Basic Cephalometrics
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Transcript of Basic Cephalometrics
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Basic Cephalometrics
Mark H. Taylor, D.D.S., F.A.C.D.
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Cephalometrics is a technique employing oriented radiographs for the purpose of making head measurements.
Purpose of Cephalometrics
• Study craniofacial growth• Diagnosis• Planning orthodontic treatment• Evaluation of treated cases
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15"60"
Source Plane
X-ray Source
Patient in Head Positioning Device
Mid-saggital Plane
Film Plane
X-ray Film in Cassette
Cephalostat
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Cephalostat
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Cephalostat
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White Black Israeli Chinese Japanese
SNA 82 85 82 82 81
SNB 80 81 78 79 77
ANB 2 4 4 3 4
U1-NA 4 mm, 22 7 mm, 23 5 mm, 24 5 mm, 24 6 mm, 24
L1-NB 4 mm, 25 10 mm, 34 6 mm, 29 6 mm, 27 8 mm, 31
U1-L1 131 119 124 126 120
GoGn-SN 32 32 35 32 34
L1-MnPl 93 100 93 93 96
L1-FH 62 51 57 57 57
Y axis 61 63 61 61 62
from Proffit,Contemporary Orthodontics, 1992
Cephalometric Values for Selected Groups
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What Are We Trying to Accomplish?
• Find out skeletal classification– anteroposterior– vertical
• Find out angulation of incisors• Consider soft tissue
– facial profile– airway considerations
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What Are We Trying to Accomplish? (In other words)
• Is the patient Class I, II, III skeletal?• Does the patient have a skeletal open bite
growth pattern, or a deep bite growth pattern, or a normal growth pattern?
• Are the maxillary/mandibular incisors proclined, retroclined or normal?
• Is the facial profile protrusive, retrusive, or straight; can the patient breathe normally?
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Structures to be Traced
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Sella
Porion
Gonion PNS
Menton
Gnathion
Pogonion
B PointA PointANS
Orbitale
Nasion
Articulare
Standard Cephalometric Landmarks
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Radiographic Landmarks
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SN Plane
Frankfort PlanePalatal Plane
Occlusal Plane
Mandibular Plane
Frequently Used Planes
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8822
Antero-posterior maxillary assessment
Skeletal AssessmentSNA
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8800
Antero-posterior mandibular assessment
Skeletal AssessmentSNB
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22Antero-posterior bimaxillary assessment
Skeletal AssessmentANB
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-1 mm-1 mmBO anterior BO anterior to AOto AO
Skeletal AssessmentWits (AO-BO)
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6666
Skeletal AssessmentY Axis
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5959
Vertical Skeletal Assessment
Skeletal AssessmentY Axis (to Frankfort Horizontal)
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3232
Vertical Skeletal Assessment
Skeletal AssessmentNS(SN plane)-GoGn
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101044
Incisor Angulation Assessment
Dental AssessmentU1-NS (Max 1 - SN)
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2222
Dental AssessmentMax 1 - NA (degrees)
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4 4 mmmm
Dental AssessmentMax 1 - NA (mm)
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9955
Incisor Angulation Assessment
Dental AssessmentL1-GoGn (Man 1 - GoGn)
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2255
Dental AssessmentMan 1 - NB (degrees)
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4 4 mmmm
Dental AssessmentMan 1 - NB (mm)
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2 mm 2 mm +/- 2+/- 2
Dental AssessmentAPog - Man 1
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131300
Inter-Incisor Angulation Assessment
Dental AssessmentU1-L1 (Max 1 - Man 1)
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-2 -2 mmmm
CHANGES WITH AGE!
Soft Tissue AssessmentE Plane
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>4 >4 mm.mm.
Soft Tissue Assessment
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Composite Cephalometric Tracing
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Children with airway obstruction, whencompared to normal controls, show:
Nasorespiratory Considerations
• Increased total and lower face heights• More retrognathic mandibles• Steeper (increased) mandibular plane
angles• Spontaneous improvement after
reestablishment of normal respiration
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Cases