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Cephalometry Landmark

Cephalometry Landmark

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Published by Md Nurul Islam

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Published by: Md Nurul Islam on Nov 24, 2011
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01/27/2013

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anatomy, cephalometric, craniofacial, landmarks, radiographic, skeletonA lateral cephalogram is one of the orthodontic records that provides information aboutthe sagittal and vertical relations of:• the craniofacial skeleton;• the soft tissue profile;• the dentition;• the pharynx; and• the cervical vertebrae.These structures and their relationships to each other are scrutinized by means of linear and angular measurements as well as by the use of ratios based on the variouscephalometric landmarks. These cephalometric landmarks should be identified; fightthat began at the errors in their identification can be minimized by a thoroughknowledge of the anatomy of the skull and by an awareness of the close correspondence between gross anatomy and radiographic appearance of each structure and the detailedcriteria for identification of each anatomical cephalometric point.
CRANIOFACIAL SKELETON
 FRONTAL BONE 
 Anatomy
 Photograph of the lateral aspect (A) and the medial aspect (B) o f the frontal bone.1 frontal bone 8 zygomatic bone2 parietal bone 9 frontonasal suture3 coronal suture 10 frontomaxillary suture4 sphenoid bone 11 frontozygomatic suture5 ethmoid bone 12 frontal sinus6 nasal bone7 maxilla
The frontal hone (1) forms the anterior part of the cranial vault. It joins posteriorly withthe parietal bones (2) at the coronal suture (3). It joins inferiorly with the sphenoid bone(4) and the ethmoid bone (5) at the frontosphenoethmoidal suture. Anteriorly, it joinswith the nasal bones (6), with the maxilla (7), and the zygomatic bone (8) at the fron-tonasal suture (9), the frontomaxillary suture (10), and the frontozygomatic suture (11),respectively. The lower anterior part of the frontal bone forms the roof of the orbit, andlaterally its zygomatic process joins with the frontal process of the zygomatic boneforming the lateral border of the orbit. The frontal sinus (12) lies in the frontal bone, inan area superior to the articulation with the nasal bone.
 
 Radiographic anatomy
 Radiograph of the lateral view of the frontal bone.1 coronal suture2 external cortical plate of frontal bone3 internal cortical plate of frontal bone4 frontal sinus5 frontonasal suture6 nasal bone7 frontosphenoethmoidal suture8 endocranial surface of frontal bone9 exocranial surface of frontal bone10 lesser wing oi sphenoid bone11 anterior clinoid 12 anterior margin of zygomatic process of frontal bone13 posterior margin of zygomatic process of frontal bone14 anterior margin of frontal process of zygomatic bone15 posterior margin of frontal process of zygomatic bone
Starting from the upper anterior part of the skull at the coronal suture (1), the frontal bone appearsas two radio-opaque lines that descend parallel to each other. The outer radio-opaque line representsthe external cortical plate of the frontal bone (2), and the inner line represents the internal cortical plate (3), which forms the anterior border of the anterior cranial fossa. These two parallel linesdiverge at the forehead area where the frontal sinus(4) appears as a radiolucent area between them.The external cortical plate terminates at the anterior part of the frontonasal suture (5), which appearsas a radiolucent line between the frontal and the nasal bones (6). The internal cortical plate extendshorizontally and posteriorly, thus terminating at the small radio-opaque triangular area thatrepresents the frontosphenoethmoidal suture (7),Above the horizontal part of the internal cortical plate there are two radio-opaque lines. Theupper*most of these two lines, which appears as a wavy radio-opaque line, represents theendocranial surface of the frontal bone (8), which forms the floor of the anterior cranial fossa. Theharmonious radio-opaque curve below the wavy line represents the exocranial surface of the frontal bone (9), which forms the roof of the orbit. This line extends posteriorly to the lesser wings of thesphenoid bone (10) and to the anterior clinoid (11). Anteriorly, it starts at the area of the frontalsinus where the junction of the roof of the orbit and its lateral border can be identified as an angular radio-opaque shadow. The lateral border of the orbit appears as a curved radio-opaque line, whichrepresents the anterior margin of the zygomatic process of the frontal bone (12). At the same area,the posterior margin of the zygomatic process of the frontal bone (13) can be identified as a radio-opaque line descending parallel behind the lateral border of the orbit. These two lines merge withthe radio-opaque lines of the anterior and posterior margins of the frontal process of the zygomatic bone (14, 15).
 
Cephalometric landmarks
F
-point F (constructed) - this point approximates the foramen caecum and represents the anatomicanterior limit of the cranial base, constructed as the point of intersection of a line perpendicular tothe S-N plane from the point of crossing of the images of the orbital roofs and the internal plate of the frontal bone (Coben);
FMN
- frontomaxillary nasal suture - the most superior point of the suture, where the maxillaarticulates with the frontal and nasal bones (unilateral); FMN is on the anterior cranial base, unlike Na , and can therefore also be used for measuring or defining the cranial base (Moyers, 1988);
Na
- nasion - the most anterior point of the fron-tonasal suture in the median plane (unilateral);
SE
- sphenoethmoidal - the intersection of the shadows of the greater wing of the sphenoid and thecranial floor as seen in the lateral cephalogram;
SOr
- supraorbitale - the most anterior point of the intersection of the shadow of the roof of theorbit and its lateral contour (bilateral) (Sassouni);
RO
- roof of orbit - this marks the uppermost point on the roof of the orbit (bilateral) (Sassouni).
 SPHENOID BONE 
 Anatomy
 Photograph of the lateral aspect (A) and the medial aspect (B) of the sphenoid bone.1 maxilla2 palatine bone3 ethmoid bone4 frontal bone5 lesser wing of sphenoid bone6 greater wing of sphenoid bone7 pterygoid process of sphenoid bone ,8 sphenoid sinus9 sella turcica10 anterior clinoid 11 posterior clinoid 12 dorsum sellae

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