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MATERIALS FOR TRACES,

LOCATION OF POINTS,
STRUCTURES, PLANS AND
CEFALOMETRIC ANGLES. THEORY
AND INTRODUCTION TO
PRACTICE

JULIANA GOMEZ ARANA


RESIDENTE PRIMER AO
INDEX
METHODS FOR STUDYING CRANEOFACIAL
PHYSICAL GROWTH.
MATERIALS FOR CEPHALOMETRIC TRACES.
PROCESS.
ANATOMICAL STRUCTURES THAT SHOULD BE
DRAWN IN LATERAL SKULL RADIOGRAPHY.
PLANES AND ANGLES
PROGRAMAS FOR MADE DIGITAL
CEPHALOMETRY
METHODS FOR STUDYING CRANEOFACIAL
PHYSICAL GROWTH:
CRANOMETRY

Measurement of skulls from human skeletal


remains.
This material has allowed to gather great
amount of information on extinguished
populations and to find out something about
their growth patterns when comparing some
skulls with others
ANTROPOMETRY

A number of parameters established in studies


with dissected skulls are measured in living
individuals using only the soft tissue areas that
CEPHALOMETRIC
RADIOGRAPH

Is based on an accurate orientation of the head. Allows


direct measurement of skeletal bone defects, since
bone can be visualized through the soft tissues that
cover it, allowing the individual to be monitored over
time.
MATERIALS FOR CEPHALOMETRIC
TRACES

Pencil
Eraser
Cephalometric ruler
Tape
Acetate mate for traces
Lateral rx
Negatoscope
PROCESS
ANATOMICAL STRUCTURES THAT SHOULD BE
DRAWN IN LATERAL SKULL RADIOGRAPHY

ORBITAL RIDGE EXTERNAL SELLA TURCICA


JAW AUDITORY FRONTAL BONE
LOWER THEET MEAUTUS NASAL BONE
GLENOID CAVITY UPPER MAXILAR
PTERIGOMAXILAR UPPER THEET
PIT
LANDMARKS IN THE HARD TISSUES

N Ar
POINT A C o Tm
Or Po
Ena S
Prs Ba
Id Is
B ARIs
Pg Ii
Gn ARIi
Pm
Me
Go
Enp
Pt
LANDMARKS IN SOFT TISSUES

N
Pn
Sn
Ls
Li
Pg
Cm
LANDMARKS IN THE HARD
TISSUES
Nasion (N): Located in
the conjunction of the
Frontal and nasal
bones. It is located in
the median sagittal
plane
Sella turcica (S):
Located in the
central part of the
Turcica sella
Osseous cavity
situated in the
bone Sphenoid
where the
Hypophysis and
the cavernous
sinus rest.
Porion (Po) of outline of
external auditory
meautus, its location
may be difficult due to
the petrous of the
temporal. As a result of
the superposition of the
cephalostat atrial olives
can be located to 4.5
mm above their centers.
Orbitale (Or): Located
in the body of the
Maxillary bone, is the
most inferior point on
margin of orbit.
Basion (Ba): Most
anterior point on
foramen magnum ,
located in the Occipital
bone that
cephalometrically
constitute the
posterior border of the
skull.
Anterior Nasal
spine (ANS):
Anterior point on
maxillary bone.
Located in the
median sagittal
plane
Posterior Nasal spine
(PNS):located
between the floor of
nasal cavity and the
inferior surface of
the palatine bone.
prosthion (Pr): It is
the most inferior
point on the
maxillary alveolar
process located
between the
central incisors in
the median sagittal
plane.
A Point (A): Called
also Subespinale or
A of Downs, it is
located in the
deepest midline
point on the
premaxilla between
the anterior nasal
spine.
B Point (B): Point located
in the deepest part of the
inferior alveolar concavity,
in the sense anteriorly on
the median sagittal plane.
It is also Called supra
mental or B of Downs. It
is usually found near to
the third apical roots of
the incisive inferior.
Infra dental Point
(Id): it is located
in the most upper
part of the
inferior alveolar
flange, between
the lower incisive
(near of the union
cement enamel)
Pogonion point (Pg):
It is the point located
in the most previous
part of the outline of
the mandibular
symphysis in the
middle sagital flat. It
is determined by a
tangent from the
Nasion.
Menton Point (Me):
Located in the body
of the jaw, in the
lowest part of the
mandibular
symphysis
Gonion Point (Go):
Situated in the jaw is
the most posterior
lower point on angle of
jaw. Can also be
constructed by
bisecting the angle
formed by intersection
of mandibular plane
and ramus of jaw
Gnation Point (Gn):
Point located
perpendicular on
mandibular
symphysis midway
between pogonion
and mentn
Articulare point (Ar): it
is located between
inferior surface of the
cranial base and the
posterior border of the
ascending ramus of the
jaw condyle and the
projection of the
apophysis basilar of the
Occipital bone.
Condyleon or
Temporomandibular
Point (C / Tm):
Situated in the part
posterior upper of
the silhouette of
the mandibular
condyle.
Prepogonion
Point (Pm): ):
Situated where
the previous edge
of the sinphysis
mentoniana
changes of
concave to
convex.
Upper Incisive point
(Is): Situated in
intersection of the
axial axis (top-
radicular) of the
incisive upper more
representative of the
group with the edge
incisal of this.
Inferior Incisive
point (Ii): Situated
in intersection of
the axial axis (top-
radicular) of the
incisive inferior
more
representative of
the group with the
edge incisal of this.
Apex Radicular
Incisive Upper
Point (ARIs):
Situated in the
intersection of the
axial axis of the
incisive upper
more
representative of
the group with the
apex radicular of
this.
Apex Radicular
Incisive Inferior
Point (ARIi):
Situated in the
intersection of the
axial axis of the
incisive upper
more
representative of
the group with the
apex radicular of
this.
LANDMARKS IN SOFT TISSUES

