Cephalometric X-Ray

Cephalometric (Lateral Radiograph of the Skull)

Analysis
“Review”

These slides are to

replenish and stimulate
your memory

How a cephalometric analysis is

Diagnostic information
organized?
Evaluate facial, skeletal and dental Hard Tissues
Cranial Base
relationships.
Maxilla
Superimposition of serial cephalometric X-rays Mandible
taken at intervals (comparison). Mx-Mn Relation
Dentition
Analyze growth patterns in the craniofacial
Soft Tissues
complex.
Facial Form
Analyze the effects of treatment. Lip Position & Form

Cephalometric Tracing
Anatomic structures
• Pituitary fossa (sella

turcica)

• Frontal bone & Nasal bone

• Orbit

• Maxilla

• Mandible

• External Auditory Meatus

• Anterior Teeth (Incisors)

1
Cephalometric S = center of sella tursica
N = nasion
Measurements
Facial Angle NPg : SN
Mean
80

Landmarks P = porion
Or = Orbitale
SN : FH 6 5
SNA 82
ANS = anterior nasal spine
SNB 80
PNS = posterior nasal spine
ANB 2
A = A point
Angle of Convexity NA : APg 0
U1 = upper central crown tip
Mand Plane : FH 25
L1 = lower central crown tip
Mand Plane : SN 32
B = B point
Y axis (SGn : SN) 60-66
Pg = pogonion
U 1 : SN 103
Me = menton
U 1 : NA 22
Gn = gnathion
U 1 : NA (mm) 4 mm
Go = gonion
Anterior part of Nose U1 : L 1 130 -132

Sn = subnasale L 1 : Mand Plane 90

Ls = upper lip tip L 1 : NB (mm) 4 mm

Li = lower lip tip Lower Face Height Total Face Height 57%
Pg’ = Soft Tissue Pogonion ANS to Gn N to Gn

Reference Planes Facial Angle = NPg : SN

• SN plane
NPg : SN = 87
• Frankfort horizontal (P-Or)

• Palatal plane (ANS-PNS)

Concave
• Occlusal plane

• Mandibular plane (Go-Gn)

Convex

SN : FH Maxilla AP

S-N-A Mean: 82

SNA
Protrusive Mx

SN : FH = 6 5
SNA
Retrusive Mx

2
 Mx-Mn Relation / Sagittal
Mandible AP

S-N-B Mean: 80 A-N-B Mean = 2o

ANB
Skeletal Class II
SNB
Prognathic Mn
ANB
Skeletal Class III

SNB DO NOT MEASURE THE ANGLE

Retrognathic Mn
JUST SUBSTRACT SNA - SNB

Angle of Convexity Mandibular plane

NA : APg = 0 • GoGn : SN = 32
The smaller angle

• GoGn : FH = 25
NA: APg
Skeletal Class II
Hyperdivergent
NA : APg
Skeletal Class III
Hypodivergent

Flat Mn plane Steep Mn plane

Y axis = 60-66 FH : SGn angle

SN : SGn angle

vertical growth
pattern

horizontal
growth pattern

3
U 1 : SN = 103 U 1 : NA = 220

proclined proclined

Retroclined Retroclined

U 1 : NA = 4mm L 1 : NA = 25

protruded proclined

Retruded Retroclined

Interincisal Angle
L 1 : NA = 4mm (U 1 : L 1) = 130-132

protruded

Retruded

Bimaxillary Dental protrusion

4
L1 : Mandibular Plane (IMPA) Procumbent lower incisors
(Go-Gn) to L1 = 90

Procumbent
lower incisors

Recumbent
lower incisors
103°

Upper Anterior Face Height Lower Anterior Face Height

Anterior face Height

Upper Anterior
Facial Height /
N-ANS (UAFH)

43%
Lower Anterior
Facial Height /
57% ANS-Me (LAFH)

Lower Face Ht Total Face H

ANS to Gn N to Gn
Increased LAFH Decreased LAFH

5
Lip Position & Form Nasolabial Angle

Cm-Sn-Ls
Mean: 102
85-110

Cm-Sn-Ls
Labionasal Angle
(abtuse)
Acute Obtuse
Cm-Sn-Ls Proclined incisors Retroclined incisors
Labionasal Angle Depressed nasal tip Elevated nasal tip
(acute)

E-Line

Upper Lip 2-4mm

behind the Line

Lower Lip 0-2mm

behind the Line