Smile analysis from the orthodontic perspective.
Major determinants of smile esthetics are discussed based on the discussions of the Proffit and Graber
Smile analysis from the orthodontic perspective.
Major determinants of smile esthetics are discussed based on the discussions of the Proffit and Graber
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.for more details please visit
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This cephalometric analysis gives an idea about the planes ,facial types, arch and axis this slide includes Introduction
Planes,Classification of facial types,Archs,Axis,Dental axis
Conclusion,Ceph tracing
Description :
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.for more details please visit
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Ricketts analysis /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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.
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COGS analysis (Cephelometrics for orthognathic surgery) / fixed orthodontics ...Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.
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.for more details please visit
www.indiandentalacademy.com
This cephalometric analysis gives an idea about the planes ,facial types, arch and axis this slide includes Introduction
Planes,Classification of facial types,Archs,Axis,Dental axis
Conclusion,Ceph tracing
Description :
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.for more details please visit
www.indiandentalacademy.com
Ricketts analysis /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
0091-9248678078
COGS analysis (Cephelometrics for orthognathic surgery) / fixed orthodontics ...Indian dental academy
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.
This seminar includes various cephelograms and various hard tissue analyses by diffreent authors followed by differences in various ethnicities and pediatric implications
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
Cephalometrics (3) /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
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
0091-9248678078
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.for more details please visit
www.indiandentalacademy.com
Cephalometrics & x ray generation principles/orthodontic courses by indian de...Indian dental academy
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
2. CONTENTS
• Introduction –defination
• Why cephalometrics
• History of cephalometrics
• Radiographic techniques used in cephalometrics
Lateral cephalometrics
Posterioanterior cephalometrics
• Tracing technique
• Cephalometric landmarks
• Cephalometric planes
• Cephalometric analysis
• Errors in cephalometric measurement
• Methods of controlling error in cephalometric
• Advances in cephalometrics
• Conclusion
3. 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.
RADIOGRAPHIC CEPHALOMETRY- ALEXANDER JACOBSON
4. 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.
5. 5
WHY CEPHALOMETRICS ?
• Growth and development
• Diagnosis
• Treatment planning
• Prognosis
• Record of patient
• Craniofacial abnormalities
• Facial types
• Soft tissue morphology
• Symmetry of face
6. HISTORY OF CEPHALOMETRIC
RADIOGRAPHY
• In 1895, Prof. Wilhelm Conrad Roentgen made a
remarkable contribution to science with the
discovery of x-rays.
• Prof. Wilhem Koening & Dr. Otto Walkhoff
simultaneously made the first dental radiograph in
1896
• Van Loon;
- First to introduce Cephalometrics to orthodontics.
- He applied anthropometric procedures in analyzing
facial growth by making plaster casts of face in to
which he inserted oriented casts of the dentition.
7. • Hellman (1920s) used cephalometric techniques and described their
value.
• A.J.Pacini (1922) The first x- ray pictures of skull in the standard
lateral view were taken
• Pacini;
Introduced a teleroentgenographic technique for standardized
lateral head radiography which proved to be of tremendous use in
cephalometry, as well as in measuring growth and dev of face.
• Atkinson (1922) advocated in locating and the soft tissue relations to
the face and the jaws.
8. • In 1923 Mc Cowen -visualize the relationship between the hard and
soft tissues and to note changes in profile which occur during
treatment.
• In 1931 cephalometric radiography came to full function when B.
Holly Broadbent in USA published methods to obtain standardized
head radiographs in the Angle Orthodontist (A new X ray tech & its
application to orthodontia).
9. • The diagnosing dental deformities by means of planes &
angles was first proposed in 1922 by Paul Simon in his
book, “Fundamental Principles of a Systematic Diagnosis
of Dental Anomalies”.
11. THE CEPHALOSTAT
Ear rod
forehead clamp
1. Ear rod
2. Forehead clamp
3. Cassette holder
4. Film cassette with intensifying screens
Cassette
holder
Radiographic cephalometry- Alexander Jacobson
12. Cephalostat
• 2 Types
- Broadbent-Bolton method
- Higley method
Used in most modern cephalostats.
