasion to A Point Angle 82 degrees +/- 2
SNB (°) Sella-Nasion to B Point Angle 80 degrees +/- 2
ANB (°) A point to B Point Angle 2 degrees +/- 2
Occlusal Plane to SN (°) SN to Occlusal Plane Angle 14 degrees
Mandibular Plane (°) SN to Mandibular Plane Angle 32 degrees
Dental
U1-NA (degree) Angle between upper incisor to NA line 22 degrees
U1-NA (mm) Distance from upper incisor to NA line 4 mm
L1-NB (degree) Angle between lower incisor to NB line 25 degrees
L1-NB (mm) Distance from lower incisor to NB line 4 mm
U1-L1 (°) Upper incisor to lower incisor angle 130 degrees
Also known as Holdaway Ratio. It states
that chin prominence should be as far
away as the farthest point of the lower
L1-Chin (mm) 4mm
incisor should be. An ideal distance is
2mm from Pogonion to NB line and L1 to
NB line.
Soft tissue
Line formed by connecting Soft Tissue
Ideally, both lips should touch
S Line Pogonion and middle of an S formed by
the S line
lower border of the nose
 Wits analysis
 The name Wits is short for Witwatersrand, which is a University in South Africa. Jacobsen in 1975
published an article called "The Wits appraisal of jaw disharmony". This analysis was created as a
diagnostic aid to measure the disharmony between the AP degree. The ANB angle can be affected by
multitude of environmental factors such as:
Patient's age where ANB has tendency to reduced with age
Change in position of nasion as pubertal growth takes place
Rotational effect of jaws
Degree of facial Prognathism
 Therefore, it measured the AP positions of the jaw to each other. This analysis calls for 1. Drawing an
Occlusal Plane through the overlapping cusps of Molars and Premolars. 2. Draw perpendicular lines
connecting A point and B Point to the Occlusal Plane 3. Label the points as AO and BO.
 In his study, Jacobsen mentioned that average jaw relationship is -1mm in Males (AO is behind BO by
1mm) and 0mm in Females (AO and BO coincide). Its clinical significance is that in a Class 2 skeletal
patient, AO is located ahead of BO. In skeletal Class 3 patient, BO is located ahead of AO. Therefore,
the greater the wits reading, the greater the jaw discrepancy.
 Drawbacks to Wits analysis includes:
Left and Right molar outlines may not always coincide
Occlusal plane may differ in mixed vs permanent dentition
If curve of spee is deep then it may be difficult to create a straight occlusal plane
Angulation of functional occlusal plane to pterygomaxillary vertical plane was shown to decrease from
age 4 to 24.
 Downs analysis
Name Description Normal Standard Deviation
Skeletal
Angle between Nasion-
Facial Angle (°) Pogonion and Frankfurt 87.8 +/- 3.6
Horizontal Line
Angle between Nasion - A point
Angle of Convexity (°) 0 +/- 5.1
and A point - Pogonion Line

Angle between Frankfort

Mandibular Plane Angle (°) horizontal line and the line 21.9 +/- 5
intersecting Gonion-Menton
Sella Gnathion to Frankfurt
Y Axis (°) 59.4 +/- 3.8
Horizontal Plane
Point A-Point B to Nasion-
A-B Plane Angle (°) -4.6 +/- 4.6
Pogonion Angle
Dental
Angle of cant of occlusal plane
Cant of Occlusal Plane (°) 9.3 +/- 3.8
in relation to FH Plane
Inter-Incisal Angle (°) 135.4 +/- 5.8
Angle between line through
Incisor Occlusal Plane Angle (°) long axis of Lower Incisor and 14.5 +/- 3.5
occlusal Plane
Angle between line through
Incisor Mandibular Plane Angle
long axis of Lower incisor and 1.4 +/- 3.8
(°)
Mandibular Plane
U1 to A-Pog Line (mm) 2.7 +/- 1.8
 Bjork analysis

This analysis by Arne Bjork was developed in 1947 based on 322

Swedish boys and 281 conscripts. He introduced a facial polygon
which was based on 5 angles and is listed below. Bjork also developed
the 7 structural signs which indicates the mandibular rotator type.[17]
Nasion Angle - Formed by line connecting ANS to Nasion to Sella
Saddle or Cranial Base Angle - Formed by line connecting Nasion to
Sella to Articulare
Articular Angle - Formed by line connecting Sella to Articulare to
Gonion
Gonial Angle - Formed by line connecting Articulare to Gonion to
Gnathion
Chin Angle - Formed by line connecting Infradentale to Pogonion to
the Mandibular Plane.
 Tweed analysis (triangle)
In this analysis, he tried describing the lower incisor position in relation to the basal bone and the face. This is described by 3
planes. He used Frankfurt Horizontal plane as a reference line.

Name Description Normal

Tweed facial triangle

Angle between long axis of lower incisor and

IMPA (°) 90 (°) +/- 5
mandibular plane angle

FMIA (°) Frankfort mandibular incisor angle 65 (°)

FMA (°) Frankfort mandibular plane angle 25 (°)

Total 180 (°)