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Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy
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Wits, sassouni, jarabak /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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  • 1. CEPHALOMETRIC ANALYSIS www.indiandentalacademy.com
  • 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 3. WITS APPRAISAL • Since the introduction of ANB angle,it has been one of the most popular means of cephalometric evaluation of the A-P relationship of apical bases. • There are many situations in which ANB reading cannot be relied upon. • Purpose of Wits appraisal is to identify these instances where ANB reading does not accurately reflect the extent of A-P jaw dysplasia. www.indiandentalacademy.com
  • 4. • Relating the jaws to SN plane has certain inherent inconsistencies because of possible variations in the craniofacial physiognomy ,such as• 1) The A-P position of nasion relative to jaws. • 2) The rotational effect of jaws relative to cranial reference plane. www.indiandentalacademy.com
  • 5. Effect of position of Nasion A) Normal relationship B) Nasion forward due to long cranial base. C) Nasion retropositioned due to short cranial base. www.indiandentalacademy.com
  • 6. Effect of angulation of jaws, occlusal plane on ANB angle A) Normal relationship. B) Effect of counterclockwise rotation of face . C) Effect of clockwise rotation of face. www.indiandentalacademy.com
  • 7. • Recognizing these shortcomings of ANB angle, number of authors came up with alternative method- 1) Jenkins (1955)-used functional occlusal plane. 1) Harvold (1963)- Projected points A and B onto occlusal plane. Termed the resulting measurement as A-B difference. 2) Jacobson (1975)- Published the classic article, “The Wits appraisal of jaw disharmony” www.indiandentalacademy.com
  • 8. • ‘WITS’- abbreviation for university of witswatersrand,Johannesburg,South Africa. • According to Jacobson- It is not an analysis per se;rather it is intended as a diagnostic aid whereby the severity or degree of A-P disharmony can be measured. • Measure of extent to which jaws are related to each other A-P, independent of relationship to cranial landmarks. www.indiandentalacademy.com
  • 9. • Occlusal plane is drawn through the region of overlapping cusps of premolars & molars. • Perpendiculars are drawn on occlusal plane from points A & B. • Contact points labelled as AO & BO. www.indiandentalacademy.com
  • 10. • In a sample of 21 adult males selected on basis of excellence of occlusion, it was found that BO was approx. 1mm ahead of AO. • In 25 adult females ,AO & BO coincided. • Therefore average jaw relationship according to wits reading is – -1mm in males 0mm in females Clinical Significance - In skeletal class II,BO located well behind AO. In skeletal class III,BO would be forward of point AO. Greater the wits reading – Greater the jaw discrepancy. www.indiandentalacademy.com
  • 11. Applications of wits appraisal • The ANB angle is shown to be affected by several enviornmental factors,diagnosis based on this angle may give false results,in certain cases. • Factors affecting ANB angle- • 1) Patient’s age- ANB has a definite tendency to reduce with increasing age. • 2) Change in spatial position of nasion. • 3) Rotational effect of jaws • 4) Change in the angle SN to occlusal plane. • 5) The degree of facial prognathism. www.indiandentalacademy.com
  • 12. • • 6) Mandibular plane angle – High angle suggests a divergent type profile, clockwise rotation of jaws, resultant increase in ANB reading. • In many cases where SNA, SNB angles are in no way representative of jaw disharmony, wits appraisal may be conveniently applied. www.indiandentalacademy.com
  • 13. • DRAWBACKS – Largely dependent on correct location or representation of the occlusal plane. Sometimes right & left sides of posterior teeth don’t always coincide. • In mixed dentition with deep bite,constructed occlusal plane may differ considerably from functional occlusal plane of deciduous & permanent molars • If curve of spee is deep,it may be difficult to follow the plane of maximum intercuspation. • The angulation of functional occlusal plane to pterygomaxillary vertical plane has been shown to decrease from age 4 to 24. • ( Sherman,Woods,Nanda, AJO-DO,May 1988) www.indiandentalacademy.com
  • 14. • As growth takes place,there is change in position of B point,which is masked by increasing prominence of the chin. • The ‘wits’ appraisal is intended not as a single diagnostic criteria but as an additional measurement, which may be included in the existing cephalometric analysis to aid in the assessment of the degree of A-P jaw disharmony . www.indiandentalacademy.com
  • 15. SASSOUNI’S ANALYSIS • First published in AJO 1955,won first prize in Essay contest sponsored by American Association of Orthodontics. • According to sassouni- “Architecture of skull is result of many forces ,genetic forces,growth forces,muscular,functional,enviornmental forces on the adaptable bony substance.” • At each period of life the skull is the end result of the interaction of these forces. www.indiandentalacademy.com
  • 16. • Problem – How can we study the architecture ? • What is the significance of this architecture for diagnosis and treatment? • Are disturbances or disproportions in facial architecture possible etiological factors in orthodontics, oral surgery, prosthetics & periodontics ? • Aim – To find some acceptably constant relationships in the architecture of the head & to use them for diagnosis & treatment. • Material – 100 lateral head X-ray films (51 girls,49 boys). White children of Mediterranean racial origin. www.indiandentalacademy.com
  • 17. Terminology www.indiandentalacademy.com Planes 1 Mandibular plane,OG – Tangent to inferior border. 2 Occlusal plane,OPThrough mesial cusps of permanent 1st molars & incisal edges of incisors. 3 Palatal plane,ON – perpendicular to mid sagittal plane,through ANS-PNS.