=
13. X-Ray Source position
• It is positioned 5 feet(152.4cm) from the subject’s
midsagittal plane.
Film position
To minimize variations in magnification from patient to
patient & to obtain consistent measurements on the patient
over time, a distance of 15cm is often used.
Radiographic cephalometry- Alexander Jacobson
15. Factor affecting cephalometric radiographic
• Patient positioned with cephalostat using –
bilateral ear rods (placed at auditory meatus)
• Pt is in standing position
• Mid sagittal plane is vertical – perpendicular
to xray beam
- parallel to film plane
• Frankfort plane parallel to floor
• To penetrate the bony structures of the skull
setting below 70Kvp should not be used
16. PATIENT POSITIONING;
• 8*10 inch film cassette equipped with the appropriate film
and intensifying screens placed horizontally or vertically in
cassette holder.
• Patient placed within the ear rods of cephalostat exerting
moderate pressure on external auditory meatus.
• Patient Frankfort plane parallel to floor
• Locking nasal positioner against bridge of nose
• Film cassette moved 15cm away from midsagittal plane
• Xray beam enter and exit the pt near horizontal axis of
auditory meatus
LATERAL CEPHALOGRAM
Radiographic cephalometry- Alexander Jacobson
17. • Once patient positioned properly, pt instructed to close to centric and
swallow
• Holding body of tongue in posterior area of soft palate
18. PATIENT POSITIONING;
PA CEPHALOMETRIC
RADIOGRAPH
Radiographic cephalometry- Alexander Jacobson
• 8*10 film cassette placed vertically with cassette
holder component of cephalostat
• Bilateral ear rods rotated 90 degree
• Pt facing the film
• Mid coronal plane perpendicular to x-ray beam of pt
and parallel to film plane
• Nasal positioner placed on bridge of nose
• The central ray should enter the posterior part of skull
in occipital region and exit at most anterior and inferior
aspect of nasal bow
19. Shortcomings of the
Frankfurt horizontal plane
• Some individuals show a variation of their FH plane
to the true horizontal to an extent of 10°.
Am J Phys. Anthropol. 16: 1956
• An alternative to overcome this was to use a functionally derived
NHP(natural head position), according to Morrees & Kean.
• It was obtained by the patient standing up & looking directly into the
reflection of his/her eyes in a mirror directly ahead in the middle of
the cephalostat.
• To record the NHP ,the ear rods are not used for locking the patient
head into a fixed position but serve to place the midsagittal plane at a
fixed distance from the film plane.
21. Tracing supplies and equipments
• A lateral cephalogram
• Acetate matte tracing paper(.003 inches thick, 8×10
inches)
• A sharp 3H drawing pencil or a very fine tipped pen
• Masking tape
Radiographic cephalometry- Alexander Jacobson
• A tooth symbol tracing template for drawing the teeth. Also
templates for tracing the outlines of ear rods.
• Dental casts trimmed to maximum intercuspation of the teeth in
occlusion.
• Viewbox (variable rheostat desirable but not essential).
• Pencil sharpener and a eraser.
22. Tracing of a Cephalogram
• Thorough familiarity with the gross anatomy is required before the
tracing.
• By convention the bilateral structures (eg, the rami and inferior
borders of the mandible) are first traced independently. An average is
then drawn by visual approximation, which is represented by a broken
line.
Radiographic cephalometry- Alexander Jacobson
24. General considerations for the tracing
• Start by placing the cephalogram on the viewbox with the
patient’s image facing towards the right.
• Tape the four corners of the radiograph to the viewbox.
• Draw three crosses on the radiographs, two within the
cranium and one over the area of the cervical vertebrae
(registration crosses).
Radiographic cephalometry- Alexander Jacobson
26. • Place the matte acetate film over the radiograph and tape it
securely.
