Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope a presentation on CEPHALOMETRY PART 1 will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best

1. CEPHALOMETRY PART 1
KOMAL GHIYA
MDS PEDODONTICS AND
PREVENTIVE DENTISTRY

2. INDEX
INTRODUCTION
USES OF CEPHALOGRAM
CEPHALOSTATS
CLASSIFICATION OF ANALYSIS
LANDMARKS
REFERENCE LINES
ANGLES
LINEAR MEASUREMENT
ANALYSIS OF FACIAL SKELETON
ANALYSIS OF MAXILLARY AND MANDIBULAR BASES

3. DENTOALVEOLAR ANALYSIS
LINEAR MEASUREMENT
SOFT TISSUE ANALYSIS:PROFILE ANALYSIS
LIP ANALYSIS
TONGUE ANALYSIS`

4. INTRODUCTION
THE FIRST PICTURES OF SKULL IN STANDARD LATERAL VEW:PACINI
AND CARRERA(1922)
1931:HOFRATH AND BROADBENT:STANDARDISED METHOD FOR
PRODUCTION OF CEPHALOMETRIC RADIOGRAPHS USING SPECIAL
HOLDERS KNOWN AS CEPHALOSTATS
S BISHARA,TEXTBOOK OF ORTHODONTICS,2001

5. USES OF CEPHALOGRAM
HELPS IN ORTHODONTIC DIAGNOSIS ENABLING THE STUDY OF
SKELETAL,DENTAL AND SOFT TISSUE STRUCTURES OF CRANIOFACIAL
REGION
HELPS IN CLASSIFICATION OF SKELETAL AND DENTAL ABNORMALITIES
AND DETERMINING OF FACIAL TYPE
HELPS IN TREATMENT PLANNING
HELPS IN EVALUATION OF THE TREATMENT RESULTS BY QUANTIFYING
THE CHANGES BROUGHT ABOUT TREATMENT
HELPS IN PREDICTING THE GROWTH RELATED CHANGES AND
CHANGES ASSOCIATED WITH SURGICAL TREATMENT
VALUABLE AID IN RESEARCH WORK INVOLVING THE CRANIO DENTO
FACIAL REGION
T RAKOSI,AN ATLAS AND MANUAL OF CEPHALOMETRIC RADIOGRAPHY,2 ND ED

6. CEPHALOSTATS
THE CEPHALOMETRIC
RADIOGRAPH ARE TAKEN USING
AN APPARATUS THAT
CONSISTS OF AN X RAY SOURCE
AND A HEAD HOLDING DEVICE
CEPHALOSTATS
CEPHALOSTATS : CONSISTS OF
TWO EAR RODS THAT PREVENT
THE MOVEMENT OF HEAD IN
HORIZONTAL PLANE
VERTICAL STABILIZATION OF
HEAD IS BROUGHT ABOUT AN
ORBITAL POINTER THAT
CONTACTS THE LOWER BORDER
OF LEFT ORBIT
THE UPPER PART OF FACE IS
SUPPORTED BY FOREHEAD
CLAMP POSITIONED ABOVE
REGION OF NASAL BRIDGE
DISTANCE BETWEEN THE XRAY
SOURCE AND THE MID SAGGITAL
PLANE OF PATIENT IS FIXED AT 5
FEET
William R. Proffit, Henry W. Fields
Jr., David M. Sarver,Contemorary
Orthodontics, 2006

7. TYPES OF CEPHALOGRAM
Basavaraj Phulari,An Atlas on Cephalometric Landmarks,2013
LATERAL CEPHALOGRAM:THIS PROVIDES A LATERAL
VIEW OF SKULL.IT IS TAKEN AS STANDARDIZED
REPRODUCICBLE POSITION AT A SPECIFIED DISTANCE
FROM THE SOURCE OF XRAY
FRONTAL CEPHALOGRAM:THIS PROVIDES AN
ANTEROPOSTERIOR VIEW OF THE SKULL

