Orthodontic Cephalometrics

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Orthodontic Cephalometrics Dr.Gyan P. Singh(Associate prof.) 8th Dec.2014

Cephalometrics-Dr.Gyan P.Singh William Down’s (1948) 5 skeletal & 5 denture patterns. SKELETAL 1. Facial angle (87.5 degrees) 2. Angle of convexity (0 ) 3. A-B Plane angle (-4.6) 4. Mandibular plane angle (21.9) 5. Y-Axis (59.4) DENTAL 1.Cant of occlusal plane (9.3) 2.Interincisal angle (135.4) 3.Mandibular incisor to occlusal plane angle (14.5) 4.Incisor- mandibular plane angle (91.4) 5. Protrusion of maxillary incisor (2.7 mm) . Cephalometrics-Dr.Gyan P.Singh 2

Cephalometrics-Dr.Gyan P.Singh 1.Facial angle- Posterior-inferior angle at the intersection of facial plane with Frankfort horizontal plane , indicates the degree of recession or protrusion of the mandible in relation to upper face. Cephalometrics-Dr.Gyan P.Singh 3

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 4

Cephalometrics-Dr.Gyan P.Singh 2. Angle of convexity This angle measures the degree of the maxillary basal arch protrusion at its anterior limit relative to the facial profile. Cephalometrics-Dr.Gyan P.Singh 5

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 6

Cephalometrics-Dr.Gyan P.Singh 3.A-B plane angle A-B plane is a measure of the relation of the anterior limit of the apical bases to each other relative to the facial plane. Cephalometrics-Dr.Gyan P.Singh 7

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 8

Cephalometrics-Dr.Gyan P.Singh 4. Mandibular plane angle Mandibular plane is tangent to the gonial angle and the lowest point of the symphysis (Me). Cephalometrics-Dr.Gyan P.Singh 9

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 10

Cephalometrics-Dr.Gyan P.Singh 5. Y-Axis It is also called as growth –axis angle measured as posterior inferior angle on S-N plane and Sella to Gnathion line. Cephalometrics-Dr.Gyan P.Singh 11

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 12

Cephalometrics-Dr.Gyan P.Singh Denture pattern 1.Cant of occlusal plane It is suggestive of anteropostrior tilt of occlusal plane in relation to the cranial base. Cephalometrics-Dr.Gyan P.Singh 13

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 14

Cephalometrics-Dr.Gyan P.Singh 2.Interincisal angle It is indicative of protrusiveness of upper and lower incisors. Cephalometrics-Dr.Gyan P.Singh 15

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 16

Cephalometrics-Dr.Gyan P.Singh 3.Mandibular incisor to occlusal plane The angle measured is the complement of the angle formed by the intersection of the long axis of lower incisor with the occlusal plane. Cephalometrics-Dr.Gyan P.Singh 17

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 18

Cephalometrics-Dr.Gyan P.Singh 4.Incisor-Mandibular plane angle It indicates inclination of the lower incisor on the mandibular plane. Cephalometrics-Dr.Gyan P.Singh 19

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 20

Cephalometrics-Dr.Gyan P.Singh 5.Protrusion of maxillary incisors The measurement is made from upper incisal edge to A-Pg line. Cephalometrics-Dr.Gyan P.Singh 21

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 22

Cephalometrics-Dr.Gyan P.Singh Cecil C Steiner (1953) 5 skeletal & 5 denture patterns. SKELETAL 1. Angle SNA(82 degree) 2. Angle SNB (80) 3. Angle ANB(2) 4. Mandibular plane angle (32) 5. Occlusal plane to S-N Plane(14.5) DENTAL 1.Maxillary incisor position(angular-22) 2. Maxillary incisor position(linear-4 mm) 3. Mandibular incisor position(angular-25) 4. Mandibular incisor position(linear-4mm) 5. Inter incisal angle(131) Cephalometrics-Dr.Gyan P.Singh 23

Cephalometrics-Dr.Gyan P.Singh 1.Angle SNA Inner angle on SN plane to N-A line. Cephalometrics-Dr.Gyan P.Singh 24

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 25

Cephalometrics-Dr.Gyan P.Singh 2. Angle SNB Inner angle on SN plane to N-B line. Cephalometrics-Dr.Gyan P.Singh 26