• After firmly affixing the acetate film, trace the three
registration crosses.
• Print the pt name, record number, age in years and months,
the date on which the cephalogram was taken and your
name on the bottom left corner of the acetate film.
• Begin tracing using smooth continuous pressure.
Radiographic cephalometry- Alexander Jacobson
27. Stepwise tracing technique
1. Tracing the soft tissue profile, external
cranium and the vertebrae,
2. Tracing the cranial base, internal
border of the cranium, frontal sinus
and the ear rods,
3. Maxilla and related structures
including the nasal bone and
pterygomaxillary fissure,
4. The mandible.
Radiographic cephalometry- Alexander Jacobson
29. A landmark is a point which serves as a guide for measurement or
construction of planes. They are divided into two types:
1. Anatomic: These represent actual anatomic structure of the skull.
1. Constructed: These have been constructed or obtained secondarily
from anatomic structures in the cephalogram.
Radiographic cephalometry- Alexander Jacobson
30. Unilateral landmarks
• Nasion (N)
• Sella (S)
• Point A (subspinale)
• Prosthion
• Infradentale
Anterior nasal
spine(ANS)
Posterior nasal spine (PNS)
Point B (Supramentale)
Pogonion (Pog)
Gnathion
Menton (Me)
Basion (Ba)
• Orbitale Articulare(Ar)
• Gonion Pterygomaxillary fissure (Pt)
• Condylion Porion(Po)
Bilateral landmarks
31. • Nasion
The most anterior point
midway between frontal and nasal
bones on fronto-nasal suture.
40. • Gonion (Go)
It is the lowest posterior and most out
ward point on the angle of the mandible.
41. • Pogonion (Pog)
The most anterior prominent point
on the chin in the median plane.
42. • Gnathion (Gn)
It is the most anterior and
inferior point of the bodychin.
43. • Menton
It is the most inferior midline point on the
mandibular symphysis
44. • Infradentale (Id)
The highest inter dental point
on the alveolar mucosa between the
mandibular central incisors.
(Highest and most anterior point).
45. • Point B –
It is the most posterior midline
point in the concavity of the
mandible between the most
superior point on the alveolar
bone
46. • Subnasale (Sn)
A skin point, the point
at which the nasal septum
merges inferiorly with the
upper lip.
47. • Point A
Deepest point on
the midline contour of
the alveolar process
between the anterior
nasal spine and
prosthion.
48. • Prosthion (Pr)
The lowest interdental point
on the alveolar mucosa in the
median plane between the
maxillary central incisor.
49. Cephalometric planes
Are derived from at least 2 or 3 landmarks and are used
for measurements, separation of anatomic divisions, definition
of anatomic structures of relating parts of the face to one
another. The various cephalometric planes used are:
50. • Frankfurt Horizontal plane: This
plane is drawn from Porion to
Orbitale
(The name is given in the conference
of anthropology,held at Frankfurt
in1885)
Horizontal planes
51. • Sella-Nasion plane: It
represents the anterior
cranial base.
• Can be accurately
located on the
radiographs.
52. • Basion-Nasion plane: This plane is
from basion to nasion point
• Palatal plane: plane passing through
the ANS and the PNS.
• Occlusion plane: It is the plane
passing through the cusp tips of the
upper and lower first molars and a
point bisecting the overbite.
53. • Mandibular plane: Different definitions
are given in different analysis
1.Downs analysis – it extends from Gonion
to Menton.
2.Steiner’s anlysis – it extends from
Gonion to Gnathion.
3.Tweed’s analysis- tangent to lower
border of mandible
Go
Me
Gn
54. Vertical Planes
• Facial plane : It extends from
nasion to pogonion.
• Y-axis : It is the line joining
sella to gnathion.
• Ramal plane : It is drawn
tangent to the posterior border
of the ramus and the condyles.
S N
Gn
Pog
56. Principle of Cephalometric analysis
• The goal is to compare the patient with a normal reference group, so
that differences between the patient’s actual dentofacial relationships
and those expected for his/her racial or ethnic groups are revealed.