8. CLASSIFICATION OF ANALYSIS
METHODOLOGICAL CLASSIFICATION: BASIC UNITS ARE ANGLES
AND DISTANCES IN MILLIMETERS
ANGULAR ANALYSIS:
DIMENSIONAL ANALYSIS
PROPORTIONAL ANALYSIS
ANALYSIS TO DETERMINE
POSITION
LINEAR ANALYSIS
ORTHOGONAL ANALYSIS
DIMENSIONAL LINEAR ANALYSIS
PROPORTIONAL LINEAR ANALYSIS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

9. NORMATIVE CLASSIFICATION: CONCEPTS ON WHICH NORMAL VALUES
HAVE BEEN BASED
MONONORMATIVE ANALYSIS:
MULTINORMATIVE: A WHOLE SERIES OF NORMS ARE USED WITH AGE,SEX
TAKEN INTO ACCOUNT
CORRELATIVE ANALYSIS: ASSESS INDIVIDUAL VARIATIONS OF FACIAL
STRUCTURE TO ESTABLISH THEIR MUTUAL RELATIONSHIPS
ARITHMETIC NORMS:
AVERAGE FIGURES BASED
ON ANGULAR ,LINEAR OR
PROPORTIONAL
MEASUREMENTS
GEOMETRICAL NORMS
AVERAGE TRACINGS ON
TRANSPARENT SHEETS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

10. CLASSIFICATION ACCORDING TO AREA OF ANALYSIS
DENTOSKELETAL ANALYSIS:
ANALYZE TEETH AND SKELETAL STRUCTURES
SOFT TISSUE ANALYSIS:
WHOLE PRFILE IN NORMA LATERALIS OR CERTAIN STRUCTURES
FUNCTIONAL ANALYSIS:FUNCTIONAL RELATIONS SUCH AS THE
OCCLUSION TO INTEROCCLUSAL SPACE RELATIONSHIP IN NORMA
LATERALIS AND NORMA FRONTALIS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

12. LANDMARKS
NAME CODE DEFINITIONS
NASION N THE MOST ANTERIOR POINT OF THE NASOFRONTAL SUTURE
IN THE MEDIAN PLANE
SELLA S THE MIDPOINT OF THE HYPOPHYSIAL FOSSA
SUBNASALE Sn A SKIN POINT AT WHICH THE NASAL SEPTUM MERGES
MESIALLY WITH INTEGUMENT OF UPPER LIP
POINT A
SUBSPINALE
A THE DEEPEST MIDLINE POINT IN THE CURVED BONY
OYTLINE FROM THE BASE TO THE ALVEOLAR PROCESS OF
MAXILLA
PROSTHION Pr ALVEOLAR RIM OF THE MAXILLA ,THE LOWEST MOST
ANTERIOR POINT ON THE ALVEOLAR PORTION OF
PREMAXILLA ,IN THE MEDIAN PLANE BETWEEN THE UPPER
CENTRAL INCISOR
INSICOR
SUPERIUS
Is TIP OF CROWN OF THE MOST ANTERIOR MAXILLARY
CENTRAL INCISOR
APICALE 1 Ap 1 ROOT APEX OF THE MOST ANTERIOR MAXILLARY CENTRAL
INCISOR
INCISOR
INFERIUS
Ii TIP OF THE CROWN OF THE MOST ANTERIOR MANDIBULAR
CENTRAL INCISOR

13. T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

14. NAME CODE DEFINITIONS
APICALE APICALE 1 ROOT APEX OF THE MOST ANTERIOR MANDIBULAR
CENTRAL INCISOR
INFRADENTALE Id ALVEOLAR RIM OF THE MANDIBLE ;THE HIGHEST MOST
ANTERIOR POINT ON THE ALVEOLAR PROCESS ,IN THE
MEDIAN PLANE,BETWEEN THE MANDIBULAR CENTRAL
INCISOR
POINT B
SUPRAMENTALE
B MOST ANTERIOR PART OF MANDIBULAR BASE
POGONION POG MOST ANTERIOR POINT OF THE BONY CHIN IN THE MEDIAN
PLANE
GNATHION Gn MOST ANTERIOR AND INFERIOR POINT OF THE BONY CHIN
GONION Go A CONSTRUCTED POINT ,THE INTERSECTION OF THE LINES
TANGENT TO THE POSTERIOR MARGIN OF THE ASCENDING
RAMUS AND MANDIBULAR BASE
MENTON Me MENTON IS THE MOST CAUDAL POINT IN THE OUTLINE OF
THE SYMPHYSIS,REGARDED AS THE LOWEST POINT OF
MANDIBLE

