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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses. For details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
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Mc Namara Analysis. / orthodontic courses by Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses. For details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses. For details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
www.indiandentalacademy.com Mc NAMARA ANALYSIS www.indiandentalacademy.com INTRODUCTION Dr James. A. McNamara.. described a method of cephalometric analysis which is used in the evaluation and treatment planning of orthodontic and orthognathic surgery patients The analysis represents an effort to relate Teeth to teeth Teeth to jaws Each jaw to the other Jaws to the cranial base www.indiandentalacademy.com Composite Normative Standards Are Based On.. Bolton's Standards Burlington Orthodontic Research Centre Ann Arbor sample of 111 young adults (Female 26 yrs 8 mon, Male 30 yrs 9 mon )
The analysis method is derived in part from the principles of cephalometric analyses of Ricketts and Harvold
www.indiandentalacademy.com Why Another Analysis ? 1940 1970 : Significant alteration in the craniofacial relationship were thought impossible Advent of numerous Orthognathic surgery procedures which allow three dimensional repositioning of almost every bony structure in the facial region
Functional appliance therapy which present new possibilities in the treatment of skeletal discrepancies In the decade from 1970 - 1980 www.indiandentalacademy.com s po Ba Co Or N ANS A Ptm Me Gn Pog Landmarks And Planes : Nasion- Most anterior point on Nasofrontal Suture Porion- Superior aspect of the external auditory meatus
Orbital- lowermost point on the orbit Basion- lowest point on the foramen magnum in the median plane Ptm-
Go www.indiandentalacademy.com s po Ba Co Or N ANS A Ptm Me Gn Pog Landmarks And Planes : ANS- Tip of the bony anterior nasal spine Point A- Deepest point on the curved bony outline ( subspinale ) Pogonion- Most anterior point on the bony chin Menton- Lowest point on the outline of the symphysis Gonion- Constructed by intersection of the lines tangent to the posterior margin of the ascending ramus & the lower border
Go www.indiandentalacademy.com s po Ba Co Or N ANS A Ptm Me Gn Pog Landmarks And Planes : Gnathion- Constructed by intersecting a line drawn perpendicularly to the line connecting Me and Pog Condylion- Most posterosuperior point on the outline of the condyle Mandibular plane Go Me
Facial axis Ptm Gn
Go www.indiandentalacademy.com Craniofacial Skeletal Complex Is Divided Into Five Major Sections Maxilla to Cranial base Maxilla to Mandible Mandible to Cranial base Dentition Airway www.indiandentalacademy.com Relating Maxilla To The Cranial Base Hard tissue evaluation:
Linear distance is measured Between nasion perpendicular to point A
0 mm in mixed dentition 1 mm in adults po or N 1 mm FH www.indiandentalacademy.com Maxillary Skeletal Protrusion Maxillary Skeletal Retrusion With Obtuse Nasolabial Angle
www.indiandentalacademy.com Relating Maxilla To The Cranial Base Soft Tissue Evaluation:
Nasolabial Angle: Formed by line drawn tangent to the base of the nose and a line tangent to the upper lip www.indiandentalacademy.com Relating Maxilla To The Cranial Base Soft Tissue Evaluation:
Cant Of Upper Lip : Female 14 degree Male 8 degree ( SD 8 0 ) N Perpendicular www.indiandentalacademy.com Relating Maxilla To The Mandible: Anteroposterior Relationship:
Effective Midfacial Length : Measured from Condylion to point A
Effective mandibular length : Measured from Condylion to gnathion
www.indiandentalacademy.com Any given effective midfacial length corresponds to a given effective mandibular length Mandibular length Midfacial length = Maxillomandibular differential
Effective lengths are not age or sex related but are related to size of component parts
Small - Mixed dentition Medium - Adult female Large - Adult male
www.indiandentalacademy.com Small : 20 mm Medium : 25 to 27 mm Large : 30 to 33 mm www.indiandentalacademy.com CLASS II DIV 1 Mandible 12 mm deficient www.indiandentalacademy.com Relating Maxilla To The Mandible: Vertical Relationship : Lower Anterior Face Height : Measured from ANS to Menton
Increases with age and is correlated With effective midfacial length
