Cephalometric super /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

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Cephalometric super /certified fixed orthodontic courses by Indian dental academy

  1. 1. CEPHALOMETRIC SUPER IMPOSITION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. A CEPHALOMETRIC SUPERIMPOSITION IS AN ANALYSIS CEPHALOGRAMS OF THE SAME PATIENT TAKEN AT DIFFERENT TIMES CEPHALOMETRIC SUPER IMPOSITIONS INVOLVE THE EVALUATION OF:  Changes in the overall face  Changes in the maxilla and its dentition  Changes in the mandible and its dentition  Amount and direction of condylar growth  Mandibular rotation www.indiandentalacademy.com OF LATERAL
  3. 3. TO PERFORM ACCURATE SUPER IMPOSITION Consecutive cepholograms should be taken under identical condition of magnification head position, and radiological exposure  The tracing of the superimpositions must be accurate It is of great importance that exactly the same structures and their corresponding radiographic shadows be traced in the consecutive cepholograms One should have the thorough knowledge of anatomy of dentofacial & cranial structures as well as radiographic interpretation They have to be registered on stable reference areas in the face. www.indiandentalacademy.com
  4. 4. SUPERIMPOSITION OF THE MAXILLA Evaluates 1. Movement of maxillary teeth 2. Rotation of maxilla  Two method for superimposing the maxillary structutres are recommended- the structural method and a modified best fit method. Structural Method : - Suggested by Bjork & Skieller in 1976. is recommended if the details of the zygomatic process of the maxilla are clearly identified in both cephalograms. Modified best fit method : - If the details of zygomatic process of maxilla are not identified in both cephalograms. www.indiandentalacademy.com
  5. 5. Structural method of superimposition of maxilla Pre treatment Tracing Post treatment Tracing Super imposition of pre & post treatment tracing On each cephologram, trace the contours of palate, maxillary 1st molar, central incisors, zygomatic process of maxilla, floor of the orbit NS line and the construction line. www.indiandentalacademy.com
  6. 6. Modified best fit method Pre treatment Tracing Progress treatment tracing Super imposition of pre & progress treatment tracing On each cephologram trace the outline of the palate 1st permanent molars and central incisors. Following structures are in a best fit alignment. Contour of the oral part of the palate Contour of the nasal www.indiandentalacademy.com floor
  7. 7. MANDIBULAR SUPERIMPOSITIONS Evaluates Movement of the mandibular teeth Mandibular rotation Amount & direction of condylar growth Stable structures for superimposition on the mandible:- According to Bjork and Skieller (1983).  The anterior contour of the chin (area 1)  The inner contour of the cortical plates at the inferior border of the symphysis. (area 2)  Posteriorly, the contours of the mandibular canal (area 3)  Lower contour of a mineralized molar germ. (area 4) before www.indiandentalacademy.com root formation.
  8. 8. Step – by – step approach for mandibular superimpositions Pre treatment Tracing Progress treatment tracing Super imposition of pre & progress treatment tracing On each cephologram trace the following  The symphysis with inner cortical bone  The inferior and posterior contour of the mandible  The anterior contour of the ramus  The most labially positioned lower incisor, and  The first molar. www.indiandentalacademy.com
  9. 9. Evaluation of the overall changes in the face Nelson’s (1960) and Melsen (1974) identified certain stable structures for superimposition. 1. 2. 3. 4. 5. The anterior wall of sella turcica; The contour of the cribiform plate of the ethmoid bone (lamina cribrosa); Details in the trabecular system in the ethmoid cells; The median border of the orbital roof; and The plane of the sphenoid bone (planum sphenoidale) www.indiandentalacademy.com
  10. 10. What can we learn from cranial base superimpositions ? 1. Cranial base superimpositions provide an over all assessment of the growth and treatment changes of the facial structures. 2. Amount and direction of maxillary and mandibular growth or displacement 3. Changes in maxillary – mandibular relationships 4. Relative changes in the soft tissue (specifically the nose, lips, and chin) 5. Information on the overall displacement of the teeth. www.indiandentalacademy.com
  11. 11. RICKETTS SUPER IMPOSITION TECHNIQUE It is one of the most important superimposition technique used. Ricketts super imposition is used to differentiate the changes in normal growth and those due to treatment mechanics. This techniques involves five super imposition areas to evaluate 1. The chin 2. The maxilla 3. The teeth in the mandible 4. The teeth in the maxilla 5. The facial profile www.indiandentalacademy.com
  12. 12. Superimposition area 1 (Basion – Nasion at CC point (Evaluation area 1) Evaluates:- growth of the chin Position of upper molar In normal growth chin grows down the facial axis at 2.8mm per year Mean change = 0o SD 3.3o/year www.indiandentalacademy.com
  13. 13. Super imposition area 2 (Basion – Nasion at Nasion) Evaluation area 2 Skeletal behaviour of maxilla In normal growth:- Basion Nasion point A angle does not change Maxilla drops in a parallel fashion with Evaluates:- Any change in position point A straight down Nasion A line. Maxilla Mean change = 0o SD 2o/year www.indiandentalacademy.com
  14. 14. Super imposition area 3 (Corpus axis at PM) Evaluation area 3 & 4 Relation of mandibular teeth to mandible Evaluates:- Position of lower central incisors & lower molar www.indiandentalacademy.com
  15. 15. Super imposition area 4 (Palate at ANS) Evaluation area 5 & 6 Relation of maxillary teeth to maxilla Evaluates:- Any changes in the upper central incisors and upper molars www.indiandentalacademy.com
  16. 16. Super imposition area 5 (Esthetic plane at the crossing of the occlusal plane) Evaluation area 7 Evaluate the soft tissue profile www.indiandentalacademy.com
  17. 17. Other Super Imposition Methods to Evaluate over all changes in the face The broadbent triangle (Na-S-Bo) and its registration point R were among the first structures used for superimpositions to determine overall changes Sella – nasion line Broadbent triangle (Na-S-Bo) In this method two tracings on the Sella – nasion line with registration at sella www.indiandentalacademy.com
  18. 18. CONCLUSION Rickett’s, Down’s & Cephalometric superimposition are a valuable tool in treatment planning. These analysis help in orthodontic diagnosis by enabling the study of skeletal, dental and soft tissue structures of the cranio facial region. These analysis also classify the skeletal and dental abnormalities and establish the facial type. www.indiandentalacademy.com
  19. 19. BIBLIOGRAPHY Orthodontic cephalometry - By E. Athanasiou Radiographic cephalometry - By Alexander Jacobson Contemporary orthodontics - By R. Proffitt American journal of orthodontics, 1960 May (Ricketts) www.indiandentalacademy.com
  20. 20. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com