1. The document describes a method for performing sagittal cephalometric analysis using Microsoft PowerPoint. Key structures and measurements are identified by tracing lines on a lateral cephalogram within PowerPoint. 2. Reference lines include the true vertical, nasion and menton perpendiculars, the ANS-PNS line, and lines tracing sagittal jaw positions. Angles like IMPA and inclinations like the palatal plane are assessed visually. 3. This PowerPoint method aims to promote diagnostic criteria formation through visualization rather than numerical measurements. It allows for easy observation and interpretation of sagittal dental and skeletal relationships.

1. 1
PRESENTED BY –
DR. FIRDOSH ROZY
SAGITTAL CEPHALOMETRICS
DIAGNOSIS USING POWER POINT
{MICROSOFT OFFICE}

2. INTRODUCTION :
 In 1931, HOFRAT in Germany and BROADBENT in US,
published a paper ‘ A new x-ray technique and its application in
cephalometrics.’This brought in consequence several studies of
lateral cephalometric analysis; Downs, Margolis, Ridel, Steiner,
Schwarz, McNamara, Fastlicht etc.
Currently the use of technology brings the possiblity of including
a teleradiographic image into a computer making it possible to
perform different cephalometric analysis by just pressing a key.
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3. SAGITTAL CEPHALOMETRICS DIAGNOSIS
USING POWER POINT{MICROSOFT
OFFICE}
ROBERTO SILVA MEZA,
2016
 The purpose of this analysis is to
show a practical method for sagittal
cephalometric diagnosis using the
Power Point software included in
the Microsoft Office package.
 The main quality of this method,
unlike others, is to promote the
formation of diagnostic criteria
mainly through visualization.
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4. METHODS
To describe how this procedure is performed, R. Silva
uses the digital image of a female, normodivergent class
Ⅰ patient of 13 yrs of age with ideal characteristics who
had not received any orthodontic treatment.
 In the photograph, a metal chain that was placed with
the purpose of having a reference of a true vertical drop
may be observed.
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5. 5

6.  Once the image is located on
the screen of microsoft office,
by using the program’s tools, a
line in the continuity of metal
chain is dropped, it will serve to
indicate “ TRUE VERTICAL”.
Then this line is doubled and
the new line is located in the
subnasal point.
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7.  In the subnasal area we can identify the following points:
1. Subnasal
2. Prominences of upper and lower lip
3. Soft tissue point B
4. Soft tissue chin
 These references and its normal values were described by ARNETT.
 These normal values can be detected without the need to measure
directly so we can do the visual exercise and an increase/decrease in these
sagittal distances are appreciated at first sight.
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8. 8