15. T RAKOSI,AN ATLAS AND
MANUAL OF
CEPHALOMETRIC
RADIOGRAPHY,2 ND ED

16. NAME CODE DEFINITIONS
APMan(18) APMan ANTERIOR LANDMARK FOR DETERMINING THE LENGTH OF
THE MANDIBLE
DEFINED AS THE PERPENDICULAR DROPPED FROM Pog TO
THE MANDIBULAR PLANE
ARTICULARE Ar PROVIDES RADIOLOGICAL ORIENTATION,BEING THE POINT
OF INTERSECTION OF THE POSTERIOR MARGIN TO
ASCENDING RAMUS AND THE OUTER MARGINTO THE
CRANIAL BASE
CONDYION Cd MOST SUPERIOR POINT ON THE HEAD OF THE CONDYLE
ORBITALE Or LOWERMOST POINT OF THE ORBIT IN THE RADIOGRAPH
Int FH/Rasc Int FH/Rasc INTERSECTION OF THE IDEAL FRANKFURT HORIZONTAL
AND THE POSTERIOR MARGIN OF THE ASCENDING RAMUS
ANTERIOR
NASAL SPINE
ANS IS THE TIP OF THE BONY ANTERIRO NASAL SPINE,IN THE
MEDIAN PLANE
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

17. T RAKOSI,AN ATLAS AND MANUAL
OF CEPHALOMETRIC
RADIOGRAPHY,2 ND ED

18. NAME CODE DEFINITIONS
POSTERIOR NASAL SPINE PNS CONSTRUCTED RADIOLOGICAL POINT ,THE INTERESECTION
OF A COTINUATION OF THE ANTERIOR WALL OF
PTERYGOPALATINE FOSSA AND FLOOR OF THE NOSE.MARKS
THE DORSAL LIMIT OF THE MAXILLA
POSTERIOR POINT FOR THE
OCCLUSAL PLANE
PPOcc MOST DISTAL POINT OF CONTACT BETWEEN THE MOST
POSTERIOR MOLARS IN OCCLUSION
ANTERIOR POINT OF
OCCLUSAL PLANE
APOc
c
A CONSTRUCTED POINT ,THE MIDPOINT IN THE INCISOR
OVERBITE IN OCCLUSION
BASION Ba LOWEST POINT ON THE ANTERIOR MARGIN OF THE FORAMEN
MAGNUM IN THE MEDIAN PLANE
PTERYGOMAXILLARY FISSURE Ptm THE CONTOUR OF THE FISSURE PROJECTED ONTO PALATAL
PLANE.
LANDMARK:ASSESING THE
MAXILLARY BASE IN POSTERIOR
SECTION
S PERPENDICULAR DROPPED FROM POINT S TO A LINE
EXTENDING THE PALATAL PLANE

19. T RAKOSI,AN
ATLAS AND
MANUAL OF
CEPHALOMETRIC
RADIOGRAPHY,2
ND ED

20. REFERENCE LINES
LINE DEFINITIONS
S-N ANTEROPOSTERIOR EXTENT OF ANTERIOR CRANIAL
BASE
S-Ar LATERAL EXTENT OF CRANIAL BASE
Ar-Go LENGTH OF RAMUS
Me-Go EXTENT OF MANDIBULAR BASE
N-A NASION –POINT A
N-B NASION –POINT B
N-Pr NASION-PROSTHION
N-Id NASON-INFRADENTALE
N-Pog NASION-POGONION
N-Go NASION-GONION
Pal PALATAL PLANE
Occ OCCLUSAL PLANE
S-Gn Y AXIS
S-Go POSTERIOR FACIAL HEIGHT
I-SN LONG AXIS OF UPPER INCISOR TO SN
T RAKOSI,AN ATLAS AND
MANUAL OF
CEPHALOMETRIC
RADIOGRAPHY,2 ND ED

