ceph Flashcards
__________= Towards the head
Metric = Measurement
Cephalad
- Useful in making measurements of the cranium and the orofacial complex, for diagnostic purposes.
CEPHALOMETRICS
The Radiograph obtained
Cephalogram
- It is a standardized method of skull radiographs.
CEPHALOMETRICS
- provides a lateral view of the skull.
- It is taken with the head in a standardized reproducible position at a specified distance from the source of the X-ray.
- commonly used for cephalometric analysis.
Lateral cephalogram
- This provides an anteroposterior view of the skull. It is generally used to assess symmetry of the face.
FRONTAL CEPHALOGRAM
- The cephalometric radiographs are taken using an apparatus that consists of an X-ray source and a headholding device called _____________
cephalostat
These landmarks represent the actual anatomic structures of the skull. They may be unilateral or bilateral.
Anatomic cephalometric landmarks
These are landmarks that have been obtained secondarily from anatomic structures in a lateral cephalogram.
Derived cephalometric landmarks
- Masking tape is used to attach the cephalometric X-ray to the _________ tracing paper sheet. Tracing is made on the frosted surface of acetate tracing sheet.
acrylic acetate
HARD TISSUE LANDMARKS (16)
- Sella (S)
- Nasion (Na)
- Orbitale (Or)
- Porion (Po)
- Point A (A)
- Point B (B)
- Anterior Nasal Spine (ANS)
- Posterior Nasal Spine (PNS)
- Incisor Superius (Is)
- Incisor Inferius (Ii)
- Molar Point (Mp)
- Pogonion (Pog)
- Gnathion (Gn)
- Menton (Me)
- Gonion (Go)
- Condylion (Co)
– Midpoint of the cavity of the sella turcica
– Where the Pituitary gland is located
– A very stable part of the cranium
Sella (S)
– The suture between the frontal and nasal bone.
Nasion (Na)
– The lowest point of the inferior margin of the orbit.
Orbitale (Or)
– The highest point on the superior surface of the soft tissue of the external auditory meatus (anatomic)
– The midpoint of the upper contour of the metal rod of the cephalometer (machine)
Porion (Po)
– The innermost point on the contour of the premaxilla between the ANS and the incisor tooth.
Point A (subspinale)
– The innermost point on the contour of the mandible between the incisor and the bony chin.
Point B (supramentale)
– The tip of bony anterior nasal spine in the midline or median plane.
Anterior Nasal Spine (ANS)
– The tip of the Posterior Spine of the Palatine bone
– At the junction of the hard and soft palate.
Posterior Nasal Spine (PNS)
– The incisal tip of the most anterior maxillary central incisor.
Incisor Superius (Is)
– The incisal tip of the most labial mandibular central incisor.
Incisor Inferius (Ii)
– The bisection of the overbite of the upper and lower first molars.
Molar Point (Mp)
– The most anterior point on the contour of the bony chin in the midline.
Pogonion (Pog)
– Is the lowest point on the symphyseal outline of the chin
– The lowest point of the mandible.
Menton (Me)
– The center of the inferior contour of the chin
– A point on the chin determined by bisecting the angle formed by the facial and mandibular planes
Gnathion (Gn)
– The center of the inferior contour of the mandibular angle.
– Is the intersection of the lines tangent to the posterior margin of the ascending ramus and the mandibular base.
Gonion (Go)
– The most posterior superior point on the condyle of the mandible.
Condylion (Co)
– It is the intersection of the inferior border of the foramen rotundum with the posterior wall of the pterygomaxillary fissure.
Pterygomaxillary Fissure (Ptm)
– Is the point of intersection of the posterior margin of the ascending ramus and the outer margin of the cranial base.
Articulare (Ar)
– The lowest point on the anterior margin of the foramen magnum in the midline.
Basion (Ba)
HARD TISSUE CEPHALOMETRIC LANDMARKS
ANATOMIC (12)
Nasion N
Anterior Nasal Spine ANS
Point A A
Prosthion Pr
Infradentale Id
Point B B
Pogonion Pog
Menton Me
Sella S
Orbitale Or
Gonion Go
Articulare Ar
SOFT TISSUE CEPHALOMETRIC LANDMARKS (8)
Soft tissue nasion n
Tip of nose no
Subspinale ss
Subnasale sn
Labial superius ls
Stomion sto
Labial Inferius li
Soft tissue pogonion pog
HORIZONTAL CEPHALOMETRIC REFERENCE PLANES (5)
- S -N plane
- F-H plane
- Occlusal plane
- Palatal plane
- Mandibular plane.
o It is the plane formed by the line connecting sella turcica (midpoint of hypophyseal fossa) and the nasion (anterior point of frontonasal suture).
Sella-Nasion Plane
o Significance: It represents the anteroposterior extent of anterior cranial base.
Sella-Nasion Plane
o Is the plane that connects the lowest point of the orbit (orbitale) to the superior point of the external auditory meatus (Porion).
Frankfort-Horizontal plane
formed by a line connecting Molar Point to the Anterior point.
Occlusal Plane
o formed by the line joining the point anterior nasal spine (ANS) to the posterior nasal spine (PNS).
Palatal Plane (ANS-PNS Plane)
o It is the plane that connects the point Me (Menton) tothe point Go (Gonion).