  • 18. • 4 Anterior cranial base plane angle,OS’- parallel to axis of upper contour of anterior cranial base & tangent to inferior border of sella turcica • 5 Ramal plane – Tangent to posterior border of ascending ramus. www.indiandentalacademy.com
  • 19. • ARCS- • 1 Anterior arc – Between anterior cranial base plane & mandibular plane,with O as center & O – ANS as radius. • 2 Posterior arc – Between anterior cranial base plane & mandibular base plane,O centre, OSp as radius. ( Sp is most posterior point on rear margin of sella turcica ) www.indiandentalacademy.com
  • 20. • Analysis- Mandible, Palate and Anterior cranial base are examined. • Mandible – 3 types • 1 Curved – Upward traction forces at gonion & downward pulling force at the menton are in equilibrium. • 2 Oblique – Upward traction & downward pulling forces seem to be so strong that we have a notch just anterior to the gonial insertion of masseter. • 3 Horizontal - Upward traction forces at gonion seems to be greater than downward pulling forces at menton. www.indiandentalacademy.com
  • 21. www.indiandentalacademy.com
  • 22. Palate • Horizontal – Line connecting ANS-PNS passes through bony structure of the palate. • Convex – Line passes above the bony structure of palate. • Concave – Line passes below the bony structure of palate. www.indiandentalacademy.com
  • 23. • Relationship – • With curved mandible; horizontal palate. • Oblique mandible; convex palate. • Horizontal mandible; concave palate www.indiandentalacademy.com
  • 24. Key Ridge • Presents 2 shapes – Vertical & straight ,or Ilike. • Double curved,like a reverse 3 or like a sigma. • Relation- When palate is concave or convex,key ridge is sigma like. • When palate is horizontal;key ridge is I – like. www.indiandentalacademy.com
  • 25. Relationship between mandibular plane,occlusal plane,palatal plane & anterior cranial base plane • In a well proportioned face, all meet posteriorly at the same point O. • If we draw a circle from O as a center,with O-ANS as radius,it passes through – pogonion,nasion,ANS, incisal edge of upper incisor. • All these points are equidistant from O. www.indiandentalacademy.com
  • 26. Posterior relationship in a well–proportioned face • • If we draw a circle with O as center,passing through posterior wall of sella turcica (Sp),it also passes through gonion. It can be said that – • A) Gonion & posterior wall of sella turcica are equidistant from O. • B) Anterior cranial base & corpal length of mandible are equal in length & position. www.indiandentalacademy.com
  • 27. Relationship between anterior & posterior arcs • • • • • • • • Face is delimited by – Above by anterior cranial base plane,OS’. Below by mandibular plane ,OG. Anteriorly by arc passing through ANS. Posteriorly by arc passing through Sp Proportion between anterior & posterior arcs is a function of angle S’O G , ratio of both radii Ra (O-ANS) / Rp (O-SP). Combination of S’OG and Ra/Rp is facial index. www.indiandentalacademy.com
  • 28. Relationships between angles • Angle S’OG (Mandibular cranial angle) is unique to each individual face. • Angle S’ON (Palatocranial ) = Angle NOG (Palatomandibular) • Angle NOP (Occlusopalatal ) is between 1/1 & 1/2 Angle POG (occlusomandibular) • Angle POG is always larger than angle NOP in a well proportioned face. www.indiandentalacademy.com
  • 29. Classification of facial types • I – Anterior cranial base plane does not meet three other planes at common point O. • II – Palatal plane does not meet at O. • III – Occlusal plane does not meet at O. • IV – Mandibular plane does not meet at O. • Type A – Plane passes above point O. • Type B – Below point O. www.indiandentalacademy.com
  • 30. • In the sample studied ,type II facial pattern was most frequent. • Normal occlusion is condition necessary but not sufficient for a well proportioned face. • Among 50 cases with normal occlusion,only 16 had well proportioned faces. www.indiandentalacademy.com