21. LINE DEFINITONS
I-Pal LONG AXIS OF UPPER INCISOR TO Pal
I-MP LONG AXIS OF LOWER INCISOR TO MANDIBULAR PLANE
ManBase EXTENT OF MANDIBULAR BASE
MaxBase EXTENT OF MAXILLARY BASE
Pn LINE PERPENDICULAR TO SeN,DRAWN FROM THE SOFT TISSUE NASION AS FAR AS Pal
H LINE MODIFIED FRANKFURT HORIZONTAL ;PARALLEL TO THE SeN LINE WHICH
BISECTS THE Pn LINE FROM N TO Pal
EL AESTHETIC LINE .TIP OF NOSE –SOFT TISSUE POGONION
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

23. A
N
G
L
E
S
POINTS OF
THE ANGLE
DEFINITION MEAN VALUE
N-S-Ar SADDLE ANGLE 123+ 5
S-Ar-Go ARTICULAR ANGLE 143+6
Ar-Go-Me GONIOLA ANGLE 128+7
Sum SUM OF SELLA ,ARTICULAR AND GONIOL ANGLE 39+4
Ar-Go-N Go1,UPPER GONIAL ANGLE 52-55
N-GO-Me Go2,LOWER GONIAL ANGLE 70-75
SNA ANTEROPOSTERIOR POSITION OF MAXILLA 81
SNB ANTEROPOSTERIOR POSITION OF MANDIBLE 79
ANB DIFFERENCE BETWEEN SNA AND SNB 2
S-N-Pr ANTEROPOSTERIOR POSITION OF ALVEOLAR PART
OF PREMAXILLA
84
S-N-Id ANTEROPOSTERIOR POSITION OF ALVEOLAR PART
OF MANDIBLE
81
Pal-MP ANGLE BETWEEN PALATAL AND MANDIBULAR PLANE 25
Pal-Occ UPPER OCCLUSAL PLANE ANGLE 11
MP-Occ LOWER OCCLUSAL PLANE 14
SN-MP ANGLE BETWEEN SN AND MANDIBULAR PLANE 32

24. POINTS OF
THE ANGLE
DEFINITION MEAN VALUE
Pn-Pal ANGLE OF INCLINATION AFTER A.M SCHWARZ 85
N-S-Gn ANGLE BETWEEN SN LINE AND S-Gn LINE
ANERIORLY
66
1-SN ANGLE BETWEEN UPPER INCISOR AXIS AND SN LINE
POSTERIORLY
102
1-Pal ANGLE BETWEEN UPPER INCISOR AXIS AND PALATAL
PLANE ANTERIORLY
70+5
1-MP ANGLE BETWEEN LOWER INCISOR AXIS AND
MANDIBULAR PLANE POSTERIORLY
90+3
ii angle INTERINCISAL ANGLE BEYWEEN UPPER AND LOWER
CENTRAL INCISOR AXIS,POSTERIORLY
135
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

25. DISTANCE DEFINITION
S-N ANTEROPOSTERIOR EXTENET OF ANTERIOR CRANIAL BASE:71mm
S-Ar EXTENT OF LATERAL CRANIAL BASE:32-35 mm
S-Go POSTERIOR FACIAL HEIGHT
N-Me ANTERIOR FACIAL HEIGHT
Max-Base EXTENT OF MAXILLARY BASE,CORRELATED WITH Se-N
Man-Base EXTENT OF MANDIBULAR BASE,CORRELATED WITH SeN
Rasc EXTENT OF ASCENDING RAMUS,CORRELATED WITH SeN
S’-F.Ptp DISTANCE FROM S’ TO PROJECTION OF THE ANTERIOR WALL OF
PTERYGOPALATINAL FOSSA ONTO PALATAL PLANE,EXPRESSION FOR
ANTEROPOSTERIOR DISPLACEMENT OF MAXILLARY BASE
S-S’ EXTENT FOR DEFLECTIONS OF MAXILLARY BASE:42-57mm
1-N-Pog DISTANCE FROM INCISAL EDGE OF 1 TO N-POG LINE
1-N-Pog DISTANCE FROM INCISAL EDGE OF 1 TO N-POG
L
I
N
E
A
R
M
E
A
S
U
R
E
M
E
N
T
S

