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INDIAN DENTAL ACADEMY
Leader in continuing dental education
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1899 – Edward Angle – Classification of Malocclusion
1915 – Van Loon – developed a method for 3D registration of face
and ...
Reserve
Craniostat

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The Bolton Room in the
Anatomical Laboratory of
the Medical School at
Western Reserve
University, Cleveland.

www.indiande...
Cephalometric Equipment
 Cephalostat or head holder
 X-ray source
 Cassette holder
 Cassette
www.indiandentalacademy.c...
Two types of cephalostats

Broadbent – Bolton method

Higley method

Specifications:
Distance from the midsagittal plane o...
Natural Head Position
NHP is a standardized and reproducible orientation of
the head in space when one is focusing on a di...
‘Discrepancies between cephalometric facial typing and
photographic facial typing disappear when a correction is
made for ...
www.indiandentalacademy.com
‘Intracranial landmarks are not stable points in the
cranium, their vertical relationship to each other is
therefore also ...
Definition of terminology
Anthropometry – Measurement of dimensions of the human body
and it’s parts.
Craniometry – Branch...
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DOWN'S ANALYSIS

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Mean Reading : 87.5o

Range : 82o – 95o

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Mean Reading : 0o

Range : -8.5o – 10o

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Mean Reading : -4.6o

Range : 0o – - 9o

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Mean Reading : 21.9o

Range : 17o – 28o
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Mean Reading : 59.4o

Range : 53o – 66o

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Mean Reading : 9.3o

Range : 1.5o – 1.4o

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Mean reading : 135.4o

Range : 130o – 150o

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Mean reading : 1.4o

Range : -8.5o – 7o

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Wriggle

Vorhies and Adams (1951)

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STEINER’ S ANALYSIS

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STEINER’S ANALYSIS
SKELETAL ANALYSIS
DENTAL ANALYSIS

SOFT TISSUE ANALYSIS

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Mean reading : 82o

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Mean reading : 80o

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ANB
Mean reading : 2o

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Mean reading : 14o

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Mean reading : 32o

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Mean reading : 130o

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WITS ‘APPRAISAL ’
ANALYSIS

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RIEDEL - 1952
ANB

University of Witwatersrand
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Anteroposterior relationship of the jaws relative to cranium

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Rotational effect of the jaws relative to the anterior cranial base

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SHORTCOMINGS OF ANB
‘Use of the apical base should be replaced
JENKINS – 1955
by a better method to determine sagittal
TAY...
“ Measurements from the cranial base,
however, do not provide a reliable
expression of anteroposterior jaw
relationship in...
Is the ANB angle a reliable
indicator of jaw discrepancy
or not?
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McNAMARA ANALYSIS

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McNamara (1984)
•

Lateral cephalogram of children comprising of
the Bolton’s Standards
•

Selected values from a group of...
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Craniofacial skeleton has been divided into five sections

 Maxilla to cranial base
 Maxilla to mandible
 Mandible to c...
Maxilla to cranial base

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Nasiolabial angle : 102o + 8o

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Cant of the Upper lip :
Women : 14o + 8o
Men

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: 8o + 8 o
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Maxilla to mandible

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Maxillomandibular differential = Midfacial length – Effective
mandibular length

Co

A

Gn
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Ideal maxillomandibular differential

Small

-

20mm

Medium

-

25 – 27mm

Large

-

30 – 33mm

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Mandible to cranial base

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Mixed Dentition = 6-8mm behind nasion
perpendicular
Adult woman = 4-0mm behind nasion
perpendicular
Adult men = 2mm behind...
Dentition

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1-3mm

4-6mm
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Airway Analysis

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COGS ANALYSIS

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COGS – Cephalometrics for Orthognathic Surgery
Charles J. Burstone – 1978

University of Connecticut
www.indiandentalacade...
COGS
 Chosen landmarks and measurements can
be altered by various surgical procedures.
 The appraisal includes all facia...
 Critical facial components can be
examined.
 Standards and statistics are available for
variations in age and sex from ...
H-P line

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Cranial Base

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Horizontal Measurements

N-A-Pg
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Vertical Measurements

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Maxilla and Mandible

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Dental Measurements

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TWEED’ S ANALYSIS

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HARVOLD ANALYSIS

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SASSOUNI’ S ANALYSIS
(1969)

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JARABAK ANALYSIS

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Why do we have to think about
Computer aided Cephalometrics
Computers & Cephalometrics
Videocephalometry?

www.indiandenta...
Conclusions:
• Cephalometric analyses are merely aids in helping
the clinician arrive at a diagnosis and treatment
plannin...
• Variation in biology is a rule, therefore a normal
value is never a point so a mean is to be always
considered.
• Serial...
• We should strive to develop cephalometric norms
and values pertaining to an Indian background instead
of using those mea...
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Hard tissue cephalometry /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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Hard tissue cephalometry /certified fixed orthodontic courses by Indian dental academy

