#OUSSAMA _ALSANDID #OLIVIER _AL _SANDID #ORTHODONTIE #orthodontics #DENTISTERIE # dentistry #DENTIST #ORTHODONTIST #france #pedodontie #pedocontics #oussama_al sandid- olivier sandid #ANALYSE_CEPHALOMETRIQUE #CEPHALOMETRI_ ANALYSIS

1. 158-Cephalometrics Analysis
Olivier Oussama SANDID
Orthodontiste

2. Analyses cephalometrics
• Classification squelettique antero-posterieure
• Angulation des incisives
• Position des tissus mous levres etc
• Profil facial
• Les amygdales ,la langue
• Etude de la croissance maxillo faciale

3. Locate the anatomic points

4. Anatomic Points

5. Tracing

6. Anatomic Points- Reconnaissance de
structure

7. Sella
Porion
Gonion
PNS
Menton Gnathion
Pogonion
B Point
A Point
ANS
Orbitale
Nasion
Articulare
Standard Cephalometric Landmarks

8. Planes

9. SN Plane
Frankfort Plane
Palatal Plane
Occlusal Plane
Mandibular Plane
Frequently Used Planes

10. Classification squelettique

11. Classification squelettique

12. Position du maxillaire

13. Position du maxillaire

14. Position de la mandibule

15. Position de la mandibule

16. 82
Antero-posterior maxillary assessment
Skeletal Assessment
SNA

17. 80
Antero-posterior mandibular assessment
Skeletal Assessment
SNB

18. 2
Antero-posterior bimaxillary assessment
Skeletal Assessment
ANB

19. -1 mm
BO anterior toAO
Skeletal Assessment
Wits (AO-BO)

20. GROWTH DIRECTION

21. Typologie faciale

22. Typologie faciale

23. 66
Skeletal Assessment
Y Axis- Growth

24. 59
Vertical Skeletal Assessment
Skeletal Assessment
Y Axis (to Frankfort Horizontal)

25. 32
Vertical Skeletal Assessment
Skeletal Assessment
NS(SN plane)-GoGn

26. Position des incisives

27. Position des incisives

28. Position des incisives

29. Position des incisives

30. Position des incisives

31. Position des incisives

32. Position des incisives

33. 104
Incisor Angulation Assessment
Dental Assessment
U1-NS (Max 1 - SN)

34. 22
Dental Assessment
Max 1 - NA (degrees)

35. 4 mm
Dental Assessment
Max 1 - NA (mm)

36. 95
Incisor Angulation Assessment
Dental Assessment
L1-GoGn (Man 1 - GoGn)

37. 25
Dental Assessment
Man 1 - NB (degrees)

38. 4 mm
Dental Assessment
Man 1 - NB (mm)

39. 2 mm +/- 2
Dental Assessment
APog - Man 1

40. 130
Inter-Incisor Angulation Assessment
Dental Assessment
U1-L1 (Max 1 - Man 1)

41. -2 mm
CHANGESWITH AGE!
Soft Tissue Assessment
E Plane

42. >4 mm.
Soft Tissue Assessment

43. Composite Cephalometric Tracing

44. White Black Palestine 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

45. Mesures cephalo

46. Mesures dentaires

47. ANALYSE DE DELAIRE

48. ANALYSE DE DELAIRE

49. CEPHALOMETRIC ANALYSIS
DENT 657

50. ANALYSIS UTILIZING THE CEPHALOMETRIC
TRACING
1) Describe the subject’s dento-facial morphology
2) Quantitative description of morphological deviations
3) Make diagnostic and treatment planing decisions
2) Evaluate change over time - treatment induced and
growth process

51. Morphological Description
• Skeletal - horizontal and vertical
• Dental - horizontal and vertical
• Comparing individual subject’s tracing to the
“ideal”
• Reference sample
Cross-sectional
Longitudinal - growth studies eg. Bolton-Brush, Ann
Arbor and Burlington

52. Cephalometric Analyses
• Down’s
• Steiner’s
• Tweed’s
• McNamara’s
• OSU

53. Cephalometric Evaluation
• Identification of anatomic landmarks
• Landmarks: stable reference structures and
maxillary and mandibular skeletal and dental
• Graphically relating the dento-facial elements
to these reference structures
• Angular and or linear measurements

54. METHODS OF CEPHALOMETRIC ANALYSIS
• Two basic approaches
• Metric approach - use of selected linear and
angular measures
• Graphic approach - “overlay” of individual’s
tracing on a reference template and visual
inspection of degree of variation

55. Metric Method - Use of selected linear and
angular measures

56. Graphic Method - Use of a Composite
Template

57. GOALS OF CEPHALOMETRIC ANLYSIS
• Evaluating relationships, both horizontal and
vertical of 5 major functional components of
the face:
• the cranial base;
• the maxilla; the mandible,
• the maxillary and mandibular dento-alveolus