26. SIGNIFICANCE OF ANGULAR AND
LINEAR MEASUREMENTS
ANALYSIS OF FACIAL SKELETON
ANALYSIS OF MANDIBULAR AND MAXILLARY BASE
DENTOALVEOLAR ANALYSIS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

27. ANALYSIS OF FACIAL SKELETON
SADDLE ANGLE (N-S - POSTERIOR CRANIAL BASE)A
LARGE SADDLE ANGLE INDICATES POSTERIOR
POSITION ,A SMALL SADDLE ANGLE AN ANTERIOR
POSITION OF CRANIAL BASE
GONIAL ANGLE (AR-GO-ME) PLAYS A ROLE IN
GROWTH PROGNOSIS
A LARGE ANGLE INDICATES MORE OF A TENDENCY
TO POSTERIOR ROTATION OF MANDIBLE,WITH
CONDYLAR GROWTH DIRECTED POSTERIORLY
A SMALL GONIAL ANGLE INDICATES VERTICAL
GROWTH OF CONDYLES
RIOLO et al NOTED AN AGE DEPENDENT
VARIATION IN MEAN VALUE FROM 132 TO 124
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

28. ANALYSIS OF MANDIBULAR VARIATIONS DUE TO ROTATIONS
GREATER ANTERIOR FACE HEIGHT IS CONCOMITANT WITH A
LARGE GONIAL AND ALSO A BASAL PLANE
SUM OF POSTERIOR ANGLES
SADDLE +ARTICULAR+GONIAL ANGLE :396+ 6:BJORK
IF IT IS GREATER THAN 396:VERTICAL GROWTH
SMALLER THAN 396:HORIZONTAL GROWTH
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

29. ANALYSIS OF MAXILLARY AND
MANDIBULAR BASES
GROUP 1: MEASUREMENTS BETWEEN VERTICAL LINES TO
DETERMINE SAGGITAL VARIATIONS
GROUP 2:MEASUREMENTS BETWEEN HORIZONTAL LINES TO
ANALYSE VERTICAL DEVIATIONS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

30. GROUP 1(ANGLES BETWEEN S-N
AND A THIRD SKELTAL POINT)
SNA ANGLE
ANTEROPOSTERIOR POSITION OF POINT A RELATIVE
TO ANTERIOR CRANIAL BASE
>84:MAXILLA LIES ANTERIORLY
<78:MAXILLA LIES POSTERIOR TO CRANIAL BASE
SNB ANGLE
ANTEROPOSTERIOR POSITION OF MANDIBLE IN
RELATION TO ANTERIOR CRANIAL BASE
>82:MANDIBLE PROGNATHIC
<77:MANDIBLE RETROGNATHIC
77-82:MANDIBLE IS ORTHOGNATHIC
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

31. ANB ANGLE:NA AND NB COINCIDES
:ANGLE WILL BE ZERO
POINT A LIES POSTERIOR TO NB :ANB
WILL BE NEGATIVE
AVERAGE VALUE:2
RIOLO et al :HIGHER AVERAGES IN
CHILDREN
POSITIVE VALUE:CLASS 2
NEGATIVE VALUE:CLASS 3
WIT’S METHOD
DESCRIBED BY JACOBSON
MEASURES THE EXTENT TO WHICH JAWS
ARE RELATED TO EACH OTHER
ANTEROPOSTERIORLY
NORMAL OCCLUSION:POINT BO WAS
APPROXIMATELY 1mm ANTERIOR TO
POINT AO
SKELETAL CL2:POINT BO WOULD BE
LOCATED WELL BEHIND POINT AO
SKELETAL CLASS 3:POINT BO WILL BE
FORWARD OF POINT AO
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

32. SN POG
DETERMINES THE BASAL POSITION OF MANDIBLE
AT AGE 6:76
AT AGE 16: 80
INCREASE OF 4 BETWEEN AGE 6-16
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

