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Analysis burstone  /certified fixed orthodontic courses by Indian dental academy
 

Analysis burstone /certified fixed orthodontic courses by Indian dental academy

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Analysis burstone  /certified fixed orthodontic courses by Indian dental academy Analysis burstone /certified fixed orthodontic courses by Indian dental academy Presentation Transcript

  • BURSTONE ANALYSIS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • Burstone Analysis Guided By:Dr. (Mrs.) P.V. Hazarey Prof. and Head Presented By:Dr. V.S. Kohli Achint Chachada Prof. and Guide P.G. Student www.indiandentalacademy.com
  • introduction ☺Charles J. Burstone et al (1978, 1980) developed an analysis specially designed for patients requiring Orthognathic surgery. ☺They used the landmarks and the measurements that can be altered by common surgical procedures. ☺This analysis is also called as Cephalometrics for Orthognathic Surgery (COGS) www.indiandentalacademy.com
  • introduction ☺COGS system describes the horizontal and vertical positions of the facial bones by the use of constant coordinate systems as follows: ☺Size of the bone are represented by direct linear measurements. ☺Shape of the bones are represented by the angular measurements. www.indiandentalacademy.com
  • characteristics ☺Chosen landmarks and measurements can be altered by various surgical procedures. ☺This analysis includes all the facial bones and a cranial base reference. ☺Critical facial skeletal components are measured. ☺Measurements used, can be readily transferred to mock surgery. ☺This systemized approach to measurements can be computerized. www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Landmarks ☺Sella (S) - The center of Pituitary Fossa ☺Nasion (N) – The most anterior point of the nasofrontal suture in the midsagittal plane ☺Anterior Nasal Spine (ANS) – The anterior most midsagittal point on the tip of sharp bony process of maxilla ☺Subspinale (A) – The deepest midsagittal point on the concavity between Anterior Nasal Spine and Prosthion ☺Supramentale (B) – The deepest point in mid sagittal plane on the concavity between infradentale and pogonion www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Landmarks ☺Pogonion (Pg) – Most anterior mid sagittal point on the contour of the chin ☺Gnathion (Gn) – Constructed by bisecting the Facial plane and tangent to lower border of mandible ☺Menton (Me) – Most inferior point on the inferior contour of the chin ☺Pterygomaxillary fissure (Ptm) – The most posterior point on the anterior contour of the maxillary tuberosity www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Landmarks ☺Posterior Nasal Spine (PNS) – The most posterior point on the contour of the palate. ☺Articulare (Ar) – The intersection of basisphenoid and the posterior border of the condyle ☺Gonion (Go) – constructed by bisecting the posterior ramal plane and mandibular plane. ☺Mandibular Plane (MP) – It is the line joining Gonion and Gnathion ☺Nasal Floor (NF) – A plane constructed by joining ANS and www.indiandentalacademy.com PNS
  • sKeLetaL and dentaL anaLysis ☺Reference plane ☺The base line used for comparison of most of the data in this analysis is a constructed plane called as Horizontal Plane (HP) ☺Most measurements in this analysis will be made either parallel to or perpendicular to this Horizontal Plane. ☺It is constructed by drawing a line 70 from SN, intersecting at N HP www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Parameters ☺Cranial Base ☺Ar-Ptm (linear) ☺Ptm-N (linear) ☺ Horizontal Skeletal Profile ☺N-A-Pg (angle) ☺N-A (linear) ☺N-B (linear) ☺N-Pg (linear) ☺Vertical Skeletal ☺N-ANS (linear) ☺ANS-Gn (linear) ☺PNS-N (linear) ☺MP-HP (linear) www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Parameters ☺Vertical Dental ☺Upper 1 – NF (linear) ☺Lower 1 – MP (linear) ☺Upper 6 – NF (linear) ☺Lower 6 – MP (linear) ☺Maxilla and Mandible ☺PNS-ANS (linear) ☺Ar-Go (linear) ☺Go-Pg (linear) ☺B-PG (linear) ☺Ar-Go-Gn (angle) www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Parameters ☺Dental ☺OP-HP (angle) ☺A-B parallel to OP (linear) ☺Upper 1 – NF (angle) ☺Lower 1 – MP (angle) www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Cranial Base Length ☺Cranial base length is measured by measuring the distance between Ar and N ☺It is measured parallel to HP ☺This measurement should not be considered as an absolute value ☺The measurement Ar to N is a relatively stable anatomical plane, however it can be changed by cranial surgery HP ☺Le Forte II and Le Forte III surgery changes position of N ☺Autorotation of Mandible changes position of Ar www.indiandentalacademy.com
  • sKeLetaL and dentaL anaLysis ☺Cranial Base Length ☺Two measurements are considered in Cranial Base length – Ar-Ptm and Ptm-N ☺Ar-Ptm is the distance between Ar and Ptm which is measured parallel to HP ☺Standard Value ☺MALES 37.1 + 2.8 mm ☺FEMALES 32.8 + 1.9 mm ☺Ar-Ptm indicates the position of mandible in relation to posterior surface of maxilla HP www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Cranial Base Length ☺Ptm-N is the distance between Ptm and N which is measured parallel to HP HP ☺Standard Value ☺MALES 52.8 + 4.1 mm ☺FEMALES 50.9 + 3 mm ☺Ptm-N indicates the position of posterior border of maxilla in relation to Nasion ☺If this value increases it indicates more posterior position of maxilla in relation to N and if it decreases it indicates anterior position of www.indiandentalacademy.com maxilla in relation to N
  • SKELETAL And dEnTAL AnALySiS ☺Horizontal Skeletal Profile Analysis ☺A few simple measurements should be made on the skeletal profile to assess the amount of discrepancy in anteroposterior direction. ☺It is called as Horizontal Skeletal Profile analysis because all the measurements in this set of analysis are made parallel to HP www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Horizontal Skeletal Profile Analysis ☺ANGLE OF SKELETAL CONVEXITY ☺It is the angle formed between N-A and A-Pg ☺Standard Value ☺MALES 3.90 + 6.40 ☺FEMALES 2.60 + 5.10 ☺A positive angle indicates convex profile while negative angle indicates concave profile www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Horizontal Skeletal Profile Analysis ☺N Perpendicular to A, parallel to HP ☺A perpendicular to HP is dropped from N (N perpendicular) and horizontal distance parallel to HP is measured from point A ☺Standard Value ☺MALES 0 + 3.7 mm ☺FEMALES -2 + 3.7 mm ☺This measurement describes the position of apical base of maxilla in relation to nasion www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Horizontal Skeletal Profile Analysis ☺N Perpendicular to B, parallel to HP ☺It is obtained by measuring the distance between Point B and Nasion perpendicular (N perpendicular) ☺Standard Value ☺MALES -5.3 + 6.7 mm ☺FEMALES -6.9 + 4.3 mm ☺This measurement describes the position of apical base of mandible w in relation to nasionww.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Horizontal Skeletal Profile Analysis ☺N Perpendicular to Pg, parallel to HP ☺It is obtained by measuring the distance between Pogonion and Nasion perpendicular (N perpendicular) ☺Standard Value ☺MALES -4.3 + 8.5 mm ☺FEMALES -6.5 + 5.1 mm ☺This measurement describes the position of mandibular chin in relation to nasion www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Skeletal Analysis ☺A Vertical skeletal discrepancy may reflect an anterior, posterior or complex dysplasia of the face ☺It is divided into two components ☺Anterior component ☺Posterior component www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Skeletal Analysis ☺N-ANS perpendicular to HP ☺Distance between N and ANS measured perpendicular to HP gives us the Middle third facial height. ☺Standard Value ☺MALES 54.7 + 3.2 mm ☺FEMALES 50 + 2.4 mm ☺Any increase or decrease in this value indicates increased or decreased middle third facial height respectively www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Skeletal Analysis ☺ANS-Gn perpendicular