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MCNAMARA ANALYSIS

INDIAN DENTAL ACADEMY
Leader in continuing dental education
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Mc NAMARA
ANALYSIS

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INTRODUCTION
described a method of cephalometric analysis which is
used in the evaluation and treatment planning of
orthod...
Composite Normative Standards
Are Based On..
Bolton's

Standards

Burlington
Ann

Orthodontic Research Centre

Arbor sa...
Why Another Analysis ?
1940 – 1970 : Significant alteration in the craniofacial
relationship were thought impossible
In th...
Landmarks And Planes :
Nasion- Most anterior point
on Nasofrontal Suture
Porion- Superior aspect of
the external auditory ...
Landmarks And Planes :
ANS- Tip of the bony
anterior nasal spine
Point A- Deepest point on the
curved bony outline
( subsp...
Landmarks And Planes :
Gnathion- Constructed by
intersecting a line drawn
perpendicularly to the line
connecting Me and Po...
Craniofacial Skeletal Complex Is
Divided Into Five Major Sections…


Maxilla to Cranial base



Maxilla to Mandible



...
Relating Maxilla To The Cranial
Base
N

Hard tissue evaluation:
po

Linear distance is measured

FH

or

1 mm

Between nas...
Maxillary Skeletal Protrusion

Maxillary Skeletal Retrusion
With Obtuse Nasolabial Angle

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Relating Maxilla To The Cranial
Base
Soft Tissue Evaluation:
Nasolabial Angle:
Formed by line drawn tangent
to the base of...
Relating Maxilla To The Cranial
Base
Soft Tissue Evaluation:
N Perpendicular

Cant Of Upper Lip :
Female – 14 degree
Male ...
Relating Maxilla To The Mandible:
Anteroposterior Relationship:
Effective Midfacial Length :
Measured from Condylion to
po...
Effective lengths are not age or sex related
but are related to size of component parts
Small - Mixed dentition
Medium - A...
Small : 20 mm

Medium : 25 to 27 mm

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Large : 30 to 33 mm
CLASS II DIV 1
Mandible 12 mm deficient
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Relating Maxilla To The Mandible:
Vertical Relationship :
Lower Anterior Face Height :
Measured

from ANS to Menton

Inc...
66 – 68 mm

60 – 62 mm

70 – 74 mm

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Vertical

maxillary excess can cause a downward
and backward rotation of mandible resulting in an
increase in lower anter...
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Mandibular Plane Angle :
Angle between FH plane and
the Mandibular plane
( Gonion – Menton )
220 + 40

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Facial Axis Angle :
Angle between a line from
basion to nasion and the
facial axis i.e. PTM to Gn
900
< 900 – ( -ve value ...
Relating Mandible To The Cranial
Base
Distance from Pog to the nasion
Perpendicular

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- 8 mm to – 6 mm

- 4 mm to 0 mm

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- 2 mm to 2 mm
Mandibular Skeletal

Mandibular Prognathism

Retrusion

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Dentition :
In

cases of malrelationship between the maxillary
and mandibular skeletal structures, errors may result if
t...
N

A

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Relating upper Incisor to Maxilla :
Anteroposterior position
Position of the upper incisor can be located by
using measure...
Vertical position :
The incisal edge of the upper incisor lies 2 –
3 mm below the upper lip at rest

Vertical position of ...
Relating Lower Incisor To
Mandible :
Anteroposterior position :
Measurement of the facial
surface of the lower
incisor to ...
If

there is a discrepancy in Anteroposterior or
vertical positioning of the maxilla and the
mandible then modifications ...
A second tracing of the mandible
and the incisor is made
The tracing is moved so that the
mandible is in the desired
posit...
Estimate the number of mm that the
mandible will be brought forward
relative to the maxilla at the end of the
treatment
Th...
Vertical Position Of The Lower
Incisor :
Relating the lower incisor tip to the functional
occlusal plane
Evaluated on the ...
Airway :
Upper pharynx
Width is measured from a point on the
posterior outline of the soft palate to the
closest point on ...
2 mm

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Airway :
Lower pharynx
Width is measured from intersection of
the posterior border of tongue and the
inferior border of th...
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Advantages :
Linear measurements rather than angles
Provides guidelines with respect to normally
occurring growth increm...
www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com
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Analysis mc namara /certified fixed orthodontic courses by Indian dental academy