33. GROUP 2
HORIZONTAL LINES
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

34. BASAL PLANE ANGLE PAL-MP
DEFINES THE ANGLE OF INCLINATION OF MANDIBLE TO
MAXILLARY BASE
LARGE BASAL ANGLE:MANDIBLE IS USUALLY ROTATED
BACKWARDS:VERTICAL GROWTH TYPE
SMALL BASAL ANGLE:MANDIBLE IS ROTATED
FORWARDS:HORIZONTAL GROWTH TYPE
MEAN BASAL ANGLE:25
DECREASE IN ANGLE WITH AGE FROM 30 DEGREE AT 6 YEARS TO
23 DEGREE AT 16
PAL OCC AND OCC MP
BASAL ANGLE IS DIVIDED IN TWO BY OCCLUSAL PLANE
UPPER ANGLE:11
LOWER ANGLE:14
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

35. ANGLE OF INCLINATION:
ANGLE BETWEEN THE Pn LINE AND PALATAL PLANE
A LARGE ANGLE SIGNIFIES ANTE INCLINATION
SMALL ANGLE:RETROCLINATION OF LOWER FACE
SN-MP
SCHUDY:
IF ANGLE IS GREATER THAN 32:INCLINATION IS POSTERIOR
ANGLE LESS THAN 32:ANTERIOR INCLINATION
AGE DEPENDENT DECREASE FROM 36-31 HAS BEEN NOTED BETWEEN AGE
6-16
N-S-Gn(Y AXIS)
DETERMINES THE POSITION OF MANDIBLE RELATIVE TO THE CRANIAL BASE
MEAN VALUE:66
GREATER THAN THAT:MANDIBLE IS IN POSTERIOR POSITION
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

36. ANTERIOR AND POSTERIOR FACE HEIGHT
FORMULA:POSTERIOR FACE HEIGHT(Sgo)*100:ANTERIOR FACE
HEIGHT
MEAN VALUE:62-65%(JARABAK)
A HIGHER PERCENTAGE MEANS A RELATIVELY GREATER
POSTERIOR FACE HEIGHT
SMALL PERCENTAGE :RELATIVELY SHORTER POSTERIOR FACE
HEIGHT AND VERTICAL GROWTH
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

37. DENTOALVEOLAR ANALYSIS
ANGULATION OF UPPER INCISOR:
1ST MEASUREMENT:LONG AXIS OF
UPPER INCISOR EXTENDED TO
INTERSECT SN LINE
MEAN VALUE 102+ 2
UPTO 7 th YEAR:94-100
2ND MEASUREMENT
ANTERIOR ANGLE BETWEEN THE
LONG AXIS OF THE INCISO AND
PALATAL PLANE IS MEASURED
MEAN VALUE:8 TH YEAR ONWARD
IS 70+ 5
T RAKOSI,AN ATLAS
AND MANUAL OF
CEPHALOMETRIC
RADIOGRAPHY,2 ND ED

38. ANGULATION OF LOWER INCISOR: POSTERIOR ANGLE BETWEEN THE LONG
AXIS OF INCISOR AND MANDIBULAR PLANE
MEAN VALUE:90+3
6 TO 12 TH YEAR ANGLE INCRESES FROM 88 TO 94
ASSESMENT OF INCISOR POSITION
MAXILLARY INCISRO AVERAGE DISTANCE :4 + 2 mm
MANDIBULAR INCISOR: -2 TO +2 mm
INTERINCISAL ANGLE
MEAN VALUE:135
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

39. LINEAR MEASUREMENTS ON SKELETAL
STRUCTURES
EXTENT OF ANTERIOR CRANIAL BASE ,SELLA ENTRANCE-NASION
HOLDAWAY:INCRESES BY ¾ mm ANNUALLY
EXTENT OF POSTERIOR CRANIAL BASE,SELLA- ARTICULARE
A SHORT POSTERIOR CRANIAL BASE DENOTES A SHORTER DISTANCE BETWEEN SELLA AND
ARTICULARE;MIDFACE APPEARS MORE PROGNATHIC,SECONDARY REDUCTION IN ANTERIOR FACE
HEIGHT
MEAN VALUE:32-35 mm WITH A MEAN RATE OF INCREASE OF 8mm BETWEEN AGE 6 AND 16
EXTENT OF MANDIBULAR BASE:
DISTANCE GONION-POGONION
MEAN VALUE AGE 8:68 mm WITH ANNUAL INCREASE OF 2mm FOR BOYS AND 1.4mm FOR GIRLS
EXTENT OF MAXLLARY BASE:
DISTANCE FROM POSTERIOR NASAL SPINE TO POINT A PROJECTED ONTO THE PALATAL PLANE
MEAN VALUE IS 45.5 mm AT AGE 8 WITH ANNUAL INCREASE OF 1.2 MM FOR BOYS AND 0.8 mm FOR
GIRLS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