Labialis superior
Point (Ls): Point of
union muco-
cutaneous of the
upper lip.
labialis inferior Point
(Li): Point of union
muco-cutaneous of
the inferior lip.
Soft Nasion (N')
Point: Point of
maximum
concavity between
the nose and the
front.
Pronasal or Nasal
(Pn/In) Point:
Point more
prominent of the
tissues of the
nose.
Columela (Cm)
Point: previous
Point of the
columela of the
nose.
Subnasale (Sn)
Point: Point In the
midline, the
junction where
base of the
columela of the
nose meets the
upper lip
Soft Pogonion
(Pg') Point:
Point more
previous of the
pogonion.
HORIZONTAL PLANES AND
LINES
- S-N PLANE (Anterior skull
base)
FRANKFORT PLANE Po-Or N
S

- Ba-N LINE Po
Or

MANDIBULAR PLANE Go-Me Ba


Enp
En
- PLANE OF CAMPER a

- OCLUSAL PLANE Go
Ii

- PALATINE PLANE
Ena-Enp
Me
VERTICAL PLANES AND
LINES
- POSTERIOR SKULL BASE
PLANE S-Ar
- Ba-S LINE
S N
- FACIAL PLANE N-Pg
-- N-B
N-A LINE
- Ar-Go LINE Ar
B Ena
-Ena-Me PLANE a A
ARIs
INE OF VERTICAL GROWTH S-Gn
Is
- ARIi-Ii LINE G
ARIi Ii
- ARIs- Is o
B
P
Me Gn
g
ANGLES

-ANGLES OF CRANIAL DEFLECTION N


S
Ba-S-N
80.6
Ar-S-N 129.6
5,4 Po 123 74.6
Or
- ANGLE OF SKULL BASE TO
Ar
FRANKFORT PLANE
86.5
Ba
- POSITION OF N TO THE
PERPENDICULAR PLANE FH SINCE A A 4.2

- S-N-A ANGLE (LOCATION OF THE
SUPERIOR JAW IN HORIZONTAL SENSE)