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 27

Cephalometrics-Dr.Gyan P.Singh 3.Angle ANB Its difference of the angle SNA and SNB . Cephalometrics-Dr.Gyan P.Singh 28

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 29

Cephalometrics-Dr.Gyan P.Singh 4. Mandibular plane angle The inclination of mandibular plane to SN represents vertical relation of the mandible with the cranium. Cephalometrics-Dr.Gyan P.Singh 30

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 31

Cephalometrics-Dr.Gyan P.Singh 5. Occlusal plane angle The angle between the occlusal plane and the SN plane. Cephalometrics-Dr.Gyan P.Singh 32

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 33

Cephalometrics-Dr.Gyan P.Singh Denture pattern 1.Maxillary incisor position(angular) The angulation of the long axis of maxillary incisor to NA line. Cephalometrics-Dr.Gyan P.Singh 34

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 35

Cephalometrics-Dr.Gyan P.Singh 2.Maxillary incisor position(linear) The linear distance of maxillary incisor to NA line. Cephalometrics-Dr.Gyan P.Singh 36

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 37

Cephalometrics-Dr.Gyan P.Singh 3.Mandibular incisor position(angular) The angulation of the long axis of mandibular incisor to NB line. Cephalometrics-Dr.Gyan P.Singh 38

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 39

Cephalometrics-Dr.Gyan P.Singh 4.Mandibular incisor position(linear) The linear distance of mandibular incisor to NB line. Cephalometrics-Dr.Gyan P.Singh 40

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 41

Cephalometrics-Dr.Gyan P.Singh 5.Inter incisal angle it is a measure of relative position of upper incisor to lower incisor. Cephalometrics-Dr.Gyan P.Singh 42

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date Cephalometrics-Dr.Gyan P.Singh 43

Cephalometrics-Dr.Gyan P.Singh Tweed’s analysis(1954) 1.FMA (25 degree)-Mandibular plane angle 2.IMPA(90)-Lower incisors angle 3.FMIA(65)-Angle between Frankfort horizontal plane and lower incisors plane. Cephalometrics-Dr.Gyan P.Singh 44

Cephalometrics-Dr.Gyan P.Singh Name , Age, Sex& Date FMIA FMIA FMA IMPA Cephalometrics-Dr.Gyan P.Singh 45

MCQ: Porion & Orbitale Nasion & sella Porion & Sella Porion & Nasion 1.Frankfort horizontal is a reference plane constructed by joining Porion & Orbitale Nasion & sella Porion & Sella Porion & Nasion 2. Facial plane is formed by Sella gnathion Sella nasion (C) Nasion pogonion (D) Nasion subspinale 46

4. Facial plane angle is between FHP and N-Pog line 3. Downs cephalometric analysis uses– line as a reference plane ANS-PNS SN plane Porion-Orbitale Gonion- menton 4. Facial plane angle is between FHP and N-Pog line FHP and mandibular plane angle (C) FHP and Sella Gonion line (D) Basion- Nasion and N-Pog line 47

(C) Both maxillary and mandibular growth (D) To design appliance 5. Y-axis is used to analyse Maxillary growth Mandibular growth (C) Both maxillary and mandibular growth (D) To design appliance 6. Decreased interincisal angle indicates Retrusion of teeth Protrusion of teeth Vertical overlap Horizontal overlap 48

7.The three landmarks which determine skeletal convexity are Glabella,prosthion, and supramentale Nasion, Sella and articulare Nasion, subspinale and pogonion Orbitale, anterior nasal spine and pogonion 8. Angle SNA is used to Relate maxilla to mandible Relate maxilla to cranial base Relate mandible to maxilla None of the above 49

9. In bimaxillary prognathism malocclusion SNA is increased SNB is increased Both SNA and SNB are increased Both SNA and SNB are decreased 10. Which of the following conditions cannot be assessed by a lateral cephalogram Mandibular lateral asymmetry Vertical facial descrepancy Increased posterior height Decreased anterior height 50

REFERENCES Graber TM:Principles and Practicce Orthodontics,WB Saunders,1988 Profitt.Contemporary Orthodontics,Elsevier India.3rd ed.,2000. 51

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