• First popularized after world war-II in the form of Down’s analysis.
58. Developed in 1948
Consists of 10 parameters --- 5 skeletal & 5 dental
FH plane is used as the reference plane.
- It was based on the study of 20 white subjects who had good occlusion
and proportional facial skeleton.
- This analysis indicates whether the dysplasia is in the facial skeleton or in
the dentition or both.
DOWN’S ANALYSIS
59. When observing facial profiles,W B Downs noted that generally the position
of the mandible could be used in determining whether or not faces were
balanced.
Downs reduced his observations to the following four basic facial types:
62. Down’s analysis consist of 10 parameters-
5 SKELETAL
- Facial angle
- Angle of convexity
- A-B Plane angle
- Mandibular Plane angle
- Y-Axis
5 DENTAL
- Cant of occlusal Plane
- Interincisal Angle
- Incisor occlusal plane angle
- Incisor mandibular Plane angle
- Upper incisor to A – POG line
63. Facial Angle
FH plane(po-o) – facial Plane (n-pog)
Used to measure degree of protrusion or retrusion of the lower
jaw
Average value – 87.8 degree
Range – 82-95 degree
Indicate anterio-posterior positioning of mandible in relation to
upper face.
Increased angle in case of class III malocclusion
Decreased in case of class II malocclusion
N
Po O
Pog
64. Angle of Convexity
N-A and A-POG
Reveals convexity of skeletal profile
Average value – 0 degree
Range – 8.5 to 10 degree
Increased angle in case of class II malocclusion
Decreased or negative angle in case of class III malocclusion
65. A-B Plane Angle
A-B and N-POG
Average value – 4.6 degree
Range – 9 to 0 Degree
Indicate maxillo-mandibular relationship in relation to
facial plane .
Negative angle- class II
Positive angle class III or class I prominence with
mandible
66. Mandibular plane
The mandibular plane acc to downs tangent to gonial
angle and lowest point of symphysis.
Relating FH plane and mandibular plane
Average value – 21.9 degree
Range - 17-28 degree
Indicate growth pattern
Increased angle – Vertical growth
Decreases angle - Horizontal growth
67. Y(growth) axis
Intersection of sella- gnathion with FH plane
Average value – 59.4 degree
Range – 53-66 degree
Increased angle – vertical growth of mandible
Decreases angle - horizontal growth
68. Cant of occlusal plane
Measure Angle between occlusal plane and FH plane
Average value – 9.3 degree
Range – 1.5-14 degree
larger +ve angle – class II maloclussion
long rami tends to decrease this angle
69. Inter incisal Angle
Line intersecting long axis of maxillary and mandibular CI.
Average value – 135.4 degree
Range – 130-150.5 degree
Increased angle – class II div II
Decreases angle – class II div I
70. Incisor occlusal plane angle
Line intersecting long axis of mandibular CI and
occlusion plane .
Average value – 14.5 degree
Range – 3.5 to 20 degree
Positive angle increases as teeth incline forward,
teeth become proclined
Values are least in class 2 div 2 when incisors are
retroclined
71. Incisor mandibular plane angle
Line intersecting long axis of mandibular CI and
mandibular plane .
Average value – 1.4 degree
Range – 8.5 to 7 degree
Increased angle – lower incisor proclination
72. Upper incisor to POG Line/protusion of maxillary
incisors
Linear measurement between incisal edge of maxillary CI
and the line joining A to POG .
Average value – 2.7 mm
Range – 1 to 5 mm
positive– Upper incisor proclination
Negative- retruded position of maxillary incisors
73.