- FACIAL DEPTH FH/ N-Pg ANGLE


- INTERMAXILAR RELATION A-N-B B
ANGLE
- ANGLE OF SAGITAL POSITION P
MANDIBULAR TO SKULL S-N-B g
ANGLES

- FACE SHAFT Ba-N/ Pt-Gn ANGLE N

- GONIACO ANGLE Ar-Go-Me

Ar P
Ba t
90

130
Go

Me
G
n
ANGLE OF THE LOWER
FACIAL HEIGHT

- Xi-Ena LINE
- Xi-Pg LINE

Po
Or
- Xi-Ena / Xi-Pg R
1
R Ena
4 R
Xi 2
45

R3
P
g
RELATIONSHIP BETWEEN
MAXILAR, MANDIBULAR AND
FACIAL LOWER HEIGHT
SIZES
-Tm-Ena LINE
-Tm-Gn LINE T
-Ena-Me LINE m

Ena

Gn
Me
INCLINATION OF HIGHER INCISIVES

-PALATINE PLANE - ARIs-Is ANGLE


- A - ARIs-Is ANGLE N
S

Po Or
- MAXILAR CRANE ANGLE S-N/Ena-
Enp
8.5
26 En Ena
p 110
- FH TO MANIDIBULAR PLANE A
ARIs
ANGLE

22 Is
INCLINATION OF LOWER INCISIVES

- MANDIBULAR PLANE - ARIi-Ii


ANGLE
- N-B - ARIi- Ii ANGLE S N

- MANDIBULAR CRANE ANGLE


34.2
ANTERIOR SKULL BASE P /
MANDIBULAR P

25
Go
Ii
90 ARIi
B

Gn
INTERINCISIVE RELATION

ARIs-Is - ARIi-Ii ANGLE

ARIs

I
Ii 130
s

ARIi
ANGLES IN SOFT TISSUES

UPPER AND LOWER LIP


PROMINENCE

- Sn-Pg LINE
- En-Pg LINE

NASOLABIAL ANGLE
Cm-Sn/Sn-Ls En
C
S m 115
n
Ls

Pg
PROGRAMAS FOR MADE DIGITAL
CEPHALOMETRY

Dolphin Imaging
software is an FDA-
cleared Class II medical
device
Ceph Tracing allows you to analyze
cephalometric radiographs and create
progress superimpositions quickly
and accurately. Utilized by thousands
of private practices throughout the
world and most orthodontic and oral
surgery training programs in North
America, Dolphin Ceph Tracing
software dramatically reduces the
tedious and time-consuming task of
cephalometric tracing.
software
ORTHOKINETOR PLUS
Is a computer program designed
for cephalometric diagnosis in
orthodontic patients, maxillary
orthopedics, maxillofacial
orthognathic surgery, pediatric
dentistry, oral re-habilitation,
tempero-mandibular disorders
and applied areas of dentistry in
general.
Additional functions will allow
you to simulate dental
movements in the three senses
of the activity, reading the
angulation of dental axes,
capturing, editing and storing
images, among others
With high performance and an
intuitive interactive user interface,
OsiriX MD is the most widely used
DICOM viewer in the world. It is the
result of more than 10 years of
research and development in digital
imaging. It fully supports the DICOM
standard for an easy integration in
your workflow environment and an
open platform for development of
processing tools. It offers advanced
post-processing techniques in 2D and
3D, exclusive innovative technique
for 3D and 4D navigation and a
complete integration with any PACS.
OsiriX MD supports 64-bit computing
and multithreading for the best
performances on the most modern
processors. OsiriX MD is certified for
medical use, FDA cleared and CE II
labeled.
EASYCEPH
https://youtu.be/fyf-KwebCJA
BIBLIOGRAPHIC REFERENCES
Scott R. McClure, P. Lionel Sadowsky, Andr Ferreira, and Alex Jacobson. Reliability
of Digital Versus Conventional Cephalometric Radiology: To Comparative Evaluation
of Landmark Identification Error. Semin Orthod 11:98-110 2005

Ralf Kurt Willy Schulze, Matthias Burkhardt Gloede, and Gerhard Michael Doll.
Landmark identification on direct Digital versus film-based cephalometric
radiographs: To human skull study. Am J Orthod Dentofacial Orthop, Volume 122,
Number 6, Pag 635-642, December 2002

Zwei-Chieng Chang, Fu-Chang Hu, Eddie Lai, Chung-Chen Yao, Mu-Hsiung Chen, and
Yi-Jane Chenc Landmark identification errors on cone-beam computed
tomography-derived cephalograms and conventional digital cephalograms Am J
Orthod Dentofacial Orthop 2011;140:and289-and297

Bravo D: Manual of cefalometra

Flavio Vellini Ferreira: Orthodontics, Diagnostic and clinical Planning. I capitulate 15,
paginas 312 330. Publishing Arts Medicas 2002
William R. Proffit: ortodoncia contemporanea