Cephalometry deals with the study of the skull through x-rays and analysis of selected linear and angular measurements. It is used for diagnosis, treatment planning, and evaluating treatment outcomes in orthodontics. Key landmarks are identified on cephalograms and used to perform analyses of the sagittal, vertical, and dental relationships of the jaws. Common analyses include Steiner, Sassouni, and McNamara which evaluate specific angular and linear measurements to assess jaw positions and tooth inclinations for orthodontic diagnosis and planning.

1. CEPHALOMETRY
Dr. Tania Arshad Siddiqui
Assistant Professor
Department of Orthodontics

3. INTRODUCTION
 Deals with the study of skull in different aspects
Diagnosis
Classification of malocclusion
Diagnosis of the orthodontic problem
Treatment planning for such
problems
Evaluating the changes brought by
treatment
Predicting the treatment outcome or
prognosis of the results
Detecting the morphology of the
orthodontic problem
Detecting the extent or degree of the
orthodontic problem
Research
Research on growth
patterns of craniofacial
complex
Growth
Studying growth of
jaws or soft tissues

4. Other uses
Pathology detection:
 Cervical spine anomalies
 Degenerative changes in the vertebrae
Goal
Evaluate relationships both horizontally and vertically of 5
major functional components of the face:
 Cranium and cranial base
 Skeletal maxilla
 Skeletal mandible
 Maxillary dentition and alveolar process
 Mandibular dentition and alveolar process

5. GOAL ACHIEVED BY
Selected linear and
angular
measurements
Graphic reference of
normative data

6. BASIC REQUIREMENTS FOR
CEPHALOGRAMS
 X-ray source- It is a high vacuum tube comprising of
three basic components: cathode, anode and the
electrical power supply
 A specialized machine called as “cephalostat”
 A patient
Variable
distance -
12 to 15
cm

7. CEPHALOMETRIC
LANDMARKS
 Series of points defined as locations on:
 Physical structure- at junction of bones
 Extreme points- most anterior or inferior points, affected
by patient’s head position
 Constructed points- formed by intersection of 2 planes

8. A
Pog
B
Go
Me

9. Hard Tissue
Landmarks
Soft Tissue
Landmarks
CEPHALOMETRIC
LANDMARKS

10. HORIZONTAL REFERENCE
PLANE
 Frankfort Horizontal Plane has two difficulties:
 Landmark location is difficult
 Natural head position is different than FH plane

13. SAGITTAL ANALYSIS

14. Angle SNA Angle SNB
Angle ANB Actual Mandibular Corpus Length
Go
Gn

15. Facial Angle Wits
 Describe severity of jaw disharmony
 Wits uses “Functional Occlusal Plane”
 Point A ahead- Millimetric measurement is positive and patient is diagnosed as Class II
 Point B ahead- Millimetric measurement is negative and patient is diagnosed as Class III
 Influenced by teeth horizontally and vertically
 Horizontally by pts. A and B
 Vertically by occlusal plane
Harvold and Wits Analysis
S
N
Pog
A
B
FOP

16. VERTICAL ANALYSIS

17. SN- MANDIBULAR PLANE SN- PALATAL PLANE
MAXILLOMANDIBULAR PLANE ANGLE Y-AXIS
SUM OF POSTERIOR
ANGLES
OCCLUSAL PLANE
Go
Me
Upper
OP
Go
Me
Lower
OP
Gn
Go
Me
ANSPNS
Gn
Go
Ar
S
N
S
N
S
N
S
N
ANSPNS
ANSPNS
FOP

18. RATIO OF POSTERIOR FACE HEIGHT
TO ANTERIOR FACE HEIGHT
RATIO OF LOWER ANTERIOR FACE
HEIGHT TO TOTAL ANTERIOR FACE
HEIGHT

19. DENTAL ANALYSIS

20. UISN UI-PP IMPA
IIA UI-NA (mm/deg) UI-NB (mm/deg)
S
N
ANSPNS
Go
Me
N
A
N
B

21. Holdaway Analysis LI-APog
Measures chin prominence in
relation to lower incisor. More
prominent the chin, the more
prominent the lower incisor can
be
A
Pog
B
N

22. SOFT TISSUE ANALYSIS

23. E- line
S- line
Nasolabial Angle

24. CEPHALOMETRIC
ANALYSIS
STEINER
 Emphasized individual
relationships into a pattern
 Gives specific guides for use of
cephalometric measurements in
treatment planning
 Overcomes magnitude of
discrepancy in ANB angle through
dental correction
Analysis
 SNA- angle
 SNB- angle
 ANB- angle
 I – NA- angle and distance
 I – NB- angle and distance
 Holdaway analysis- Ratio of I –
NB: NB- Pog
 SN- MP

26. CEPHALOMETRIC
ANALYSIS
 SASSOUNI ANALYSIS
 Emphasises vertical and horizontal relationships and the
interaction between vertical and horizontal proportions
 The planes converge toward a single point in well proportioned
faces

27. Skeletal Open Bite
 Planes intersect
close to face
 Diverge quickly
anteriorly
 Long face anteriorly
and short posteriorly
Skeletal Deep Bite
 Planes are nearly
parallel
 Diverge only slowly
as they pass
anteriorly
 Short face overall

28. Harvold and Wits Analysis
 Describe severity of jaw disharmony
 Wits uses “Functional Occlusal Plane”
 Point A ahead- Millimetric measurement is positive and
patient is diagnosed as Class II
 Point B ahead- Millimetric measurement is negative and
patient is diagnosed as Class III
 Influenced by teeth horizontally and
vertically
 Horizontally by pts. A and B
 Vertically by occlusal plane

29. McNAMARA ANALYSIS
 More precise
measurement of tooth
and jaw relations
 Reference planes are:
 Frankfort Horizontal
 Basion- Nasion plane
Analysis
 AP position of Mx and Md in
relation to Nasion
Perpendicular
 Harvold approach for jaw
length measurement
 Ricketts approach for lower
incisor protrusion (LI- APog)
 Upper incisor protrusion
measured from
perpendicular from pt. A
CEPHALOMETRIC
ANALYSIS
Ba
N
FH Plane

30.  Strengths of McNamara:
 More accurate in diagnosing the sagittal position of the
jaws
 Normal range of measurements are most accurate
CEPHALOMETRIC
ANALYSIS