to HP ☺Distance between ANS and Gn measured perpendicular to HP gives us the Lower third facial height. ☺Standard Value ☺MALES 68.6 + 3.8 mm ☺FEMALES 61.3 + 3.3 mm ☺Any increase or decrease in this value indicates increased or decreased lower third facial height respectively HP || www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Skeletal Analysis ☺PNS-N, perpendicular to HP ☺Distance between PNS and HP gives us the posterior maxillary height. ☺Standard Value ☺MALES 53.9 + 1.7 mm ☺FEMALES 50.6 + 2.2 mm ☺Any increase or decrease in this value indicates increased or decreased posterior maxillary height respectively www.indiandentalacademy.com HP HP ||
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Skeletal Analysis ☺MP – HP Angle ☺Mandibular plane angle in relation to Horizontal plane intersecting at Gn gives us posterior divergence of mandible ☺Standard Value ☺MALES 230 + 5.90 ☺FEMALES 24.20 + 50 ☺This angle relates posterior facial divergence with respect to anterior HP || facial height ☺Any increase or decrease in value suggests increasedwww.indiandentalacademy.com or decreased posterior facial divergence
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Dental Analysis ☺Upper 1 to NF ☺To obtain upper anterior dental height, perpendicular distance from incisal edge of upper incisor to NF is measured ☺Standard Value ☺MALES 30.5 + 2.1 mm ☺FEMALES 27.5 + 1.7 mm ☺Any increase or decrease in this value indicates increased or decreased upper anterior dental height respectively www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Dental Analysis ☺Lower 1 to MP ☺To obtain lower anterior dental height, perpendicular distance between incisal edge of lower incisor to MP is measured ☺Standard Value ☺MALES 45 + 2.1 mm ☺FEMALES 40.8 + 1.8 mm ☺Any increase or decrease in this value indicates increased or decreased lower anterior dental height respectively www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Dental Analysis ☺Upper 6 to NF ☺To measure upper posterior dental height a perpendicular line is dropped from the tip of mesiobuccal cusp of upper first molar to NF ☺Standard Value ☺MALES 26.2 + 2.0 mm ☺FEMALES 23 + 1.3 mm ☺Any increase or decrease in this value indicates increased or decreased upper posterior dental height respectively www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Vertical Dental Analysis ☺Lower 6 to MP ☺To measure lower posterior dental height a perpendicular line is dropped from the mesiobuccal cusp of lower first molar to MP ☺Standard Value ☺MALES 35.8 + 2.6 mm ☺FEMALES 32.1 + 1.9 mm ☺Any increase or decrease in this value indicates increased or decreased lower posterior dental height respectively www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Maxilla and Mandible ☺ANS to PNS ☺ANS and PNS are projected on HP ☺Distance between these two points on HP gives us total effective maxillary length ☺Standard Value ☺MALES 57.7 + 2.5 mm ☺FEMALES 52.6 + 3.5 mm www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Maxilla and Mandible ☺Ar to Go ☺Mandibular ramal length is the linear distance between Articulare and Gonion ☺Standard Value ☺MALES 52 + 4.2 mm ☺FEMALES 46.8 + 2.5 mm ☺Variation in Ramal length can be a causative factor for skeletal open bite or deep bite www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Maxilla and Mandible ☺Go to Pg ☺Mandibular body length is the linear distance between Gonion and Pogonion ☺Standard Value ☺MALES 83.7 + 4.6 mm ☺FEMALES 74.3 + 5.8 mm www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Maxilla and Mandible ☺Point B to Pg ☺This measurment describes the prominence of chin in relation to mandibular apical base ☺It is obtained by measuring the distance between point B and a perpendicular to MP passing through Pg ☺Standard Value ☺MALES 8.9 + 1.7 mm ☺FEMALES 7.2 + 1.9 mm www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Maxilla and Mandible ☺Ar-Go-Gn Angle (Gonial angle) ☺This measurment represents the relationship between the ramal plane and mandibular plane ☺Standard Value ☺MALES 119.10 + 6.50 ☺FEMALES 1220 + 6.90 ☺Gonial angle also contributes to skeletal open bite or deep bite www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Dental parameters ☺OP-HP (Angle) ☺OP is Occlusal Plane constructed from buccal groove of first permanent molars through a point 1 mm apical to the incisal edge of the central incisors ☺When incisors are not in proper overbite relation, two OP are to be constructed, upper and lower. ☺Standard Value ☺MALES 6.20 + 5.10 ☺FEMALES 7.10 + 2.50 www.indiandentalacademy.com HP ||
