olivier oussama sandid-mohamad abou el naser-dentists lebanon - lebanese university - oussama sandid- Olivier sandid – orthodontists Lebanon Beirut arab university # dentistry_dentistrie #dentist_dentist #orthodontiste_france #orthodontist_orthodontiste #orthodontiste-world #universite_libanaise #Dentiste-liban #orthodontist_ksa #Orthodontist_usa - #pediatricien_lebanon #pediatre_lebanon #medecin _Lebanon #medecins_liban #doctors_Lebanon #docteur_liban #usj #universite-saint_joseph- beyrouth #AUB #Americaine_university_of _beirut صنديد اسامة

1. 213-Ceph tracing-Dolphin imaging
Olivier Oussama SANDID
Orthodontiste- France

2. Reconnaissance de structure

3. Reconnaissance de structure

4. Reconnaissance de structure

5. 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

6. Examen Complementaires ?
• 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

7. Structures to be Traced

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

9. Radiographic Landmarks

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

11. 82
Antero-posterior maxillary assessment
Skeletal Assessment
SNA

12. 80
Antero-posterior mandibular assessment
Skeletal Assessment
SNB

13. 2
Antero-posterior bimaxillary assessment
Skeletal Assessment
ANB

14. -1 mm
BO anterior toAO
Skeletal Assessment
Wits (AO-BO)

15. 66
Skeletal Assessment
Y Axis

16. 59
Vertical Skeletal Assessment
Skeletal Assessment
Y Axis (to Frankfort Horizontal)

17. 32
Vertical Skeletal Assessment
Skeletal Assessment
NS(SN plane)-GoGn

18. 104
Incisor Angulation Assessment
Dental Assessment
U1-NS (Max 1 - SN)

19. 22
Dental Assessment
Max 1 - NA (degrees)

20. 4 mm
Dental Assessment
Max 1 - NA (mm)

21. 95
Incisor Angulation Assessment
Dental Assessment
L1-GoGn (Man 1 - GoGn)

22. 25
Dental Assessment
Man 1 - NB (degrees)

23. 4 mm
Dental Assessment
Man 1 - NB (mm)

24. 2 mm +/- 2
Dental Assessment
APog - Man 1

25. 130
Inter-Incisor Angulation Assessment
Dental Assessment
U1-L1 (Max 1 - Man 1)

26. -2 mm
CHANGESWITH AGE!
Soft Tissue Assessment
E Plane

27. >4 mm.
Soft Tissue Assessment

28. Composite Cephalometric Tracing

29. Direction de la croissance

30. Typologie faciale

31. Typologie faciale

32. Position du maxillaire

33. Position du maxillaire

34. Position de la mandibule

35. Position de la mandibule

36. Classification squelettique

37. Classification squelettique

38. Mesures cephalo

39. Position des incisives

40. Position des incisives

41. Position des incisives

42. Position des incisives

43. Position des incisives

44. Position des incisives

45. Position des incisives

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

78. Analyse de Tweed

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

88. 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

89. 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

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

91. Angle nasio- labial

92. Profondeur du nez

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

95. Mesures cephalometrique

96. Classe III

97. Classe III

98. Classe III Cas 2