  • 31. Classification based on vertical Proportions • I Equal – Upper & lower faces are equal. Cranial base plane ANS = ANS – M.P. II Minus – Lower face is smaller than upper face. III Plus – Lower face is larger. www.indiandentalacademy.com
  • 32. Classification of profile • I Archial – Anterior arc passes through Na,ANS,upper incisor edge,pogonion. www.indiandentalacademy.com
  • 33. • II Pre archial – ANS,Upper incisor,Pogonion are situated anterior to anterior arc passing through Na. www.indiandentalacademy.com
  • 34. • III Post archial – Situated posterior to anterior arc. www.indiandentalacademy.com
  • 35. • Convex – ANS,Upper incisor , are situated anterior to anterior arc passing by Na,Pogonion. www.indiandentalacademy.com
  • 36. • Concave – ANS & upper incisor are situated posterior to anterior arc passing by Na & pogonion. www.indiandentalacademy.com
  • 37. Conclusions • A complete well proportioned face as seen on lateral X ray film is one in which – • 1) Four facial planes meet at point O. • 2) Anterior upper & lower faces are equal. • 3) Posterior upper & lower faces are equal. • 4) Profile is archial. • 5) Corpus of mandible is equal in size & position to the anterior cranial base. www.indiandentalacademy.com
  • 38. • Thus there can be number of well proportioned faces as it is a question of proportion & not of absolute size. • Acc. To Sassouni : “We have to admit that there is no universal normality; there is no norm which can be applied indiscriminately to every body” www.indiandentalacademy.com
  • 39. The Sassouni cephalometric analysis – A Racial Comparison. Dr. Ashima Valiathan J.I.D.A.1977 • Compared the caucasians,Negro,Indian profiles. Findings – • 1) Majority of caucasians have archial profile, majority of Indians have post archial ( 65%) ,largest number of negroes presented with a post-archial profile. • 2) Both Indians & Negroes showed an overall procumbency of the anterior teeth. • 3) Compared to caucasians who showed equal upper & lower facial heights,in Indians the anterior & posterior lower facial height were more. • 4) Corpus of mandible was found to be longer than the cranial base in Indians as well as Negroes. www.indiandentalacademy.com
  • 40. JARABAK ANALYSIS • Presented by Joseph R .Jarabak in 1972. • Composite analysis, takes into account the skeletal aspects of growth as described by Bjork. • Analysis can be used in clinical assessment of growth events to follow, shows how to design treatment in anticipation of these growth events. www.indiandentalacademy.com
  • 41. • Takes into account ,the relationship between anterior & posterior cranial base, face & cranium, cranium & mandible. • Interpret how craniofacial growth will influence the dentition during treatment or post treatment growth period. . www.indiandentalacademy.com
  • 42. • A feature of analysis is POLYGON, Na – S – Ar – Go - Me to assess anterior & posterior face height relationships & to predict the direction of growth changes in lower face. • Basis of approach is relationship of 3 angles• 1 Saddle angle- Na-S-Ar • 2 Articular angle- S-Ar-Go • 3 Gonial angle- Ar-Go-Me www.indiandentalacademy.com
  • 43. • At age 11, anterior cranial base ( S-Na) should equal to mandibular body length ( Go-Me). • Ideal ratio of posterior cranial base length ( S-Ar) to ramus height ( Ar-Go) is 3:4. • CLOCKWISE GROWTH CHANGE – If sum of 3 angles is > 396°, ratio of posterior ( S-Go) to anterior face height ( N-Me) is 56% to 64%. • Anterior face height is increasing rapidly, downward & backward growth change at symphysis, & anterior open bite tendency. www.indiandentalacademy.com
  • 44. www.indiandentalacademy.com
  • 45. • COUNTERCLOCKWISE CHANGE – • 3 angles sum is < 396°,ratio of posterior to anterior face height 65 to 80 %. • More rapidly increasing posterior face height, forward growth of condyle,anterior deep bite tendency. www.indiandentalacademy.com
  • 46. • Sample – • Origin – some of the measurments were described & taken . Bjork cephalometric analysis. • Facial growth predictions were made after the age of 10 yrs, using the mean values based on 200 treated cases, 5 yrs after treatment. www.indiandentalacademy.com