58. REFERENCE LINES
• Frankfort’s Horizontal (porion to orbitale)
• Sella - Nasion line
• True horizontal plane
• True vertical plane

59. sella nasion
porion orbitale
Reference Lines

60. SKELETAL HORIZONTAL - MAXILLA
SNA 82 ± 2 deg
NA TO FH 90 ± 3
deg
s n
a
F H

61. SKELETAL HORIZONTAL - MANDIBLE
s
n
b
P g
F H
SNB 80 ± 2 deg
N-PG TO FH
88 ± 6 deg

62. SKELETAL HORIZONTAL - MAXILLA TO
MANDIBLE
N
A
B
ANB 2 ± 2 deg

63. SKELETAL VERTICAL
F H
S
G N
M E
G O
FH TO GOGN 22 ± 5
deg
Y AXIS 59 ± 6 deg
LFH 55% OF TFH

64. DENTAL - UPPER TO LOWER INCISOR
INTERINCISAL 130
± 5 deg

65. DENTAL - MAXILLARY INCISOR
F H
N
A
U1 TO FH 110 ± 5
deg
U1 TO NA 22deg
U1 TO NA 4mm

66. DENTAL - MANDIBULAR ANTERIOR
GO
GN
B
N
L1 TO NB 25deg
L1 TO NB 4mm
L1 TO GOGN 91 ±
6deg

67. SOFT TISSUE
NASOLABIAL
ANGLE 102 ± 8 deg
L.LIP TO E PLANE -2
±2mm

68. Limitations of the Metric Method
• Stable reference structures are only relatively
stable
• Validity of landmarks
• Error in landmark identification

69. Graphic Method
• Template
• Changes between 2 time points

70. Superimposition Method - on the cranial
base

71. Maxillary and mandibular
superimposition

72. Limitations of Cephalometric Analysis
• Individual variability
• Ethnic variability
• Gender variability

73. 15"
60"
Source Plane
X-ray Source
Patient in Head Positioning
Device
Mid-saggital Plane
Film Plane
X-ray Film in
Cassette
Cephalostat

74. Cephalostat

75. Cephalostat

76. Children with airway obstruction, when
compared 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

79. ANALYSE DE TWEED
http://www.boskitos.com/fac/odf/analyses.ht
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80. L`ANALYSE DE TWEED
Est basée sur la comparaison de
moyenne, des mesures d`angle
,l`incisive inferieure doit rester stable
perpendiculaire aux bases osseuses
mandibulaire

81. Plans
Plan de Francfort :du point sous orbitaire Or au Porion Po
Plan mandibulaire de Downs : plan qui rejoins la partie la plus
inferieure de l`angle mandibulaire et la plus postérieure de l`image de
la symphyse

82. Valeurs sagittales
• Angle SNA valeur normale 82 degré
• Angle SNB valeur normale 80 degré
• ANB valeur normale 2 degré =SNA-SNB
• Donnent le degré de prognathie ou de
retrognathie maxillaire ou mandibulaire par
rapport a la base du crane
• Maxillaire ou mandibule défaillant ou les deux
• ANB détermine la classe squelettique

83. • Classe I 0 < ANB < 4
• Classe II ANB > 4
• Classe III ANB < 0

84. AO-BO
• C`est la distance qui sépare La projection
orthoghonale du point A et du point B sur le
plan d`occlusion , précise les indications
thérapeutiques des décalages des maxillaires.
La direction de la croissance et l`inclinaison du
plan occlusal
• Classe I -2< AOBO<+2
• Classe II AOBO > 2
• Classe III AOBO <-2

85. Triangle de Tweed

86. -FMA 25

93. • CRITERES D’EVALUATION CEPHALOMETRIQUE
DU PROFIL CUTANE DU NEGRO-AFRICAIN ET
DU CAUCASIEN

94. Ligne de Steiner Ivoirien Europeen
-La lèvre inférieure dépasse de 8 mm La lèvre supérieure dépasse de 5 mm
-Les lèvres sont en arrière de cette ligne

95. Ligne de Burstone Ivoirien Europeen
-La lèvre inférieure dépasse de 9 mm La lèvre supérieure dépasse de 8 mm
-Lèvre supérieure ne dépasse la ligne que de 3,5 mm tandis que l'inférieure que de 2 mm seulement

96. Angle H d'Holdaway
(Ivoirien) et Europeen
H=15 et H = 9

97. Angle nasio- labial

98. Profondeur du nez

99. Angle Z de Merrifield
Z=58 et Z= 9

101. Mesures cephalometrique

102. Classe III

103. Classe III

104. Classe III Cas 2