74. Introduced by Charles tweed (1895-1870)
tweed’s analysis is based on:
Inclination of mandibular incisors to the basal bone
And its association with vertical relation of the mandible to cranium
TWEED’S ANALYSIS
Tweed used three planes to establish a diagnostic triangle, the three planes used in this
analysis are:
1. Frankfurt horizontal plane
2. Mandibular plane
3. Long axis of lower incisor
76. FMA indicates the direction of lower facial growth,both
horizontally and vertically
Mean -25 degree
If FMA Is less than 25 degree –horizontal growth pattern
FMA is greater than 25 degree –vertical growth atettern
IMPA indicates the upright position of mandibular incisor
And balance and harmony of lower facial profile
Mean -90 degree
FMIA indicates balance and harmony betwwen lower face
and anterior limit of dentition
Mean- 65 degree
77. 2. FMA from 28 ° to 35 °, prognosis fair
3. FMA above 35°, Prognosis bad.
Following Can be derived from the change in its value as:
1. FMA 16° to 28 ° : prognosis good
Approximately 60 percent
malocclusions have FMA
between 16° and 28°
78. STEINER’S ANALYSIS
Developed by C.Steiner in 1953 can be considered the first of the modern
cephalometric analysis.
Sella nasion is a reference line.
Based on three different parameters -
• Skeletal analysis
• Dental analysis
• Soft tissue analysis
82. Relationship of maxilla and
mandible
ANB: 20
Difference between SNA and SNB.
Reflects anterio-posterior relationship of maxilla
to mandible
Large value – Class II skeletal tendency
Lesser value or zero- class III tendency
N
A
B
S
84. Occlusal plane
OP-SN: 140
Angle between SN and Occlusal Plane
Indicate relation of occlusal
plane to cranial base
Large value – vertical growth pattern/long
faces
Skeletal open bite
Decreases in – horizontal growth
pattern/skeleteal deep bite
S
N
Occlusal
plane
85. Mandibular plane
MP-SN: 320
Angle between SN and mandibular Plane
Indicate relation of mandibular
plane to cranial base
Large value – vertical growth pattern
S
N
mandibular
plane
Go
Me
87. Dental analysis
maxillary incisor position
UI-NA= 220
UI-NA= 4mm
NA
Angle between upper incisor and N-A Plane
Indicate relative inclination of maxillary incisor
Large angle seen –class 2 div 1
Angle less than 22 degree – class 2 divison 2
Measurement greater than 4mm-convex
profile,common class 1 bimaxillary protrusion
or class 2 div 1 malocclusion
Less than 4mm –concave profile, class 2 div 2
N
A
89. Mandibular incisor position
LI-NB = 250
LI-NB = 4mm
NB
Angle between lower incisor and N-b Plane
Indicate relative inclination of mandibular
incisor
Angle greater-class 2 div 1
Angle less – class 2 div 2 or class 3
N
B
90. Interincisal
angle: 1300
Angle between lower incisor and upper incisor
Indicate relative position of mandibular incisor
to maxillary incisor.
More acute or less than 130 – upper or lower
incisor require uprighting
greater – correcting of axial inclination
91.
92. SOFT TISSUE ANALYSIS
STEINER’S S-LINE-
-Line extending from middle of S formes by
lower border of nose and contour of chin.
- Lips should fall on this line
- If lips beyond – Convex profile
- If lips behind – Concave profile
93.
94. The mean values for Steiner’s analysis are as follows:
SNA 82°
SNB 80°
ANB 2°
SND 76°
Upper incisor to NA 22°
Upper incisor to NA 4mm
Lower incisor to NB 25°
Lower incisor to NB 4mm
interincisal angle 130°
MP to SN 32°
95. WIT’S APPRAISAL
The severity or degree of anteroposterior jaw disharmony can be measured on a lateral cephalometric head
film.
Cranial and denture landmarks
Point A is located at the deepest point on the contour of the maxilla between the anterior nasal spine
and the alveolus.
point A must be regarded as the anterior limit of the maxillary denture base.
Point B was described by Downs in 1948 as a point at the deepest curvature of the outline of the
symphysis of the chin.
This point is subjected to change with lower incisor movement may be regarded as the anterior limit
of the lower denture base
96. ANB angle as a measure of jaw dysplasia
The ANB angle in normal occlusions is generally 2 degrees.