  • 47. MEASUREMENTS • Saddle angle – Cranial base bend formed by joining N-S-Ar. Mean Value – 123 ± 5°. • Among Indians mean value 124 ± 4°. North Indians have a higher saddle angle, indicate a slightly posterior position of mandible. • ( Manish Valiathan ,Ashima Valiathan, V.Ravinder, JIOS 2001). www.indiandentalacademy.com
  • 48. • Large angle – Mandibular fossa growth will be more posterior for the remaining growth increment. Leads to increase in length of body of mandible , arrangement of ascending ramus if face has to remain orthognathic. • If mandibular body length is same or shorter than anterior cranial base, face will be retrognathic & continue to grow that way. • If angle is small,it tends to increase facial prognathism. • An extremely small angle can be seen in achondroplastic patients. www.indiandentalacademy.com
  • 49. • Flexure in saddle angle can be either large or small in 3 body types. • Higher angle – ectomorphs, • lower angles – endomorphic & mesomorphic pattern. • Lokar showed in a stastically significant sample that a small saddle angle is one of the most frequently seen characteristics of skeletal class III malocclusions. • Saddle angle is in no way influenced by orthodontic treatment. www.indiandentalacademy.com
  • 50. • Articular angle – is between S-Ar-Go. • Mean value – 143 ± 6°. • Indian – 141 ± 2°. • Can be changed by orthodontic treatment. • If bite is opened by extrusion of teeth or by driving molars distally, angle will increase. www.indiandentalacademy.com
  • 51. • If bite is closed by moving posterior teeth anteriorly,articular angle will decrease. • Females have a slightly higher articular angle than males indicating that females have a retrognathic mandibles in comparison with males. www.indiandentalacademy.com
  • 52. • • • • Gonial angle- between Ar-Go-Gn. Expresses the form of mandible & its growth direction. Mean value – 128 ± 7° Indian – 120 ± 1° Manner in which ascending ramus & mandibular body are related to each other to form gonial angle determines how the mandibular growth will influence facial structure. www.indiandentalacademy.com
  • 53. • To determine the angular relationship in which the ramus & mandibular body are put together angle is divided into 2 parts – • upper & lower gonial angle by facial depth line through a tangent of lower border of mandible & posterior surface of ascending ramus. www.indiandentalacademy.com
  • 54. • Upper angle – Slant of ramus . • Mean value – 52° – 55° • Indian value – 51° ,South Indian males show a higher value. • • • • Lower angle – Slant of body of mandible. Mean value – 70 ° – 75 ° Indian value - 69° If upper angle is large, remaining growth increment will be in sagittal direction. • If it is small, remaining increment will be downward or downward & backward. www.indiandentalacademy.com
  • 55. • Thus on completion of treatment,an allowance for growth must be made, leaving a somewhat greater overjet. • Provides incisive freedom between anterior teeth. • Otherwise either mandibular crowding may follow or anterior teeth may begin to assume a class III relationship. www.indiandentalacademy.com
  • 56. Ramus height • Distance between Go & Ar. • Mean value – 44 ± 5mm. • Boys – 40 – 46mm. • Girls – 38 – 40 mm. • Indian value; • Males : 51 – 54 mm • Females: 47mm. www.indiandentalacademy.com
  • 57. • In boys ramus height increases 1 – 2 mm /yr , in girls : ¾ to 1 ¼ mm/ yr. • As long as 3: 4 ratio ( posterior cranial length to ramus height ) prevails children having small faces would show favorable downward mandibular growth. www.indiandentalacademy.com
  • 58. Mandibular body length • From Go – Me. • Mean value : 71± 5mm. • Increase in mandibular body length contributes little to total facial prognathism, tend to increase mandibular prognathism. • A good incisor relation van go into class III, open bite as a result of increase in ramus & mandibular body length. • Usually happens when – saddle angle is small, mandibular body length to cranial base length is > than 1.1 : 1: ; ramus height is more than 46mm & upper gonial angle is large. www.indiandentalacademy.com