40. EXTENT OF ASCENDING RAMUS:
REPRESENTED BY DISTANCE OF GONION TO CONDYLION
EAN:AT AGE 8:46mm WITH AN ANNUAL INCREASE OF 2 mm FOR
BOYS AND 1.2 mm FOR GIRLS ,UPTO AGE 16
WIDTH OF ASCENDING RAMUS:
DETERMINED AT HEIGHT OF THE OCCLUSAL PLANE
MEAN WIDTH:27 mm AT AGE 8; AT AGE 16:32.5 mm FOR BOYS
,30.5 mm FOR GIRLS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

41. SOFT TISSUE ANALYSIS
PROFILE ANALYSIS
LIP ANALYSIS
TONGUE ANALYSIS
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

42. PROFILE ANLYSIS
REFERENCE POINTS:
CODE DEFINITIONS
n Skin nasion: DEEPEST POINT IN CONCAVITY OF SOFT
TISSUE CONTOUR OF ROOT OF NOSE
no Tip of nose
sn Subnasale: INTERSECTION OF LOWER BORDER OF NOSE
AND THE OUTER CONTOUR OF UPPER LIP
Is Labrale superius: MEDIAN POINT IN UPPER MARGIN OF
UPPER MEMBRANOUS LIP
sto Stomion: MIDPOINT ON LIP
li Labrale inferius: MEDIAN POINT IN THE LOWER MARGIN OF
LOWER MEMBRANOUS LIP
pog Skin pogonion:MOST PROMINENT POINT ON SOFT TISSUE
CONTOUR OF CHIN
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

43. PROPORTIONAL ANALYSIS
Frontal third: tr-n :1/3
Nasal third: n-sn :1/3
Gnathic third: sn-gn : 1/3
Proportions of anterior face height(mid face to lower face):fig
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

44. ANGULAR PROFILE ANALYSIS,CONVEXITY OF
PROFILE:SUBTENLY
SKELETAL
CONVEXITY:N-A
Pog:MEAN VALUE:175
MEAN VALUE AT AGE
12:177.5
SKELETAL CONVEXITY
DECREASES WITH AGE
SOFT TISSUE
CONVEXITY: n-sn –pog
MEAN VALUE:161
DOES NOT CHANGE T RAKOSI,AN ATLAS
AND MANUAL OF
CEPHALOMETRIC
RADIOGRAPHY,2 ND
ED

45. THICKNESS OF SOFT TISSUE
PROFILE
THICKNESS OF SOFT TISSUE NASION WAS PRACTICALLY CONSTANT
THICKNESS AT SULCUS INCREASED BY APPROX 5mm
THICKNESS OF SOFT TISSUE CHIN INCREASE BY APPROX 2mm
GREATER INCREASE IN MAXILLARY AS DISTINCT FROM MANDIBULAR
SOFT TISSUE EXPLAINS WHY THE SOFT TISSUE PROFILE GROWS MORE
CONVEX WITH AGE ,DESPITE THE TENDENCY OF SKELETAL PROFILE
TO STRAIGHTEN OUT
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

46. PROFILE ANALYSIS AFTER A.M
SCHWARZ REFERENCE LINES :
H LINE:CORRESPONDING TO FRANKFURT
HORIZONTAL
Pn LINE
Po LINE(ORBITAL PERPENDICULAR), A
PERPENDICULAR FROM ORBITALE TO H LINE
DEPENDING ON POSITION OF SUBNASALE
AVERAGE FACE:SUBNASALE LYING ON NASION
PERPENDICULAR
RETROFACE :SUBNASALE BEHIND NASION
PERPENDICULAR
ANTEFACE:SUBNASALE IN FRONT OF NASION
PERPENDICULAR
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

