Mc namara analysis /certified fixed orthodontic courses by Indian dental academy


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Mc namara analysis /certified fixed orthodontic courses by Indian dental academy

  1. 1. Mc NAMARA ANALYSIS INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. INTRODUCTION Described by James A McNamara in 1984 Jr Professor of Orthodontics, Centre for Human Growth and development, University of Michigan. This analysis helps in the evaluation and treatment planning of orthodontic and orthognathic surgery patients  In a normal well balanced occlusion, the skeletal and dentoalveolar components of jaw are well related to each other.
  3. 3. Need for this analysis  It relates teeth to teeth, teeth to jaws, each jaw to the other and jaws to the cranial base.  This analysis can be easily communicated to lay persons ,such as patients and parents, and to other dental professionals who do not have detailed knowledge of cephalometrics.
  4. 4.  The composite normative standards used in this analysis were derived from 3 sources; 1. lateral cephalograms of the children comprising the Bolton standards 2. selected values from a group of untreated children from the Burlington Research Centre 3. a sample of young adults from Ann Arbor, having good to excellent facial and dental configurations and good skeletal balance with an orthognathic facial profile
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  6. 6. LANDMARKS  ANS - ant tip of the sharp bony process of maxilla in the midline of the lower margin of ant nasal opening  Co - the most posterosuperior pt on the outline of mand condyle  Ba – median pt of the ant margin of the foramen magnum  Ptm – contour of pterygomaxillary fissure formed ant by retromolar tuberosity of maxilla & posteriorly by ant curve of pterygoid processof sphenoid bone
  7. 7.  The craniofacial skeletal complex is divided into 5 major sections – to create a clinically useful analysis 1. Maxilla to cranial bone 2. Maxilla to mandible 3. Mandible to cranial bone 4. Dentition 5. Airway
  8. 8. MAXILLA TO CRANIAL BASE  Soft tissue evaluation. 1. nasolabial angle 2. cant of upper lip  Nasolabial angle is formed by drawing a line tangent to the base of the nose and a line tangent to the upper lip  In adult males & females 102 deg (SD of 8)  Acute angle due to dentoalv protrusion or orientation of base of nose
  9. 9. Nasolabial Angle
  10. 10. Cant of upper lip  Should be slightly forward to form an angle with nasion perpenticular  14 (SD of 8 )in women  8 (SD of 8 ) in man
  11. 11. Hard tissue evaluation  To determine the anteroposterior orientation of maxilla, relative to cranial base –linear distance between N perpendicular and pt A  Ant position of pt A -- +ve value post position of pt A -- -ve value In well balanced face, 0 mm in mixed dentition 1 mm in adult male& female
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  13. 13.  Exceptions:  Nasion perpenticular variability: cl III malocclusion – short cranial base. backward position of N gives an appearance of excessively anteriorly positioned max &mand  Pt A variability: In cl II div 2 case - excessive lingual tipping of crowns of upper incisors,so pt A is 1-2 mm labially placed.
  14. 14. MAXILLA TO MANDIBLE Anteroposterior relationship Mid facial length- a line from condylion to pt A Effective mandibular lengtha line from Co to Gn Any effective midfacial length corresponds to an effective mand length
  15. 15.  The effective lengths max &mand are related to the size of the component parts . thus termed , small for mixed dentition medium for adult female large for adult male To determine the maxillomandibular difference the mid facial length is substracted from mand length (Co-Gn)-(Co-A) in small inividuals20-23 mm in medium sized individuals 27-30 mm in large individuals 30-33 mm
  16. 16.  Vertical relationship - lower ant face height - mand plane angle - facial axis angle  Lower anterior face height -measured from ANS - Me -it correlates with the length of midface -forwardly or backwardly placed chin point attribute to deficient or excessive lower face height respectively.
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  19. 19. Mandibular plane angle Angle between the Frankfort horizontal & line drawn along the lower border of the mandible (Go-Me) Avg 22 deg + 4 deg
  20. 20.  Facial axis angle Angle formed by line constructed from the posterosuperior aspect of the pterygomaxillary fissure to Gnathion relative to the Cranial base (Ba-Na). In a balanced face- Facial axis angle is perpendicular. A –ve value means excessive vertical growth of face. A +ve value means deficient vertical growth of face.
  21. 21. Facial Axis Angle
  22. 22. MANDIBLE TO CRANIAL BASE  Is determined by measuring distance from pogonion to nasion perpendicular. In mixed dentition 6-8 mm (behind N per) In adult female 4-0 mm (behind N per) In adult male 2 mm (behind or fwd of N per)
  23. 23. DENTITION Helps in determining the anteroposterior position of both upper and lower incisors. Maxillary Incisor Position Vertical line is drawn through pt A parellel to nasion perpendicular. The distance from pt A to facial surface of upper incisor is measured. The normal value is 4-6 mm.
  24. 24. Mandibular Incisor Position The distance between the edge of the mandibular incisor and a line drawn from pt A to pog is measured. In a well-balanced face it is 1-3 mm.
  25. 25. AIRWAY ANALYSIS The purpose of this analysis is to find out the possibility of any airway impairment. Upper Pharynx Is measured from a pt on the post outline of the soft palate to the closest point on the pharyngeal wall. The avg nasopharynx is 15-20 mm. A width of 2 mm or less indicate airway impairment.
  26. 26. Lower Pharynx Is measured from the pt of intersection of the post border of the tongue and the inferior border of the mandible to the closest pt on the post pharyngeal wall. Avg measurement is 11-14 mm.
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  28. 28. Cant of upper lip 102o + 8 14o + 8 0 – 1mm 112-114 89 26 + 4 65 + 4 93deg 23o -7mm 112 89 23 69 33deg -2deg normal normal Maxillary skeletal retrution normal normal increased Vertically growing pattern
  29. 29. -5.5 + 4 -15mm 10mm 9mm 13mm 10mm Retrusive mandible Forwardly placed decreased
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