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Analysis mc namara /certified fixed orthodontic courses by Indian dental academy

  1. 1. MCNAMARA ANALYSIS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Mc NAMARA ANALYSIS www.indiandentalacademy.com
  3. 3. INTRODUCTION described a method of cephalometric analysis which is used in the evaluation and treatment planning of orthodontic and orthognathic surgery patients The analysis represents an effort to relate…  Teeth to teeth  Teeth to jaws  Each jaw to the other  Jaws to the cranial www.indiandentalacademy.com base
  4. 4. Composite Normative Standards Are Based On.. Bolton's Standards Burlington Ann Orthodontic Research Centre Arbor sample of 111 young adults (Female – 26 yrs 8 mon, Male – 30 yrs 9 mon ) The analysis method is derived in part from the principles of cephalometric analyses of Ricketts and Harvold www.indiandentalacademy.com
  5. 5. Why Another Analysis ? 1940 – 1970 : Significant alteration in the craniofacial relationship were thought impossible In the decade from 1970 - 1980 Advent of numerous Orthognathic surgery procedures which allow three dimensional repositioning of almost every bony structure in the facial region Functional appliance therapy which present new possibilities in the treatment of skeletal discrepancies www.indiandentalacademy.com
  6. 6. Landmarks And Planes : Nasion- Most anterior point on Nasofrontal Suture Porion- Superior aspect of the external auditory meatus N s po Co Ptm Or Ba A Orbital- lowermost point on the orbit Basion- lowest point on the foramen magnum in the median plane ANS Go Ptmwww.indiandentalacademy.com Pog Me Gn
  7. 7. Landmarks And Planes : ANS- Tip of the bony anterior nasal spine Point A- Deepest point on the curved bony outline ( subspinale ) Pogonion- Most anterior point on the bony chin Menton- Lowest point on the outline of the symphysis N s po Co Ptm Or Ba A ANS Go Gonion- Constructed by intersection of the lines tangent to the posterior margin of the ascending ramus www.indiandentalacademy.com Pog Me Gn
  8. 8. Landmarks And Planes : Gnathion- Constructed by intersecting a line drawn perpendicularly to the line connecting Me and Pog N s po Condylion- Most posterosuperior point on the outline of the condyle Co Ptm Or Ba A ANS Mandibular plane – Go – Me Go Pog Facial axis – Ptm – Gn Me Gn www.indiandentalacademy.com
  9. 9. Craniofacial Skeletal Complex Is Divided Into Five Major Sections…  Maxilla to Cranial base  Maxilla to Mandible  Mandible to Cranial base  Dentition Airway www.indiandentalacademy.com
  10. 10. Relating Maxilla To The Cranial Base N Hard tissue evaluation: po Linear distance is measured FH or 1 mm Between nasion perpendicular to point A 0 mm – in mixed dentition 1 mm – in adults www.indiandentalacademy.com
  11. 11. Maxillary Skeletal Protrusion Maxillary Skeletal Retrusion With Obtuse Nasolabial Angle www.indiandentalacademy.com
  12. 12. Relating Maxilla To The Cranial Base Soft Tissue Evaluation: Nasolabial Angle: Formed by line drawn tangent to the base of the nose and a line tangent to the upper lip www.indiandentalacademy.com
  13. 13. Relating Maxilla To The Cranial Base Soft Tissue Evaluation: N Perpendicular Cant Of Upper Lip : Female – 14 degree Male – 8 degree ( SD 8 0 ) www.indiandentalacademy.com
  14. 14. Relating Maxilla To The Mandible: Anteroposterior Relationship: Effective Midfacial Length : Measured from Condylion to point A Effective mandibular length : Measured from Condylion to gnathion www.indiandentalacademy.com
  15. 15. Effective lengths are not age or sex related but are related to size of component parts Small - Mixed dentition Medium - Adult female Large - Adult male Any given effective midfacial length corresponds to a given effective mandibular length Mandibular length – Midfacial length = Maxillomandibular differential www.indiandentalacademy.com
  16. 16. Small : 20 mm Medium : 25 to 27 mm www.indiandentalacademy.com Large : 30 to 33 mm
  17. 17. CLASS II DIV 1 Mandible 12 mm deficient www.indiandentalacademy.com
  18. 18. Relating Maxilla To The Mandible: Vertical Relationship : Lower Anterior Face Height : Measured from ANS to Menton Increases with age and is correlated With effective midfacial length www.indiandentalacademy.com
  19. 19. 66 – 68 mm 60 – 62 mm 70 – 74 mm www.indiandentalacademy.com