www.indiandentalacademy.com 60 62 mm 66 68 mm 70 74 mm www.indiandentalacademy.com Vertical maxillary excess can cause a downward and backward rotation of mandible resulting in an increase in lower anterior face height and vice versa An increase or decrease in the lower anterior face height can have a profound effect on the horizontal relationship of the maxilla and mandible If the lower anterior face height is increased then the mandible will appear to be more retrognathic and vice - versa www.indiandentalacademy.com www.indiandentalacademy.com Mandibular Plane Angle : Angle between FH plane and the Mandibular plane ( Gonion Menton ) 22 0 + 4 0
www.indiandentalacademy.com Facial Axis Angle : Angle between a line from basion to nasion and the facial axis i.e. PTM to Gn 90 0 < 90 0 ( -ve value ) excessive vertical development > 90 0 ( +ve value ) deficient vertical development www.indiandentalacademy.com Relating Mandible To The Cranial Base Distance from Pog to the nasion Perpendicular
www.indiandentalacademy.com - 8 mm to 6 mm - 4 mm to 0 mm - 2 mm to 2 mm www.indiandentalacademy.com Mandibular Skeletal
Mandibular Prognathism Retrusion www.indiandentalacademy.com Dentition : In cases of malrelationship between the maxillary and mandibular skeletal structures, errors may result if the position of the upper incisor is determined by any measurement that uses mandible as a reference point e.g. A pogonion line
A measurement of upper incisor to the N A line is valid only if the maxilla is in neutral position anteroposteriorly relative to the cranial base
www.indiandentalacademy.com N A www.indiandentalacademy.com Relating upper Incisor to Maxilla : Anteroposterior position Position of the upper incisor can be located by using measurement that relate dental portion of maxilla to the skeletal portion Line parallel to nasion perpendicular through point A Distance from point A er
To the facial surface of upper incisor is measured www.indiandentalacademy.com Vertical position : The incisal edge of the upper incisor lies 2 3 mm below the upper lip at rest
Vertical position of the upper lip is best determined at the time of clinical examination www.indiandentalacademy.com Relating Lower Incisor To Mandible : Anteroposterior position :
Measurement of the facial surface of the lower incisor to the A Pog line Normal : 1 mm to 3 mm anterior A Pog www.indiandentalacademy.com
If there is a discrepancy in Anteroposterior or vertical positioning of the maxilla and the mandible then modifications in this measurement procedure is necessary
To predict Anteroposterior position of the incisor after functional or surgical intervention www.indiandentalacademy.com A second tracing of the mandible and the incisor is made The tracing is moved so that the mandible is in the desired position relative to the maxilla A new A Pog line is drawn The incisor is expected to lie 1 2 mm anterior to the constructed line www.indiandentalacademy.com Estimate the number of mm that the mandible will be brought forward relative to the maxilla at the end of the treatment Then a new point A is constructed the same number of mm in the opposite direction Post treatment A Pog line www.indiandentalacademy.com Vertical Position Of The Lower Incisor : Relating the lower incisor tip to the functional occlusal plane Evaluated on the basis of existing lower anterior facial height Excessive Curve of Spee LAFH is normal or excess Intruded LAFH is inadequate Eruption of the Molars www.indiandentalacademy.com Airway : Upper pharynx Width is measured from a point on the posterior outline of the soft palate to the closest point on the posterior pharyngeal wall Average : 15 - 20 mm www.indiandentalacademy.com 2 mm www.indiandentalacademy.com Airway : Lower pharynx Width is measured from intersection of the posterior border of tongue and the inferior border of the mandible to the closest point on the posterior pharyngeal wall Average : 10 12 mm
www.indiandentalacademy.com www.indiandentalacademy.com Advantages : Linear measurements rather than angles Provides guidelines with respect to normally occurring growth increments The method is more sensitive to the vertical changes Easily explained to non specialist and lay persons such as patients and parents www.indiandentalacademy.com
www.indiandentalacademy.com For more details please visit www.indiandentalacademy.com