Cephalometric assessment Lecture one Cephalometric assessment

The radiograph thus obtained is called a cephalogram. Definition: Cephalometric radiography is a standardized method of production of skull radiographs, which are useful in making measurements of the cranium and the orofacial complex. The radiograph thus obtained is called a cephalogram.

Cephalometric radiographs is divided in to: Lateral view. Frontal view. (PA)

Lateral Cephalogram First introduced in 1931 by: Hofran (Germany) and Broadbent (USA)

Advantages of lateral cephalogram Assess facial and dento-skeletal relationships as an aid for treatment planning Evaluation of changes due to growth Evaluation of changes due to treatment Could be useful in detection of pathology in the cervical spine, skull, cranial base, jaws, …etc.

Patient in Head Positioning Device Cephalostat 60" 15" Film Plane Source Plane X-ray Source X-ray Film in Cassette Mid-saggital Plane Patient in Head Positioning Device

Cephalostat

Head position in the cephalostat Ear rods in the external auditory canals+ fixation at the bridge of the nose and the forehead Frankfort plane: Horizontal OR Natural head position Teeth: In centric occlusion Lips: In habitual position

Cephalometric landmarks Cephalometric landmarks are divided into: Unilateral landmarks. These landmarks identify structures in the mid-sagittal plane. Bilateral landmarks. These landmarks identify structures in the right & left side of the head.

Unilateral Cephalometric landmarks

Sella (S): The midpoint of the sella turcica Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Sella (S): The midpoint of the sella turcica

Nasion (N): The most anterior point of the frontonasal suture Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Nasion (N): The most anterior point of the frontonasal suture

Anterior nasal spine (ANS): The tip of the anterior nasal spine Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Anterior nasal spine (ANS): The tip of the anterior nasal spine

Posterior nasal spine (PNS): The tip of the posterior nasal spine Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Posterior nasal spine (PNS): The tip of the posterior nasal spine

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare A B Point A: subspinale The most posterior point on the profile of the maxilla between the anterior nasal spine and the alveolar crest

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare A B Point B: supramentale The most posterior point on the profile of the mandible between the chin point and the alveolar crest

Pogonion (Pog): The most anterior point of the bony chin Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Pogonion (Pog): The most anterior point of the bony chin

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Gnathion (Gn): The most inferior anterior point on the mandibular symphysis in the midline

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Menton (Me): The lowermost point of the mandibular symphysis in the midline

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Incision superius (IS): The tip of the crown of the most prominent upper central incisor

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Incision inferius (II): The tip of the crown of the most prominent lower central incisor

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Superior Prosthion (SPr or PR) Also termed supradentale. The most anterior Inferior point on the maxillary alveolar process.

Unilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Infradentale (Id) The most anterosuperior point on the mandibular alveolar process.

Unilateral Cephalometric landmarks Basion (Ba) The most infero-posterior point in the sagittal plane on the anterior rim of the foramen magnum (the tip of the posterior cranial base).

Bilateral Cephalometric landmarks

Bilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Gonion (Go): The most posterior inferior point on the angle of the mandible

Orbitale (Or): The most inferior anterior point of the orbit Bilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Orbitale (Or): The most inferior anterior point of the orbit

Bilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Porion (Po): The uppermost, outermost point on the bony external auditory meatus

Bilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Articulare (Ar) The intersection of the posterior border of the neck of the condyle and the lower margin of the posterior cranial base

Bilateral Cephalometric landmarks Sella Porion Gonion PNS Menton Gnathion Pogonion ANS Nasion Articulare Pterygomaxillary Fissure (Ptm) A bilateral teardrop-shaped area of radiolucency, the anterior shadow of which is the posterior surfaces of the tuberosities of the maxilla.

Bilateral Cephalometric landmarks Bolton Point (BO) The highest point in the upward curvature of the retrocondylar fossa.

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