Angles greater than this indicate tendencies toward Class II jaw disharmonies
smaller angles (extending to negative readings) reflect Class III anteroposterior jaw discrepancies
97. Lateral cephalometric head film tracing of a Class II malocclusion (A) and normal
occlusion(B), each having an ANB angle of 7 degrees.
98. Further example of a Class II malocclusion (A) and a normal occlusion (B) having
identical ANB angles readings (6 degrees).
99. The anteroposterior relationship of the jaws in these examples is not satisfactorily reflected by the ANB angle
readings.
Relating jaws to cranial reference planes presents inherent inconsistencies because of variations in cranio-
craniofacial complex will directly influence the ANB reading
Diagrammatic representation of an “average normal occlusion.” B, Nasion located farther
forward. This has the effect of reducing the ANB angle reading in this instance from 2 degrees to 2
degrees. C, Nasion positioned farther back has the effect of increasing the ANB angle, in this
example, from 2 degrees to 5 degrees.
100. Diagrammatic representation of an “average” normal occlusion. B, Counterclockwise
rotation of the jaws has the effect of reducing the ANB angle (in this instance from 2 degrees to 5
degrees). C, Clockwise rotation of the jaws has the effect of increasing the ANB angle (from 2
degrees to 8 degrees).
101. The “Wits” appraisal of jaw disharmony
The method of assessing the
degree or extent of the jaw disharmony entails
drawing perpendiculars on a lateral
cephalometric head film tracing from points A
and B on the maxilla and
mandible, respectively, onto the occlusal plane
which is drawn through the region of maximum
cuspal interdigitation.
The points of contact on the occlusal plane from
points A and B are labeled AO and BO
102. AO-BO
1. Skeletal Class-II : BO is
placed more than 4 mm
behind AO(positive reading)
2. Skeletal Class-III : BO is
ahead of AO A
B
O
Basis on excellence of occlusion
Average
In females AO And BO coincides
In males BO is located 1mm ahead
of point AO
105. Application of the “Wits” appraisal
A, Class II malocclusion: ANB angle, 7 degrees; “Wits” reading, 10 mm. B, Normal occlusion: ANB
angle, 7 degrees; “Wits” reading, 0
106. A, Class II malocclusion: ANB angle, 6 degrees; “Wits” reading, 6 mm. B, Normal occlusion: ANB angle, 6
degrees; “Wits” reading, 0 mm.
107. The ANB angle measures 10 degrees. By conventional assessment, this is a severe Class II
jaw disharmony. According to “Wits” appraisal (2 mm), the malocclusion is that of a mild Class
II skeletal pattern
108. appraise severity of anteroposterior jaw disharmony or dysplasia, the jaws must of necessity be related to
each other and to neither cranial nor extracranial landmarks.
109. Orthodontic procedures, we should strive never to allow this measurement to become less
than 1.5 mm. Faces with average lip thickness where there is a 3 mm. measurement are
preferred.
High skeletal convexity associated with mandibles that have obtuse gonial angles and long
lower face dimension, or in cases of very thin lips, it may be necessary to settle for a 1
mm. measurement.
With less face height, more prominent chins, and longer or thicker upper lips a measure
ment of up to 4 mm may not be excessive
110. UPPER AND LOWER GONIAL ANGLE
The gonial angle may be divided by a line drawn
from nasion to gonion.
• This gives an upper and lower gonial angle
• The upper angle is formed by the ascending
ramus and the line joining nasion and gonion.
• A larger upper angle indicates horizontal growth.
• The mean value is 50-55°.
• The lower angle is formed by the line joining
nasion and gonion and the lower border of the
mandible.
• A larger lower angle indicates vertical growth
pattern.
• The mean value is 72-75°.
111. FACIAL HEIGHT
POSTERIOR FACIAL HEIGHT is measured from S to
Go.
It is more in patients having horizontal growth
pattern than patients having vertical growth
pattern.
ANTERIOR FACIAL HEIGHT is measured from N to
Me.