Mandibular Plane / Me-Go Plane
VERTICAL CEPHALOMETRIC REFERENCE PLANES (6)
- A-Pog line
- Facial plane
- Facial axis
- E-plane
- S-Ar plane
- Ar-Go plane
o It is a line from point A on the maxilla to pogonion on the mandible.
A-Pog line
o It is a line from the anterior point of the frontonasal suture (nasion) to the most anterior point of the mandible (pogonion).
Facial plane
o A line from Ptm point to cephalometric gnathion.
Facial axis
o also called esthetic plane and it is a line between the most anterior point of the soft tissue nose and chin.
E-plane
o It is the plane between the sella point (center of sella turcica) and the Ar (articulare) point.
S-Ar plane
o Significance: This plane represents the lateral extent of cranial base.
S-Ar plane
o formed by the line connecting from articulare (Ar) to the gonion (Go).
Ar-Go plane
o Significance: This plane is important in the determination of length of ramus.
Ar-Go plane
- S-Gn plane
- Normal Range: ______
63˚-69˚
- FH Plane (Frankfort Horizontal plane)
- Normal Range: _____
57˚-61˚
Upper Airway
o Normal Range: _____
8-18mm
Lower Airway
o Normal Range: ______
10-12mm
Upper Airway: ________
Lower Airway:_________
(Nasopharynx)
(Oropharynx)
- Significance of this angle: helps in assessing whether the growth pattern is horizontal or vertical.
FMA (Frankfort Mandibular Plane Angle)
FMA (Frankfort Mandibular Plane Angle)
* Normal Range: _____
* Higher = __________/High Angle
* Lower = ________/Low Angle
21˚-29˚
Hyperdivergent pattern
Hypodivergent pattern
Y Axis to FH
o Increased Y-axis: It is indicative of _______ growth pattern.
o Decreased Y-axis: It is indicative of _______ growth pattern.
vertical
horizontal
- Measured from Ans to Me
LAFH (Lower Anterior Face Height)
LAFH (Lower Anterior Face Height)
- Normal Range: ______
58-72mm
- Total Anterior Facial Height
o _______ Adult
o _______ Child
45-55%
50-50%
- Used to establish the vertical position of the mandible.
SN to GoMe (Steiner)
SN to GoMe (Steiner)
- Normal Range: __________
- Higher = ________
- Lower = _________
29˚-39˚
Dolichocephalic or Open Bite
Brachycephalic or Deep Bite
MP - OB
* Vertical Dimension
* Mandibular Plane to Occipital Base
* Normal – ________
Within Occipital Base
MP - OB
- Low Angle:
o Below Occipital Base/____________,
o Less Complicated Case - High Angle:
o Above Occipital Base/___________,
o More Complicated Case
Hypodivergent
Hyperdivergent
- Condylion to Point A
- Measured in mm
Co-A (Maxillary Length)
- Condylion to Gnathion
- Measured in mm
Co-Gn (Mandibular Length)
- Measures the extent to which the jaws are related to each other antero-posteriorly.
WIT’S APPRAISAL (Jacobson)
SNA
* Normal Range: ______
o Higher = __________
o Lower = __________
79˚-85˚
Maxillary Protrusion / Prognathic Maxilla
Maxillary Retrusion / Retrognathic Maxilla
- Designed to evaluate the antero-posterior position of the maxilla relative to the anterior cranial base.
SNA
- Used for evaluating the antero-posterior position of the mandible relative to the anterior cranial base
SNB
SNB
- Normal Range: ______
o Higher = _________
o Lower =___________
77˚-83˚
Mandibular Protrusion / Prognathic Mandible
Mandibular Retrusion / Retrognathic Mandible
- Indicates the Magnitude of skeletal jaw discrepancy
- Classifies Skeletal Relationship (Class I, II, III)
- SNA minus SNB
ANB
ANB
- Normal Range: ____
o Higher Value = ________
o Lower Value = ______
3˚
Class II
Class III
Na Perp - A
- Nasion Perpendicular to Point A
- Nasion line forming a perpendicular line related to the Frankfort line.
- Measure in MM to Point A
- Normal Range: ______
1-2mm
- It is the angle formed by the intersection of the long axis of the lower incisor with mandibular plane (MeGo)
IMPA
* Incisor Mandibular Plane Angle
IMPA
- Normal Range: _______
o Higher = _________
o Lower = __________
85˚-95˚
lower incisor proclination / labially inclined
lower incisor retroclination / lingually inclined
- Relates the angular position of the long axis of the upper and lower central incisor to each other.
U1 – L1 (Interincisal Angle)
U1 – L1 (Interincisal Angle)
- Normal Range: ______
o Higher = ______
o Lower = ______
127˚-135˚
Upright Incisors
Flared Incisors
U1 – SN (Maxillary Incisal Angle)
* Normal Range: _______
* Higher = _________
* Lower = _________
100˚-114˚
Proclined / Labially Inclined / Flared / Labially Tipped
Retroclined / Lingually inlined
L1 to A-Pog
- Normal Range: ______
- Higher = _________
- Lower = ________
-1mm to 3mm
Protruded / Proclined Lower Incisor
Retruded / Reclined Lower Incisor
- The angle is formed at the Subnasale by a line drawn tangent to the base of the nose with a line drawn from the upper lip to the subnasale.
Nasolabial Angle
Nasolabial Angle
- Normal Range: _______
96 ˚-108˚
- If the patient can close his/her mouth without any effort.
Lip Seal