  • SKELETAL And dEnTAL AnALySiS ☺Dental parameters ☺OP-HP (Angle) ☺An increased OP-HP may be associated with skeletal open bite, lip incompetence and increased anterior facial height ☺An decreased OP-HP may be associated with skeletal deep bite, decreased anterior facial height and lip redundancy www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Dental parameters ☺A-B parallel to OP ☺ This distance is obtained by measuring the distance between projection of Point A and Point B on OP ☺Standard Value ☺MALES -1.1 + 2.0 mm ☺FEMALES -0.4 + 2.5 mm ☺This distance gives us relationship between maxillary and mandibular apical bases in relation to OP www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Dental parameters ☺Upper 1 to NF (Angle) ☺ This angle is constructed by intersecting a line passing through the tip of insical edge through the root tip of upper incisor and NF line ☺Standard Value ☺MALES 1110 + 4.70 ☺FEMALES 112.50 + 5.30 ☺This angle gives us the inclination of upper incisors in relation to palatal plane (NF) www.indiandentalacademy.com
  • SKELETAL And dEnTAL AnALySiS ☺Dental parameters ☺Lower 1 to MP (Angle) ☺ This angle is constructed by intersecting a line joining the incisal edge of lower incisor passing through its root tip and MP ☺Standard Value ☺MALES 95.90 + 5.20 ☺FEMALES 95.90 + 5.70 ☺This angle gives inclination of lower incisors in relation to MP www.indiandentalacademy.com
  • SofT TiSSuE AnALySiS ☺Landmarks ☺Glabella (G) - The most prominent point in the midsagittal plane of the forehead ☺Soft tissue nasion (N’)- The point of greatest concavity in the midline between the forehead and nose ☺Columella point (Cm) – The most anterior point on the columella of the nose ☺Subnasale (Sn) – The point at which the columella merges with the upper lip in the midsagittal plane ☺Labrale superius (Ls) - A point indicating the mucocutaneous www.indiandentalacademy.com border of the upper lip i
  • SofT TiSSuE AnALySiS ☺Landmarks ☺Stomion superius (Stms)- The lower most point on the vermilion border of the upper lip ☺Stomion inferius (Stm )- The upper i most point on the vermilion border of the lower lip ☺Labrale inferius (Li) - A point indicating the mucocutaneous border of the lower lip ☺Mentolabial sulcus (Si) – The point of greatest concavity in the midline between the Li and Pg’ ☺Soft tissue Pogonion (Pog’)- The most prominent or anterior point www.indiandentalacademy.com on the chin in midsagittal plane. i
  • SofT TiSSuE AnALySiS ☺Landmarks ☺Soft tissue Gnathion (Gn’)- The constructed midpoint between soft tissue pogonion and soft tissue menton ☺Soft tissue Menton (Me’) – lowest point on the contour of the soft tissue chin ☺Cervical Point (C) – the innermost point between the submental area and neck i . C www.indiandentalacademy.com .Gn’
  • Soft tiSSue analySiS ☺Parameters ☺Facial Form ☺Facial Convexity Angle (G-Sn-Pg) ☺Maxillary Prognathism (G-Sn) ☺Mandibular Prognathism (G-Pg) ☺Vertical Height Ratio (G-Sn/Sn-Me) ☺Lower Face Throat Angle (Sn-Gn-C) ☺Lower Vertical height depth ratio (Sn-Gn/C-Gn) ☺Lip position and form ☺Nasolabial Angle (Cm-Sn-Ls) ☺Upper Lip Protrusion (Ls to Sn-Pg) ☺Lower Lip Protrusion (Li to Sn-Pg) ☺Mentolabial Sulcus depth (Si to Sn-Pg) ☺Vertical Lip Chin Ratio (Sn-Stm/Sti-Me) ☺Maxillary Incisor Exposure (Stm U1) ☺Inter labial Gap www.indiandentalacademy.com