  1. 1. www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. 1899 – Edward Angle – Classification of Malocclusion 1915 – Van Loon – developed a method for 3D registration of face and dentition – Cubus Craniophorus 1922 – Simon – modified Van Loon’s inventon by using a face bow. 1922 – Pacini – Paved the way for standardized head radiography 1931 – Hofrath in Germany and Broadbent in United States – published their works in the ‘ Forschritte der Orthodontie’ and the Angle Orthodontist respectively. 1939 – Lucien de Coster – published his work on proportional relationships of the face.www.indiandentalacademy.com
  4. 4. Reserve Craniostat www.indiandentalacademy.com
  5. 5. www.indiandentalacademy.com
  6. 6. www.indiandentalacademy.com
  7. 7. www.indiandentalacademy.com
  8. 8. www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10. The Bolton Room in the Anatomical Laboratory of the Medical School at Western Reserve University, Cleveland. www.indiandentalacademy.com
  11. 11. Cephalometric Equipment  Cephalostat or head holder  X-ray source  Cassette holder  Cassette www.indiandentalacademy.com
  12. 12. Two types of cephalostats Broadbent – Bolton method Higley method Specifications: Distance from the midsagittal plane of the subject’s head to the X-ray tube = 60” (5ft) Distance from the midsagittal plane of the subject’s head to the film = 7” American convention – subject’s left side to the film European convention – subject’s right side to the film www.indiandentalacademy.com
  13. 13. Natural Head Position NHP is a standardized and reproducible orientation of the head in space when one is focusing on a distant point at eye level. 1884 – German Anthropological Society – Frankfort Agreement 1956 – William Downs – discrepancies in cephalometric facial typing and photographic facial typing – Analysis of dentofacial profile www.indiandentalacademy.com
  14. 14. ‘Discrepancies between cephalometric facial typing and photographic facial typing disappear when a correction is made for those persons who do not have a level frankfort plane.’ William Downs(1956) www.indiandentalacademy.com
  15. 15. www.indiandentalacademy.com
  16. 16. ‘Intracranial landmarks are not stable points in the cranium, their vertical relationship to each other is therefore also subject to biologic variation.’ Bjerin (1957) www.indiandentalacademy.com
  17. 17. Definition of terminology Anthropometry – Measurement of dimensions of the human body and it’s parts. Craniometry – Branch of anthropometry dealing with measurements of dimensions and angles of bony skull. Cephalometry – Scientific measurement of dimensions of the ‘living’ head. Cephalometric analysis – Process of evaluating the skeletal, dental, and soft tissue relationships of a patient by comparing measurements performed on the patient’s cephalometric tracing with population norms for respective measurements, to come to a diagnosis of the patient’s orthodontic problem. www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19. DOWN'S ANALYSIS www.indiandentalacademy.com
  20. 20. Mean Reading : 87.5o Range : 82o – 95o www.indiandentalacademy.com
  21. 21. Mean Reading : 0o Range : -8.5o – 10o www.indiandentalacademy.com
  22. 22. Mean Reading : -4.6o Range : 0o – - 9o www.indiandentalacademy.com
  23. 23. Mean Reading : 21.9o Range : 17o – 28o www.indiandentalacademy.com
  24. 24. Mean Reading : 59.4o Range : 53o – 66o www.indiandentalacademy.com
  25. 25. Mean Reading : 9.3o Range : 1.5o – 1.4o www.indiandentalacademy.com
  26. 26. Mean reading : 135.4o Range : 130o – 150o www.indiandentalacademy.com
  27. 27. Mean reading : 1.4o Range : -8.5o – 7o www.indiandentalacademy.com
  28. 28. Wriggle Vorhies and Adams (1951) www.indiandentalacademy.com
  29. 29. STEINER’ S ANALYSIS www.indiandentalacademy.com
  30. 30. STEINER’S ANALYSIS SKELETAL ANALYSIS DENTAL ANALYSIS SOFT TISSUE ANALYSIS www.indiandentalacademy.com
  31. 31. www.indiandentalacademy.com
  32. 32. Mean reading : 82o www.indiandentalacademy.com
  33. 33. Mean reading : 80o www.indiandentalacademy.com
  34. 34. ANB Mean reading : 2o www.indiandentalacademy.com
  35. 35. Mean reading : 14o www.indiandentalacademy.com
  36. 36. Mean reading : 32o www.indiandentalacademy.com
  37. 37. www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com
  39. 39. Mean reading : 130o www.indiandentalacademy.com
  40. 40. www.indiandentalacademy.com
  41. 41. WITS ‘APPRAISAL ’ ANALYSIS www.indiandentalacademy.com
  42. 42. RIEDEL - 1952 ANB University of Witwatersrand www.indiandentalacademy.com
  43. 43. Anteroposterior relationship of the jaws relative to cranium www.indiandentalacademy.com
  44. 44. Rotational effect of the jaws relative to the anterior cranial base www.indiandentalacademy.com
  45. 45. www.indiandentalacademy.com
  46. 46. www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com
  48. 48. www.indiandentalacademy.com
