A method of cephalometric analysis that is sensitive
not only to the position of the teeth within a given
bone but also to the relationship of the jaw elements
and cranial base structures one to another.
In short, the method of analysis described here
represents an effort to relate teeth to teeth, teeth to
jaws, each jaw to the other, and the jaws to the cranial
Skeletal and dental components of the
face in normal occlusion
The method of analysis described here
represents an effort to relate
teeth to teeth,
teeth to jaws,
each jaw to the other, and
the jaws to the cranial base.
THE COMPOSITE NORMATIVE STANDARDS DERIVED FROM 3
• Lateral cephalograms of the children
comprising the Bolton standards
• Selected values from a group of
untreated children from the Burlington
• A sample of 111young adults from
Ann Arbor, having good to excellent
facial and dental configurations and
good skeletal balance with an
orthognathic facial profile
CANT OF UPPER
DRAWING A LINE TANGENT TO THE BASE OF THE NOSE
AND A LINE TANGENT TO THE UPPER LIP FORMS THE
Maxilla To Mandible
Effective mandibular length
Any effective midfacial length corresponds
to an effective mandibular length .
measuring a line from Condylion to point A.
Condylion- most posterosuperior point
on the outline of mandibular condyle
-measuring a line from Condylion to
Gnathion – most anteroinferior aspect of the
The effective lengths of max & mand are related to
the size of the component parts .
small for mixed dentition
medium for adult female
large for adult male
The Maxillomandibular Difference :
In small individuals: 20-24 mm,
In medium sized individuals: 25-28 mm
In large individual : 29-33 mm
Correlated to the
of the midface.
It is the angle between anatomic FH and the
line drawn along the lower border of the
mandible through constructed Gonion(Go)
Average is 22 ± 4 degrees.
- Excessive lower facial height
- Deficiency in lower facial height.
It is formed by a line constructed from the
posterosuperior aspect of the pterygomaxillary
fissure (PTM) to gnathion(Gn) and a line
perpendicular to cranial base (ie a line from
basion(Ba) to nasion(N).
An ideal relationship is when PTM-Gn lies on
the perpendicular(0 degrees).
If PTM-Gn lies anterior to the perpendicular,
the angle is positive, suggesting deficient
vertical development of face and vice versa.
Is determined by measuring distance from
pogonion to nasion perpendicular.
In mixed dentition 6-8 mm (behind N per)
In adult female
0-4 mm (behind N per)
In adult male
2 mm(behind to 5 mm
fwd of N per)
Helps in determining the antero-posterior
position of both upper and lower incisors
Ideal distance measured horizontally from point A
to the facial surface of maxillary incisors is 4 to 6
Measurement of the
facial surface of the lower
incisor to the A-Pogonion
Normal = 1 - 3 mm
In vertical position mandibular incisors are
related to functional occlusal plane.
If curve of Spee is excessive
incisors intruded or molars
LAFH is the determining factor
Two measurements are used to
examine the possibility of airway
It is measured from a point on the posterior
outline of the soft palate to the closest point
on the posterior pharyngeal wall.
Normal(adults) - 17.4 mm
Increases with age
It is measured from the intersection of the
posterior border of the tongue and the inferior
border of the mandible to the closest point on
the posterior pharyngeal wall.
Normal – 10 – 12mm
Does not change with age
Adenoid obstruction of upper airway –
upper pharyngeal width decreases.
Lower pharyngeal width –greater than
-anterior positioning of tongue –
enlargement of tonsils .
1. Maxilla to cranial base
Normal upper lip
Cant of upper lip
Normal upper lip
Point A to Nperpendicular
2.Maxilla to mandible
Maxillary length normal
decreased mandibular length
Facial Axis Angle
Backwardly placed chin
to point A
Protrusive upper incisor
incisor to A-p0g
Protrusive lower incisor
Pog to Nperpendicular
Normal upper pharyngeal width
Normal lower pharyngeal width