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Advances in Diagnostic Aids

Digital Cephalometry
Videocephalometry
DigiGraph

CT Scan
MRI
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Structured Light techinque
Laser scanning

Stereophotogrammetry
3-D Study models

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CEPHALOMETRIC
RADIOGRAPHS
X- ray was discovered by Roentgen in1895.
W.A.Prince in 1900 showed the importance
of radiography as a diagnostic aid in
orthodontics.
Hofrath (Germany) and Broadbent (US) in
1934 provided both, a research and a clinical
tool for the study of malocclusion and
underlying skeletal disproportion which still
remains relatively unchanged today.
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Lateral cephalogram have two
purposes: -
1. It reveals details of skeletal and dental
relationships that cannot be observed in
any other way.
2. It evaluates the precise evaluation of
response to the treatment.
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Limitations of 2-dimensional
cephalogram
1. It is a two dimensional representation of a
three dimensional object.
2. Cephlalometric analyses are based on the
assumption of perfect superimposition of
the right and left sides, but this is observed
infrequently.
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Hand Wrist Radiograph
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Hand Wrist Radiographs
Chronological age is often not sufficient for
assessing the developmental stage and
maturity of the patient.
Thus, biological age has to be determined.

Hand Wrist radiographs are an effective tool
to assess the biological age.
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In the early 1900s, Pryor(1907), Rotch(1908),
and Crampton(1908) began tabulating
indicators of maturity on sequential
radiographs of the growing hand and wrist.

Todd(1937) compiled hand-wrist data that
was further elaborated on by Greulich and
Pyle(1959) in atlas form.
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Fishman(1979) developed a system of hand-
wrist skeletal maturation indicators (SMIs)
using four stages of bone maturation at six
anatomic sites on the hand and the wrist.

Hagg and Taranger(1980) created a method
using the hand-wrist radiograph to correlate
certain maturity indicators to the pubertal
growth spurt.
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Cervical Vertebrae Maturation Index
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Study Cast Analysis
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Study cast analysis is a three-dimensional
assessment of the maxillary and mandibular
dental arches and the occlusal relationships.

The importance of this method of evaluation
for orthodontic diagnosis and treatment
planning in the past been over-emphasized.
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Symmetric Maxillary Arch
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Midline shift in Maxillary Arch (right)
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Measurement of Palatal Height
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DIGIGRAPH
It allows any cephalometric point to be
located within the three planes of space.

Digigraph work station is about 5x3x7 feet
and requires about 25 feet of working area.

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Ear rods and forehead and posterior head
pieces are used to minimize patient
movement.

The ear rods can be removed so that facial
and intraoral images can also be recorded
while the patient is sitting in the adjustable
chair.

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Videocephalometry
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Step 1
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Step 2
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Digital Radiography
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In digital radiography, instead of the silver
halide grain, the image is constructed using
pixels.

A digital image is a matrix of square pieces,
or picture elements (pixels), that form a
mosaic pattern from which the original image
can be reconstructed for visual display.
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