1. Cephalometric assessment
Lecture one
Cephalometric assessment

2. 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.

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

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

5. 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.

6. 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

7. Cephalostat

8. 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

9. 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.

10. Unilateral Cephalometric landmarks

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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.

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

24. 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).

25. Bilateral Cephalometric landmarks

26. 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

27. 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

28. 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

29. 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

30. 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.

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

32. Thank you