  • Soft tiSSue analySiS ☺Facial Form ☺Facial Convexity Angle ☺This angle is formed by intersecting G-Sn line and Sn-Pg’ line ☺Standard Value ☺120 + 40 ☺Any increase or decrease in this value indicates Convex or Concave Profile respectively. ☺Maxillary Prognathism ☺Distance between Sn and a line perpendicular to HP passing through glabella gives maxillary prognathism ☺Standard Value ☺6 + 3 mm ☺A negative number suggests Retrognathism while a large www.indiandentalacademy.com positive value suggests Prognathism
  • Soft tiSSue analySiS ☺Facial Form ☺Mandibular Prognathism ☺Distance between Pg and a line perpendicular to HP passing through G gives Mandibular prognathism ☺Standard Value ☺0 + 4 mm ☺A negative number suggests Retrognathism while a large positive value suggests Prognathism www.indiandentalacademy.com
  • Soft tiSSue analySiS ☺Facial Form ☺Vertical Height Ratio ☺It is the ratio between G-Sn (Middle Facial third) and Sn-Me’ (Lower Facial third) measured perpendicular to HP ☺Standard Value ☺1 : 1 ☺Increased ratio suggests increased middle third height and vice versa ☺Lower Face Throat Angle ☺It is the angle formed by intersection of Sn-Gn’ and Gn’-C ☺Standard Value ☺1000 + 70 ☺This angle affects treatment planning to correct anteroposterior www.indiandentalacademy.com facial dysplasia
  • Soft tiSSue analySiS ☺Facial Form ☺Lower face Vertical Height Depth Ratio ☺It is obtained by dividing Sn-Gn’ distance with C-Gn’ distance ☺Standard Value ☺1.2 : 1 ☺A much larger than 1 value indicates that patient has a relatively short neck www.indiandentalacademy.com
  • Soft tiSSue analySiS ☺Lip Position and Form ☺Nasolabial Angle ☺It is the angle formed by intersection of Cm-Sn line and Sn-Ls ☺Standard Value ☺1020 + 80 ☺Lower than normal Nasolabial angle suggests proclination of upper incisors or anterior maxillary base protrusion or both ☺Higher than normal Nasolabial angle suggests retroclination of upper incisors or maxillary base retrusion or both www.indiandentalacademy.com
  • Soft tiSSue analySiS ☺Lip Position and Form ☺Upper Lip Protrusion ☺It is perpendicular distance between Ls to Sn-Pg’ line ☺Standard Value ☺3 + 1 mm ☺Lower Lip Protrusion ☺It is perpendicular distance between Li to Sn-Pg’ line ☺Standard Value ☺2 + 1 mm www.indiandentalacademy.com
  • Soft tiSSue analySiS ☺Lip Position and Form ☺Mentolabial Sulcus Depth ☺It is perpendicular distance between deepest point on the mentolabial sulcus to Li-Pg’ line ☺Standard Value ☺4 + 2 mm ☺The depth of sulcus is affected by various factors which are – flared lower inciors, flaccid lower lip tone, extruded upper inciors causing rolling of lower lip, and www.indiandentalacademy.com prominence of chin
  • Soft tiSSue analySiS ☺Lip Position and Form ☺Vertical Lip:Chin ratio ☺It is ratio between Sn-Stms and Stmi-Me’ ☺Standard Value ☺0.5 or 1:2 ☺Whenever the value decreases vertical reduction genioplasty should be considered www.indiandentalacademy.com
  • Soft tiSSue analySiS ☺Lip Position and Form ☺Maxillary Incisor Exposure ☺It is obtained by measuring the distance between tip of upper central incisor and Stms ☺Standard Value ☺2 + 2 mm ☺Increased incisor exposure may be due to vertical maxillary excess or short upper lip ☺Decreased incisor exposure may be due to vertical maxillary deficiency or larger upper lip www.indiandentalacademy.com
  • Soft tiSSue analySiS ☺Lip Position and Form ☺Inter Labial Gap ☺It is the distance between Stms and Stmi ☺Standard Value ☺2 + 2 mm ☺Patients with vertical maxillary excess tend to have large interlabial gap and lip incompetence ☺Patients with vertical maxillary deficiency tend to have no Inter labial gap and Lip redundancy www.indiandentalacademy.com
  • Summary This cephalometric analysis is one step in diagnosis and treatment planning for a surgical case. It gives the clinician an insight into the quantitative nature of the skeletodental and also soft tissue dysplasia. COGS analysis uses linear dimensions to describe the size and positions of facial bones and this is practical because surgeon thinks more in millimeters than in angles for planning and accomplishing procedures. www.indiandentalacademy.com
  • Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com