  • 59. Posterior & Anterior facial height • Ratio of posterior to anterior face height of 56 – 62 % indicates clockwise growing face. • 65 – 82 % - higher posterior facial growth takes place, face grew counter – clockwise. • If posterior face is short , one can expect face to be more retrognathic. www.indiandentalacademy.com
  • 60. www.indiandentalacademy.com
  • 61. Facial depth & Facial length • Facial depth – distance from Na to Go. • Facial length – distance from sella to the intersecting lines of facial & mandibular planes www.indiandentalacademy.com
  • 62. • Facial depth increases with growth in almost all faces. • Increment is greater when both gonial angles are small. • Facial length is a function of horizontal & vertical growth combined, will be greater where growth increments of lower face are more horizontal than vertical. www.indiandentalacademy.com
  • 63. DENTURE ANALYSIS • Mandibular incisors to facial plane – • Ideally : 2mm in front or behind facial plane. • if posterior to plane,chin are prominent, & lips are withdrawn. ( Dished in). • Anterior to facial plane : lower face has a denture prominence. www.indiandentalacademy.com
  • 64. • Ideal relation of maxillary teeth to facial plane is 5 ± 2 mm. • In Indians, South Indian show greater maxillary dental protrusion; South Indian females have greater mandibular dental protrusion. • Maxillary incisor to SN plane – Mean angulation : 102 ± 2°. www.indiandentalacademy.com
  • 65. Relating Mandibular molars to symphysis • Linear measurement of distance from mandibular 1st molar ( crown or mesial root) to posterior border of symphysis. • Indirectly tells abount the degree of overbite that may develop in retention & post retention periods. www.indiandentalacademy.com
  • 66. • If distance from these 2 points decreases as a result of treatment , it indicates molars were moved forward. • Will result in increased overbite after teeth have settled in function • If roots & crowns moved in different amounts , means molar were tipped during treatment. www.indiandentalacademy.com
  • 67. SOFT TISSUE PROFILE • Analysis uses Rickett’s E plane because of its simplicity ,reliability & chair side use. • Esthetic E line : straight line from tip of nose to tip of chin. • Desirable relation : Lower lip lightly touches the straight edge & upper lip is 2 – 4 mm behind E line. www.indiandentalacademy.com
  • 68. www.indiandentalacademy.com
  • 69. www.indiandentalacademy.com
  • 70. www.indiandentalacademy.com
  • 71. • Nose being the most changeable of the 2 reference structures, has a profound influence on relations of lips to the E plane. • Influence is not seen before 14 th yr. • From 14 – 18 yrs it grows considerably in boys. • Generally prominent in malocclusions characterized by forward maxilla. www.indiandentalacademy.com
  • 72. REFERENCES • 1 Valiathan A : Sassouni’s Cephalometric analysis – A racial comparison. J I D A 1977; 49 : 393 – 95. • 2 Valiathan M, Valiathan A, V.Ravinder: Jarabak analysis reborn. J I O S 2001;34 : 66 -76. • 3 Jarabak, Fizzell: Technique and treatment with light wire edgewise appliance.St. Louis, Mosby , 2nd edtn,Vol I ; Pg- 131 – 166. • 4 Sassouni V. : A roentgenographic cephalometric analysis of cephalo-facial dental relationships. AJO 1955; 735 -61. www.indiandentalacademy.com
  • 73. • 5 Jacobson: Wits appraisal of jaw disharmony. AJO 1975. • 6 Sherman, Woods, Nanda: Longitudinal effects of growth on wits appraisal. AJO 1988. • 7 Samir E. Bishara, Julie A. Fahl, Larry C. Peterson: Longitudinal changes in ANB angle and wits appraisal – Clinical implications. AJO 1983;84 (2): 133 -39 • 8 Jacobson : Introduction to radiographic cephalometry. Lea & Febgier, Philadelphia; 1985,2nd edtn. Pg-63 – 71. www.indiandentalacademy.com
  • 74. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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