Computerised cephalometric systems (2)

COMPUTERIZED
CEPHALOMETRIC
SYSTEMS
www.indiandentalacademy.com

ACKNOWLEDGEMENT
DR.E.MUNIRATHNAM NAIDU- PRINCIPAL
DR.P.JAYAKUMAR. HEAD OF DEPARTMENT
ALL STAFF MEMBERS & P.G. COLLEAGUES
DEPT. OF ORTHODONTICS & DENTOFACIAL
ORTHOPEDICS,
MEENAKSHI AMMAL DENTAL COLLEGE
CHENNAI

INTRODUCTION
• Cephalometric radiography
was introduced in 1930’s and computerized cephalometry
in 1970’s.
• Used in Orthodontics for diagnostic, prognostic and treatment
evaluation.

Communication with patients
through graphic imaging.
Visualize facial effects of treatment
before final decisions are made.
Allows the Orthodontist to design
the face first and measure what is
needed to get there.
COMPUTERS HAVE FACILITATED

COMPUTER APPLICATIONS IN
PREDICTION
• It offers treatment planing manipulations such
as growth estimation, orthopedic intervention,
orthodontic tooth movement and orthognathic
surgery.
• Can be used for case diagnosis and
treatment planing.
• Can be used for formulation of computer
generated treatment plans, so called visual
treatment objectives (VTO’s) or surgical
treatment objectives (STO’s).www.indiandentalacademy.com

ADVANTAGES OVER MANUAL
TECHNIQUE
• Faster than manual technique.
• Removes human error except for errors of
landmark identification.
• Facilitates the use of double digitization of the
land marks and the significantly increases the
reliability of the analysis.www.indiandentalacademy.com

Contd...
• Easy storage and retrieval of cephalometric
values and tracing.
• Cephalometric data can be combined with
patient’s files, photographs and dental casts.
• In Orthognathic surgery computerized
cephalometric prediction of the surgical outcome
on hard tissue and soft tissue profile are better
than manual technique.www.indiandentalacademy.com

LANDMARK TRACING
MANUAL COMPUTERIZED

TRACINGS -ANALYSIS
MANUAL COMPUTERISED

TECHNICAL PRINCIPLES
• It can be divided in to two components
1. Data Acquisition
2. Data Management
• Data acquisition is achieved by various means
including ionizing radiation, magnets, sound
and light.

IMAGE ACQUISITION
• Three methods are available
1. The phosphor plate technique
2. Direct receptor technique
3. Transparency scanner technique

THE PHOSPHOR PLATE
TECHNIQUE
• Uses Photo stimulable phosphor plates instead
of film.
• Conventional X-ray tube is used to expose the
plate.
• The sensitivity of the plate allows a reduction in
x-ray exposure up to 90%.
• Plates are reusable.www.indiandentalacademy.com

DIRECT RECEPTOR
TECHNIQUE
• Photo sensitive such as a CCD in place of
x-ray film.
• Conventional x-ray tube is used.
• The sensor transfers its data through a
thin cable directly to an interface
board in a computer
• Data are converted to a gray scale image
and saved to the disk.

TRANSPARENCY SCANNER
TECHNIQUE
• Simplest and least expensive method.
• X-ray film is scanned by a light source.
• The transmitted light is detected by a
CCD and is digitized into gray scale
intensities.

DIGITIZATION
• A process by which analog information is
converted into digital form.
• Digitizer is an inexpensive, accurate tool
for digitizing cephalograms.
• Digitizers may be opaque, translucent or
transparent.

Two modes of digitization
• Two modes of digitization
1. Point mode
2. Stream mode
• Point mode digitization refers to the discrete
location of individual landmarks.
• Stream mode digitization : A process in which a
stream of coordinate pairs is recorded as the user
traces a radiographic contour and is controlled by
programmable options.www.indiandentalacademy.com

CEPHALOMETRIC ANALYSIS
AND TREATMENT PLANING
• Cephalometrics - 1. Static function
2. Dynamic function
• Static function - Information is derived from the
radiographic contours on a current film or
collection of films.
• Dynamic function - Elements of the cephalometric
representation are transformed or manipulated.

