Cephalometric Analysis

Arya Brahmanta,drg.Sp.Ort
 HISTORY
•  Cephalometrics
introduced for use by
orthodontists in 1931
by Dr. Broadbent in
the USA and
Hofrath in Germany
independently of one
another.
 
LATERRAL  VIEW    OF  THE  SKULL  
 Cephalometric  Analysis  
•  Downs  (1948)  
•  Steiner  (1953)  
•  Rickets  (1960)  
•  Tweed  (1966)  
•  Wits  (1975)  
•  McNamara  (1988)  

 
 Definition
Cephalo: head
Metric: measurments

•  Cephalometry: is the analysis and the interpretation of

standardized radiographs of the facial bones.

•  It is a standardized and reproducible form of skull

radiography used extensively in orthodontics to asses the
relationships of the teeth to the jaws, and the jaws to the
rest of the facial skeleton.
 The cephalostat

•  Head position: the patient’s head is oriented

in the same position relative to the x-ray
beam every time a film is taken, with the use
of a cephalostat.
•  Ear rods: in the ear canals (external auditory
meatus).
•  Frankfort plane: horizontal.
•  Teeth: in centric occlusion.
•  Lips: in their habitual position.
 Indications for cephalometric
evaluation

•  Assess facial and dentoskeletal relationships.

•  To study growth and growth patterns
•  Evaluation of post treatment changes.
•  Research purposes and long term follow-up studies.
 Cephalometric Tracing

•  The cranial base.

•  The facial skeleton.
•  Soft tissues.
Cephalometric landmarks
Landmarks

•   Sella Turcica (S)

The midpoint of the
sella turcica

 • 
     Orbitale (Or)
The most inferior
anterior point on the
margin of the orbit
 
 
 
Landmarks
 
  •   Nasion (N)
The most anterior point
of the frontonasal
suture
Landmarks

•   Anterior Nasal Spine

(ANS)

The tip of the anterior nasal

spine

•   Posterior Nasal Spine

(PNS)
The tip of the
posterior nasal spine
Landmarks
•   A point

The most posterior point

on the profile of the
maxilla between the
anterior nasal spine and the
alveolar crest
•  B point
• The most posterior point on the
profile of the mandible between
the chin point and the alveolar
crest
Landmarks

•   Pogonion (Pog)
 
The most anterior point
on the bony chin
 •       Menton (Me)
 
The lowermost point of
 
the mandibular symphysis
       
in the midline
Landmarks

•   Gnathion (Gn)
• The most inferior point on
the mandibular symphysis
in the midline
•  Gonion (Go)
               
The most posterior inferior
point on the angle of the
mandible
 
 
Landmarks
  •   Porion (Po):
superior
point of external
auditory meatus

•   Machine Porion:
landmark created by ear
post of cephalostat
Cephalometric lines of reference
 REFERENCE  LINES  
•  Frankfort’s  Horizontal  (porion  to  orbitale)  
•  Sella  -­‐  Nasion  line  
•  Maxillary  plane  
•  Oklusal  plane  
•  Mandibular  plane  
Frankfort Horizontal Plane
Sella-Nasion Plane (SN)
Maxillary line:
ANS - PNS
 
Mandibular plane:
Me - Go
 
Occlusal plane:
Cusp tips of molars – tip of
lower incisor
 
 ANALYSIS      CEPHALOMETRIC  
measurement    
Skeletal  
•  the  cranial  base;  
•  the  maxilla;  the  mandible,  
Dental    
•  the  maxillary  and  mandibular  dento-­‐alveolus  
So\  ]ssue  
 
Comparing  individual  subject’s  tracing  to  the  “ideal”  /  
normal    
 
 skeletal relationships (ant-post)

Angle SNA (82 ± 3)

Prognathism of
maxillary apical base
 
 skeletal relationships (ant-post)

Angle SNB (79 ± 3)

Mandibular
prognathism
 
 skeletal relationships (ant-post)

Angle ANB (3 ± 1)
The anteroposterior
apical base
relationship (skeletal
pattern)
 skeletal relationships (ant-post)

Wits analysis (Jacobson,

1975)
Compares the
relationships of the
maxilla and mandible
with the occlusal
plane (FOP)
 
 
Dentoskeletal
relationships  
U1 TO FH 110 ± 5
deg
U1 TO NA 22deg
                 DENTAL  -­‐  MAXILLARY  INCISOR  
U1 TO NA 4mm

FH

A
L1 TO NB 25deg
L1 TO NB 4mm
                 DENTAL  -­‐  MANDIBULAR  ANTERIOR  
L1 TO GOGN 91
± 6deg

GO B

GN
INTERINCISAL
130 ± 5 deg

         DENTAL  -­‐  UPPER  TO  LOWER  INCISOR  

So\  Tissue  
NASOLABIAL
ANGLE 102 ± 8
deg
L.LIP TO E
SOFT  TISSUE  
PLANE -2 ±2mm
 Tweed  
“  The  Diagnos]c  Facial  Triangle”  
•  Frankfort-­‐Mandibular  plane  Angle  (FMA)  
•  Frankfort-­‐Mandibular  Incisor  Angle  (FMIA)  
•  Incisor  –  Mandibular  plane  Angle  (IMPA)  
 Tweed  Analysis  

When  FMA  21-­‐29  degrees,  FMIA  should  be  68  degrees  

When  FMA  is  30  degrees  or  >,  FMIA  should  be  65  degrees  
When  FMA  is  20  degrees  or  <,  IMPA  should  not  exceed  92  degrees  
3  D  Cephalometric  
3  D  Cephalometric  
https://sites.google.com/a/hangtuah.ac.id/arya-brahmanta-publikasi/