47. LIP
ANALYSIS
METRIC DETERMINATION:
LENGTH OF UPPER LIP::average:22.5 mm for boys and 20 mm for girls
Cl 2 and cl 3 cases : upper lip is slightly shorter
LENGTH OF LOWER LIP:,average:45.5 mm in boys and 40 mm in girls
Length increases in cl 2 and cl 3
Cl2 treatment: following retraction of upper teeth, lower lip curls up
and moves forward
Cl 3 treatment: lower incisors undergo lingual tipping so that lower lip
moves backwards
THICKNESS OF RED PART OF UPPER LIP: : measured form the labial
surface of most labial incisor to the most anterior point on the red part
of upper lip . Average thickness:11.5 mm
Cl 2:thinner,cl 3:thicker
THICKNESS OF RED PART OF LOWER LIP: measured from labial surface
of lower incisor to the most anerior point on red part of lower lip
Cl 2:thicker;cl3:thinner
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

48. REFERENCE PLANES FOR LIP
PROFILES ASSESMENT
RICKETTS LIP ANALYSIS
REFERENCE LINE USED BY RICKETS IS DRAWN FROM
THE TIP OF NOSE TO SKIN POGONION
NORMAL RELATIONS MEAN THAT THE UPPER LIP IS
2-3 mm
LOWER LIP IS 1-2 mm BEHIND THIS LINE
STEINER’S ANALYSIS
UPPER REFERENCE POINT FOR STEINER’S ANALYSIS IS
AT THE CENTER OF S SHAPED CURVE BETWEEN TIP
OF NOSE AND SUBNASALE
SOFT TISSUE POGONION REPRESENTS THE LOWER
POINT
LIPS LYING BEHIND THE LINE CONNECTING THOSE
TWO POINTS ARE TOO FLAT,THOSE LYING ANTERIOR
TO IT ,TOO PROMINENT
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

49. HOLDAWAY’S LIP ANALYSIS
DETERMINES THE ANGLE BETWEEN A TANGENT TO
UPPER LIP AND NB LINE
THE ANGLE BETWEEN THESE TWO LINES IS CALLED
H ANGLE
WITH AN ANB ANGLE 1-3,H ANGLE SHOULD BE 7-
8
HOLDAWAY DEFINES PERFECT PROFILE AS
FOLLOWS:
ANB ANGLE:2;H ANGLE:7-8
LOWER LIP TOUCHING THE SOFT TISSUE LINE
THE RELATIVE PROPORTIONS OF NOSE AND UPPER
LIP ARE BALANCED
THE TIP OF NOSE IS 9mm ANTERIOR TO THE SOFT
TISSUE LINE
THERE IS NO LIP TENSION
THE UPPER LIP IS TENSED IF THE DIFFERENCE
BETWEEN SOFT TISSUE THICKNESS AND THE
THICKNESS OF RED PART OF UPPER LIP IS GREATER
THAN + 1 mm
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

50. ANALYSIS OF TONGUE
ASSESMENT OF TONGUE POSITION:
ROOT OF TONGUE: small space is found between root of tongue and
the soft palate in cases of mouth breathing and small tongue
DORSUM OF TONGUE : relatively high with cl 2 malocclusion
DEEP BITE : dorsum of tongue is high at back and low in front
TIP OF TONGUE : retracted in cases of cl 3 and cl 2 cases with nasal
breathing
ASSESMENT OF TONGUE MOBILITY : position of tongue in dental
occlusion is compared with that in rest position
T RAKOSI,AN ATLAS AND MANUAL OF
CEPHALOMETRIC RADIOGRAPHY,2 ND ED

51. CEPHALOMETRY PART 2
CEPHALOMETRIC ANALYSIS:
STEINER’S ANALYSIS
DOWN’S ANALYSIS
TWEED’S ANALYSIS
ERRORS IN CEPHALOMETRY
NEWER ADVANCES

52. REFERENCE
T RAKOSI,AN ATLAS AND MANUAL OF CEPHALOMETRIC
RADIOGRAPHY,2 ND ED
S BISHARA,TEXTBOOK OF ORTHODONTICS,2001
BASAVARAJ PHULARI,AN ATLAS ON CEPHALOMETRIC
LANDMARKS,2013
WILLIAM R. PROFFIT, HENRY W. FIELDS JR., DAVID M.
SARVER,CONTEMORARY ORTHODONTICS, 2006