DIFFERENT TYPES OF
COMPUTERIZED
CEPHALOMETRIC SYSTEMS
• RMO’s (Rocky Mountain orthodontics) Jiffy
orthodontic evaluation.
• The first to provide a computer aided cephalometric
diagnosis in 1960.
• JOE is a static analysis program.
• Tracing of lateral or frontal cephalograms using
Ricketts, Jarabak, Sassouni, Steiner and Grummons
analyses. www.indiandentalacademy.com

POR DIOS (Purpose on request
Digitizer input output System)
• Is capable of solving measuring problems the two
dimensional Cartesian coordinate system.
• Based on a library of mathematical procedures (i.e.
angular and linear)
• It uses Cephalometric analysis including Bjork,
Burstone, Coben, Downs, Frontal McNamara, Profile,
Ricketts, Seiner and Tweed.www.indiandentalacademy.com

Contd…
• Capable to produce occlusograms from
photocopies of dental casts.
• It is multilingual.
• Can produce a database file containing the
results of the digitization.

DENTOFACIAL PLANNER
• Computer aided diagnostic and treatment
planing software system.
• It works with an IBM compatible to 286 or
386processor.
• It allows to do superimpositions, estimate facial
growth, to simulate the skeletal and soft tissue
effects of orthopedic appliances and to stimulate
orthodontic tooth movement.www.indiandentalacademy.com

QUICK CEPH IMAGE
• Programme designed especially for high end
macintosh computers.
• A high resolution monitor should be used.
• The Hardware also consists of a black- white
camera, camera stand and a colour printer.
• It allows the user to take all the patient’s
pictures, including intra orals.

DIGI GRAPH
• Is a synthesize of video imaging, computer technology
and 3 dimensional sonic digitizing.
• Work station equipment measures above 5 feet x 3 feet x
7 feet.
• This device uses sonic, digitizing electronics to record
cephalometric landmarks by lightly touching the sonic
digitizing probe to the patients skin.
• Three dimensional www.indiandentalacademy.com

Digigraph uses sonic
digitizing electronics
to record
cephalometric
landmarks by lightly
touching the sonic
digitizing probe to
the patient’s skin.

TREATMENT VISUALIZATION
APPLICATIONS
• Applied to cephalometric projections of
anticipated growth and treatment response.
• Two visualization approaches
1. Image Editing
2. Manipulation of linked photocephalometric
pairs. www.indiandentalacademy.com

Graphic Imaging - Treatment simulations
Initial Record
High pull H. G
4’s
Extraction
Growth Forecast
Mandibular
Advancement

IMAGE EDITING SYSTEMS
• Facial images are modified using a variety
of simple image editing tools to stimulate
the effects of the treatment on facial form.

PHOTO CEPHALOMETRIC
TREATMENT VISUALIZATION
• These are done by linking digitized lateral
cephalograms to lateral facial bitmapped imaged
for automatic facial transformation.
• Treatment visualization applications perform
cephalometric prediction and image
transformation in a manner that appears tobe
virtually simultaneous.

PHOTO CEPHALOMETRIC TREATMENT VISUALIZATION

SELECTION OF COMPUTERIZED SYSTEM
• User friendly
• Should transform all digitized points into x and y co-
ordinates,
• Compatible with all cephalometric analyses.
• Easy to modify and add new points to the system.
• Should have a graphic demonstration of the patient’s
structures.

Contemporary diagnosis and treatment
planning have been taken to a different
level with the advent of computerised
cephalometrics.
With ever widening technological
advances, this will be the future of
orthodontic diagnosis, treatment
planning, prediction of growth and
treatment outcome, be it orthodontic
treatment or orthognathic surgery.

Computerised cephalometric systems (2)

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