  49. 49. SHORTCOMINGS OF ANB ‘Use of the apical base should be replaced JENKINS – 1955 by a better method to determine sagittal TAYLOR – WITS apical base difference. The1969 appraisal could be used a possible BEATTY – 1975 alternative.’ JARVINEN – 1985 (1985) JARVINEN www.indiandentalacademy.com
  50. 50. “ Measurements from the cranial base, however, do not provide a reliable expression of anteroposterior jaw relationship in the dentofacial complex.” Jacobson www.indiandentalacademy.com
  51. 51. Is the ANB angle a reliable indicator of jaw discrepancy or not? www.indiandentalacademy.com
  52. 52. www.indiandentalacademy.com
  53. 53. McNAMARA ANALYSIS www.indiandentalacademy.com
  54. 54. McNamara (1984) • Lateral cephalogram of children comprising of the Bolton’s Standards • Selected values from a group of untreated children from Burlington research center. • Sample of young adults from Ann Arbor having excellent dental and facial pattern. www.indiandentalacademy.com
  55. 55. www.indiandentalacademy.com
  56. 56. Craniofacial skeleton has been divided into five sections  Maxilla to cranial base  Maxilla to mandible  Mandible to cranial base  Dentition  Airway www.indiandentalacademy.com
  57. 57. Maxilla to cranial base www.indiandentalacademy.com
  58. 58. Nasiolabial angle : 102o + 8o www.indiandentalacademy.com
  59. 59. Cant of the Upper lip : Women : 14o + 8o Men www.indiandentalacademy.com : 8o + 8 o
  60. 60. www.indiandentalacademy.com
  61. 61. Maxilla to mandible www.indiandentalacademy.com
  62. 62. Maxillomandibular differential = Midfacial length – Effective mandibular length Co A Gn www.indiandentalacademy.com
  63. 63. Ideal maxillomandibular differential Small - 20mm Medium - 25 – 27mm Large - 30 – 33mm www.indiandentalacademy.com
  64. 64. www.indiandentalacademy.com
  65. 65. www.indiandentalacademy.com
  66. 66. www.indiandentalacademy.com
  67. 67. Mandible to cranial base www.indiandentalacademy.com
  68. 68. Mixed Dentition = 6-8mm behind nasion perpendicular Adult woman = 4-0mm behind nasion perpendicular Adult men = 2mm behind to 2mm ahead of nasion perpendicular www.indiandentalacademy.com
  69. 69. Dentition www.indiandentalacademy.com
  70. 70. 1-3mm 4-6mm www.indiandentalacademy.com
  71. 71. Airway Analysis www.indiandentalacademy.com
  72. 72. COGS ANALYSIS www.indiandentalacademy.com
  73. 73. COGS – Cephalometrics for Orthognathic Surgery Charles J. Burstone – 1978 University of Connecticut www.indiandentalacademy.com
  74. 74. COGS  Chosen landmarks and measurements can be altered by various surgical procedures.  The appraisal includes all facial bones and a cranial base reference.  Rectilinear measurements can be readily transferred to a study cast for mock surgery. www.indiandentalacademy.com
  75. 75.  Critical facial components can be examined.  Standards and statistics are available for variations in age and sex from 5 to 20  Consists of a series of measurements that can be computerised. www.indiandentalacademy.com
  76. 76. H-P line www.indiandentalacademy.com
  77. 77. Cranial Base www.indiandentalacademy.com
  78. 78. Horizontal Measurements N-A-Pg www.indiandentalacademy.com
  79. 79. Vertical Measurements www.indiandentalacademy.com
  80. 80. Maxilla and Mandible www.indiandentalacademy.com
  81. 81. Dental Measurements www.indiandentalacademy.com
  82. 82. www.indiandentalacademy.com
  83. 83. TWEED’ S ANALYSIS www.indiandentalacademy.com
  84. 84. www.indiandentalacademy.com
  85. 85. HARVOLD ANALYSIS www.indiandentalacademy.com
  86. 86. www.indiandentalacademy.com
  87. 87. SASSOUNI’ S ANALYSIS (1969) www.indiandentalacademy.com
  88. 88. www.indiandentalacademy.com
  89. 89. JARABAK ANALYSIS www.indiandentalacademy.com
  90. 90. www.indiandentalacademy.com
  91. 91. Why do we have to think about Computer aided Cephalometrics Computers & Cephalometrics Videocephalometry? www.indiandentalacademy.com
  92. 92. Conclusions: • Cephalometric analyses are merely aids in helping the clinician arrive at a diagnosis and treatment planning. • All anteroposterior skeletal discrepancies cannot be corrected to an ideal jaw relationship. • Cephalometric measurements are not to be regarded as final points or values and it is not necessary that values should exactly tally. www.indiandentalacademy.com
  93. 93. • Variation in biology is a rule, therefore a normal value is never a point so a mean is to be always considered. • Serial cephalograms taken during course of treatment helps us to ascertain whether our treatment goals are achieved. • The Wits appraisal is a linear measurement and not an analysis per se. It is simply an adjunctive diagnostic aid that may prove useful in assessing the extent of anteroposterior skeletal dysplasia and in determining the reliability of ANB angle. www.indiandentalacademy.com
  94. 94. • We should strive to develop cephalometric norms and values pertaining to an Indian background instead of using those meant for Caucasian norms. www.indiandentalacademy.com

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