Orthodontic cephalometrics 1 st Dec 2014 Dr Gyan

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Orthodontic cephalometrics 1 st Dec. 2014 Dr. Gyan P. Singh Associate Professor Department of

Orthodontic cephalometrics 1 st Dec. 2014 Dr. Gyan P. Singh Associate Professor Department of Orthodontics&Dentofacial Orthopaedics

. • In 1931 Brodbent in USA and Hofrath in Germany simultaneously presented a

. • In 1931 Brodbent in USA and Hofrath in Germany simultaneously presented a standardized cephalometric technique. • Cephalogram are of two types: Lateral cephalogram Frontal cephalogram

Principles Cephalogram film size is 8 x 10 inch Kvp = 80 MA =

Principles Cephalogram film size is 8 x 10 inch Kvp = 80 MA = 12 Time = 0. 5 sec Distance between radiograph source and mid - sagittal plane is= 5 feet The distance between the mid- sagittal plane of the patient and the radiograph=15 cms

Cephalostate Machine

Cephalostate Machine

INDICATIONS & USES OF CEPHALOGRAM 1. Severity of dental malocclusion 2. Severity of skeletal

INDICATIONS & USES OF CEPHALOGRAM 1. Severity of dental malocclusion 2. Severity of skeletal malocclusion 3. Identify the location of the dysplasia 4. Evaluate soft tissue and its relationship with dental hard tissue and skeleton of face

4. Aids in treatment planning decision on extraction/ growth modification/surgical 5. Stage and post-treatment

4. Aids in treatment planning decision on extraction/ growth modification/surgical 5. Stage and post-treatment cephalograms are taken to monitor progress of treatment. 6. Added advantage of using CVMI to know the status of the growth. 7. Design and plan retention strategy.

. Cephalometric landmarks • • Anatomic : Nasion, Orbitale, Sella, Menton Derived : Gonion,

. Cephalometric landmarks • • Anatomic : Nasion, Orbitale, Sella, Menton Derived : Gonion, Gnathion • Unilateral : Sella, Point A, Point B • Bilateral : Orbitale , Gonion, Porion

. • Nasion - Most anterior point on frontonasal suture mid- saggital plane •

. • Nasion - Most anterior point on frontonasal suture mid- saggital plane • Sella – Cenre of sella turcica • Orbitale – Lower-most point of the bony orbit

Name , Age, Sex& Date . Nasion Sella Orbitale

Name , Age, Sex& Date . Nasion Sella Orbitale

• Porion – Highest bony point on the upper margin of external auditory

• Porion – Highest bony point on the upper margin of external auditory meatus. • Point A – Deepest point in the midline between the anterior nasal spine and alveolar crest between the central incisor. • Point B – Deepest point in midline between the alveolar crest of mandible and the mental process.

Name , Age, Sex& Date . Porion Point A Point B

Name , Age, Sex& Date . Porion Point A Point B

• ANS : The most anterior point of the tip of anterior nasal

• ANS : The most anterior point of the tip of anterior nasal spine in midsaggital plane • PNS : A constructed point , intersection of the continuation of anterior wall of pterygo-maxillary fissure and nasal floor. • Pogonion - the most anterior point of chin in the midsaggital plane.

Name , Age, Sex& Date . PNS ANS Pogonion

Name , Age, Sex& Date . PNS ANS Pogonion

• Menton – Most inferior point of the outline of symphysisin mid-saggital plane

• Menton – Most inferior point of the outline of symphysisin mid-saggital plane • Gnathion – Anterio- inferior point on bony chin • Gonion - Constructed point at the intersection of the lines tangent to the posterior border of the ramus and the lower border of the mandible

Name , Age, Sex& Date . Gonion Gnathion Menton

Name , Age, Sex& Date . Gonion Gnathion Menton

MCQ: 1. Cephalostat was introduced by (A) Margolis & William Wilson in 1925 (B)

MCQ: 1. Cephalostat was introduced by (A) Margolis & William Wilson in 1925 (B) Tweed & Mills in 1940 (C) Bjork & Sassouni 1995 (D) Broadbent & Hofrath in 1932 2. In lateral cephalometrics, the distance at which source and object are placed from mid-sagittal plane is (A) 50 inches (B) 60 inches (C) 75 inches (D) 90 inches

3. Which of the following statement regarding lateral cephalogram is true (A) Right side

3. Which of the following statement regarding lateral cephalogram is true (A) Right side is towards the tube (B) Left side is towards the cassette (C) Left side of face is viewed clearly (D) All of them 4. Which of the following landmark is not located in the mandible (A) Pogonion (B) Gnathion (C) Menton (D) Porion

5. Gonion, Menton, Pogonion are cephalometric landmarks located on (A) Midline (B) Mandible (C)Bony

5. Gonion, Menton, Pogonion are cephalometric landmarks located on (A) Midline (B) Mandible (C)Bony chin (D)Profile skeletal 6. Nasion is situated at (A) Frontonasal suture (B) Zygomatic process (C) Orbital floor (D) None of the above

7. The deepest point between the anterior nasal spine and superior prosthion is (A)

7. The deepest point between the anterior nasal spine and superior prosthion is (A) Infraspinale (B) Subspinale (C) Supranasal (D) Gnathion 8. The most anterior part of bony chin (A) Gonion (B) Menton (C) Pogonion (D) Porion

9. Unilateral landmark on lateral cephalogram (A) Nasion (B) Gonion (C) Porion (D) Orbitale

9. Unilateral landmark on lateral cephalogram (A) Nasion (B) Gonion (C) Porion (D) Orbitale 10. The bilateral landmark on the lateral cephalogram (A) Basion (B) Pogonion (C) Gonion (D) Nasion

REFERENCES 1. Graber TM: Principles and Practicce Orthodontics, WB Saunders, 1988 2. Profitt. Contemporary

REFERENCES 1. Graber TM: Principles and Practicce Orthodontics, WB Saunders, 1988 2. Profitt. Contemporary Orthodontics, Elsevier India. 3 rd ed. , 2000. 3. Kharbanda. diagnosis and management of malocclusion and dentofacial deformities. Elsevier India. 1 ST edition, 2009.

5 marks

5 marks

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