  20. 20. Vertical maxillary excess can cause a downward and backward rotation of mandible resulting in an increase in lower anterior face height and vice – versa An increase or decrease in the lower anterior face height can have a profound effect on the horizontal relationship of the maxilla and mandible If the lower anterior face height is increased then the mandible will appear to be more retrognathic and vice - versa www.indiandentalacademy.com
  21. 21. www.indiandentalacademy.com
  22. 22. Mandibular Plane Angle : Angle between FH plane and the Mandibular plane ( Gonion – Menton ) 220 + 40 www.indiandentalacademy.com
  23. 23. Facial Axis Angle : Angle between a line from basion to nasion and the facial axis i.e. PTM to Gn 900 < 900 – ( -ve value ) excessive vertical development > 900 – ( +ve value ) deficient vertical development www.indiandentalacademy.com
  24. 24. Relating Mandible To The Cranial Base Distance from Pog to the nasion Perpendicular www.indiandentalacademy.com
  25. 25. - 8 mm to – 6 mm - 4 mm to 0 mm www.indiandentalacademy.com - 2 mm to 2 mm
  26. 26. Mandibular Skeletal Mandibular Prognathism Retrusion www.indiandentalacademy.com
  27. 27. Dentition : In cases of malrelationship between the maxillary and mandibular skeletal structures, errors may result if the position of the upper incisor is determined by any measurement that uses mandible as a reference point e.g. A – pogonion line A measurement of upper incisor to the N – A line is valid only if the maxilla is in neutral position anteroposteriorly relative to the cranial base www.indiandentalacademy.com
  28. 28. N A www.indiandentalacademy.com
  29. 29. Relating upper Incisor to Maxilla : Anteroposterior position Position of the upper incisor can be located by using measurement that relate dental portion of maxilla to the skeletal portion Line parallel to nasion perpendicular through point A Distance from point A er To the facial surface of upper incisor is measured www.indiandentalacademy.com
  30. 30. Vertical position : The incisal edge of the upper incisor lies 2 – 3 mm below the upper lip at rest Vertical position of the upper lip is best determined at the time of clinical examination www.indiandentalacademy.com
  31. 31. Relating Lower Incisor To Mandible : Anteroposterior position : Measurement of the facial surface of the lower incisor to the A – Pog line Normal : 1 mm to 3 mm anterior A Pog www.indiandentalacademy.com
  32. 32. If there is a discrepancy in Anteroposterior or vertical positioning of the maxilla and the mandible then modifications in this measurement procedure is necessary To predict Anteroposterior position of the incisor after functional or surgical intervention www.indiandentalacademy.com
  33. 33. A second tracing of the mandible and the incisor is made The tracing is moved so that the mandible is in the desired position relative to the maxilla A new A – Pog line is drawn The incisor is expected to lie 1 – 2 mm anterior to the constructed line www.indiandentalacademy.com
  34. 34. Estimate the number of mm that the mandible will be brought forward relative to the maxilla at the end of the treatment Then a new point A is constructed the same number of mm in the opposite direction Post treatment A – Pog line www.indiandentalacademy.com
  35. 35. Vertical Position Of The Lower Incisor : Relating the lower incisor tip to the functional occlusal plane Evaluated on the basis of existing lower anterior facial height Excessive Curve of Spee… LAFH is normal or excess – Intruded LAFH is inadequate – Eruption of the Molars www.indiandentalacademy.com
  36. 36. Airway : Upper pharynx Width is measured from a point on the posterior outline of the soft palate to the closest point on the posterior pharyngeal wall Average : 15 - 20 mm www.indiandentalacademy.com
  37. 37. 2 mm www.indiandentalacademy.com
  38. 38. Airway : Lower pharynx Width is measured from intersection of the posterior border of tongue and the inferior border of the mandible to the closest point on the posterior pharyngeal wall Average : 10 – 12 mm www.indiandentalacademy.com
  39. 39. www.indiandentalacademy.com
  40. 40. Advantages : Linear measurements rather than angles Provides guidelines with respect to normally occurring growth increments The method is more sensitive to the vertical changes Easily explained to non specialist and lay persons such as patients and parents www.indiandentalacademy.com
  41. 41. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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