9. The analysis can be
continued by drawing a
horizontal line
perpendicular to
subnasal vertical, from
point Nasion.
This line represents the
upper facial edge.
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10. Then replicate this
horizontal line at the
reference point menton.
This line represents the
lower facial edge.
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11. By using subnasal
vertical we can
duplicate the
verticle line at
point A.
Another will be
placed tangent to
the most anterior
surface of the most
prominent upper
incisor.
Then at point
Nasion.
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12. According to McNamara distance b/w point A
vertical and Tangent to upper incisor is normally
4-6 mm.
An increase and decrease of this distance suggest
proclination or retroclination of the upper
incisors.
PROCLINATION RETROCLINATION
INTERPRETATION :
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13. The ideal sagittal position of upper central incisor
{dotted} must be in b/w subnasal and Nasion
vertical.
And if not located in this position we can
interprete protusion and retrusion of the upper
incisors.
PROTRUSION RETRUSION
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14.  In general terms, the normal
value of sagittal maxillary as
well as mandibular ideal
relationship regarding
Nasion vertical line for a
class Ⅰ normodivergent
malocclusion is 2±2 mm.
 Any discrepancy in this
distance will consider as
prognathism/retrognathism
of maxillary/mandibular jaw
in the sagittal dimension.
This fig clearly exemplifies a mandibular
retrognathism combined with the ideal sagittal
maxillary position.
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15. To determine the sagittal intermaxillary relationship, i.e. to determine
the Angle class {Ⅰ, Ⅱ, Ⅲ} we can use the point A line because it serves
to easily locate the relationship of points ‘A’ and ‘B’.
This fig exemplified the above mentioned sowing class 1 relationship.
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16. Continuing with the procedure we traced the lines for the mandibular plane and
the lower incisor axis to display the IMPA angle of tweed..wic 90-95 degree in
general.
It is easy to analyze this angle visually.
Any increase and decrease in this angle will signifies inclination of lower incisor
in relation to mandibular body.
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17. Subsequently S-Gn axis or Y-Axis can be drawn.
It will indicate the direction of facial growth and it should be ideally || to the
axis of upper incisors.
When there is no parallelism both lines must be identifies separately in
order to detect whether the problem is dental, skeletal, or combination of
both.
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18.  Next we create 2 lines || to Nasion horizontal place one from ANS, and other
from PNS, In case bot are same, only 1 line is preferred.
The ideal position of palatal plane is determined when the line of PNS is below
the line of ANS with an inclination of 2 degree.
The interpretation of the inclination of palatal plane is related to an anterior or
posterior mandibular rotation.
Downward / Backward platal plane will favor a posterior mandibular rotation
contributing to a classⅡ/ Ⅲ malocclusion respectively.
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19. Next a line is drawn in upper stomion. Ideally by Legan-Burstone upper
incisors are located below the line approx. 3mm, while the incisal edges of
lower incisor rests in this line. When this happens there is balance and hormony
b/w the incisal guide and the position of tongue and lips thus providing function
and esthetics.
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20. To assess total facial height, Nasion and Menton horizontal lines are used.
Generally face is divided into 2 halves upper and lower facial half. Upper facial half
is in b/w Nasion and palatal plane horizontal, and lower half is in between palatal
and menton horizontal.
In general lower half is one third longer than upper half.
To facilitate the display we can use power point tools to draw rectangles.
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21. The lower portion of lower rectangle ideally represent one third of the lower
face. {Normodivergent}
 when it increases { hyperdivergent} / decreases { hypodivergent }…it relates to
vertical / horizontal facial growth, a postero-mandibular / antero-mandibular
rotation , or vertical mandibular excess / deficiency respectively.
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22.  As mentioned at the beginning, we believe that the use of this cephalometric
tracing in power point program Microsoft Office may be of great help for an
easier observation of sagittal lateral headfilm.
Like other methods its practice throughout time will best prove its
effectiveness.
Althoug its numerical norms established by prior analysis, it relies mainly in
objectively.
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23. Lateral ceph of a patient by placing a mettalic wire for the purpose of reference
vertical plane. 23

24. Lateral ceph of a patient by placing a mettalic wire for the purpose of reference
vertical plane. 24

25. S
nTrue
verticle
•
•
•
•
•
Nasion perpendicular
Menton perpendicular
‘A’Verticle
NasionVerticle
•
ANS-PNS
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26. Subnasal - || -
Up L Promin -3-4 mm - Proquelia
Lwr L Prominance -0-2 mm - Proquelia
B’ - -5 mm - Normal
Pog’ - -3mm - Retrusive
Nasion perpendiculr - Upper facial edge
Menton perpendicular - Lower facial edge
‘A’ Vt to Incisor Vt - 4-6 mm - Proclined
( Dotted line is not in b/w ‘A’ Vt nd Incisor Vt )
Nasion Vt to maxilla - 2±2 mm - Orthognathic maxilla
Nasion Vt to mandible - 2±2 mm - Retrognathic mandible
Nasion Horizontal – ANS-PNS < ANS-PNS-Menton - Lower facial half is
MORE.
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27. N Verticle
ANS
PNS
Horizontal stomion
Menton perpendicular
N-PNS
N-ANS
ANS-Gn 27

28. IMPA - 90-95 - Protusive
Y- Axis - 53-66 - Verticle Gro
S-Gn and Ʇ Up Incisor not || - - Protusive Maxilla
ANS || to Nasion Vt nd PNS || to Nasion Vt Angle (-2) - Downward palatal inclina
contributed to post. Mand rotation may lead into class 2 malocclusion.
Up Incisor more than 3mm below placed - Lip and Incisors not in harm
related to stomion horizontzl.
N-ANS
ANS-Gn Legan and Burstone - lower facial half more
PNS-N
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