It is more in patients having vertical growth
pattern than patients having horizontal growth
pattern.
It is given by ratio
Posterior facial height/anterior facial height multiply 100
Ratio less than 62% express vertical growth pattern
More than 65% express horizontal growth pattern
112. EXTENT OF ANTERIOR
BASAL LENGTH
It is taken from N to Se.
It is increased in horizontal growth pattern and
reduced in vertical growth pattern.
Mean value is 75mm.
113. EXTENT OF POSTERIOR
BASAL LENGTH
It is measured from S to Ar.
Also called as lateral cranial base length.
It is based on posterior facial height and position of the
fossa.
Short cranial bases are seen in vertical growth
pattern and skeletal open bites.
Mean value is 32-35mm
114. ANALYSIS OF JAW BASES
• SNA expresses the sagittal relationship of the
anterior limit of the maxillary apical base to the
anterior cranial base.
• It is large in prognathic maxilla and small in
retruded maxilla.
• Mean value is 81°.
115. SNB
• SNB expresses the sagittal reltionship between the
anterior extent of the mandibular apical base and
anterior cranial base.
• It is large with a prognathic mandible and small
with a retrusive mandible.
• If SNB is small and mandible is retrognathic
functional appliance therapy is indicated.
116. Base plane angle
The base plane angle is the angle between the
palatal plane and the mandibular plane.
• It is large in vertical growth pattern and small in
horizontal growth patterns.
• Mean value is 25° .
• The base plane angle is divided into 2:
Upper – between the palatal plane and the
occlusal plane. Mean value is 11°.
lower – between the occusal plane and the
mandibular plane . Mean value is 14°.
117. Inclination angle
It is the angle formed by the perpendicular line
dropped from N- Se at N and the palatal plane.
• A large angle expresses upward and forward
inclination whereas small angle indicates down and
back tipping of the anterior end of the palatal
plane and maxillary base.
• Mean value is 85°
118. Linear measurement of jaw bases
The extent of the mandibular base is determined
by measuring the distance between Go and Pog.
• More in patients having horizontal growth
pattern than patients having vertical growth
pattern.
• Ideally it should be 3mm more than N-Se distance
Extent of mandibular base
119. • It is determined by measuring the distance
between the PNS and a perpendicular drawn
from point A to the palatal plane.
• The difference of the measurement between
horizontal and vertical growth pattern is slight.
• Mean value is 44mm.
Extent of maxillary base
120. Length of ascending ramus
• The length of the ascending ramus is done by
measuring the distance between the gonion and
the condylion.
• The length of the ramus is more in patients
having horizontal growth pattern than vertical
growth pattern.
• Mean value is 46mm.
121. Analysis of dentoalvelor relationships
• The long axis of the upper incisors is extended to
intersect the S-N line and the posterior angle is
measured.
• It is used to determine the position of the
maxillary incisors.
• In cases of proclined upper incisors the angle
increases.
• Mean value is 102° .
• A smaller angle indicates the incisors are
lingually tipped which is advantageous for
functional appliance treatment.
122. Lower incisors
• The long axis of the lower incisors is extended to
intersect with the mandibular plane and the
posterior angle is measured.
• Smaller angle indicates lingual tipping of the
incisors.
• • Mean value is 90° .
123. Position of upper and lower incisors
• Position of the incisors is the distance
of the incisal edges from the N-Pog line
the so called facial plane.
• The average position of the maxillary
incisors is 2 to 4mm anterior to the N-
Pog line
• The average position of the mandibular
incisors is 2mm anterior or posterior to
the N-Pog line
124.
125.
126.
127.
128. CONCLUSION
• Cephalometrics although a major one- is one of many approaches and
considerations in the diagnosis and treatment of an orthodontic patient.
• Cephalometric analysis is essentially a technique to be used as a guide
in the diagnosis of a case of malocclusion.
• Although innumerable controversies exist in the field of
cephalometrics, it is still a very significant & effective diagnostic tool.