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An Atlas On Cephalometric Landmarks
An Atlas On Cephalometric Landmarks
Cephalometric
Landmarks
An Atlas on
Cephalometric
Landmarks
Formerly
Faculty, Department of Orthodontics and
Dentofacial Orthopedics
Mauras College of Dentistry, Hospital and
Oral Research Institute
Republic of Mauritius
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or device.
An Atlas on Cephalometric Landmarks
First Edition: 2013
ISBN: 978-93-5090-324-7
Printed at
To
My dear parents Subhashchandra and Shivalingamma Phulari
brothers Sangamesh, Jagadish and manjunath
my beloved wife Dr Rashmi GS
and my dear sons Yashas and Vrishank
Preface
Cephalometrics has been used in orthodontics for diagnosis, treatment planning, to evaluate the dentofacial
changes during treatment and to assess the dentofacial growth and development. Cephalometrics makes use
of certain landmarks on the skull. The first important step in cephalometric analysis is accurate location and
tracing of cephalometric landmarks on the cephalogram. Any error in tracing the landmarks may result in incorrect
cephalometric analysis.
This book focuses on understanding the various cephalometric landmarks. Each cephalometric landmark is
explained in detail including its abbreviation, definition by various researchers, origin and radiographic anatomy of
the landmarks.
There are 20 chapters divided into 11 sections. Chapter two lists the different ways of classifying cephalometric
landmarks given in the literature. In addition, a new working classification has been given that lists the numerous
cephalometric landmarks logically which makes remembering easier.
This working classification is used as a blueprint to systemically explain the cephalometric landmarks from
chapter 3 through chapter 19. Chapter 20 explains application of all types of cephalometric landmarks in various
cephalometric analyses. In addition to the landmarks on lateral cephalogram, the landmarks on the posteroanterior
(P-A) cephalogram and submentovertex (S-V) radiographic projection are also dealt in this book.
I regret any deficiencies and shortcomings that might have crept in despite my best efforts. I would also welcome
comments and suggestions from both students and teachers for further improvement of the book.
Acknowledgments
I express my heartfelt gratitude to Dr Rajendrasinh Rathore MDS, Chairman of Manubhai Patel Dental College and
Hospital, Vadodara, Gujarat for his inspirational support during this endeavor and throughout my career. I also thank
Dr Yashraj Rathore, Trustee, Manubhai Patel Dental College and Hospital, Vadodara, Gujarat, India for encouraging
me during this project.
I am indebted to my dear parents for all their love and sacrifices that have made me what I am. My special thanks
are due to my beloved wife for her valuable comments and suggestions, and my dear sons for being the constant
source of inspiration to set and reach new goals in life.
I would like to thank Anatomage Inc. for providing images in chapter 17 and for the cover.
Most of all I thank the Almighty for all His kindness and blessings showered upon me.
Contents
Section 1: Introduction and History
1. Cephalometry in Orthodontics....................................................................................................... 3
Technical Aspects4
Cephalometric X-ray Tracing Techniques4
Nasion 16
Supra-Orbitale 17
Roof of the Orbital Cavity 17
Frontonasal/Frontomaxillary Nasal Suture 18
Temporale21
Nasion26
Porion32
Zygomatic Arch32
Mastiodale33
Dorsum of Sella36
Floor of Sella37
Clinoidale38
Spheno-Occipital Synchondrosis39
Pterygoid point40
Sella41
Sella Entrance41
Sphenoethmoidal point42
Pterygomaxillary Fissure44
xii
Basion46
Opisthion48
Boltons point48
Spheno-occipital synchondrosis50
Orbitale52
Temporale54
Infradentale86
Point B87
Pogonion88
Gnathion89
dd91
Menton92
Gonion93
Articulare93
kk94
Condylion95
Hyoid101
cv2ip104
cv2ap104
cv2ia106
cv3sp106
xiii
cv5ip113
cv5sa113
cv5ia115
cv6sp115
cv6ip116
cv6sa116
cv6ia118
Cervical Vertebrae as Indicators of Skeletal Maturity118
cv3ip107
cv3sa107
cv3ia109
cv4sp109
cv4ip110
cv4sa110
cv4ia112
cv5sp112
Subnasale131
Soft Tissue Subspinale133
Labrale Superius134
Stomion135
Labrale Inferius136
Soft Tissue Submentale136
Soft Tissue Pogonion138
Soft Tissue Gnathion139
Contents
Zygomatic Prominence149
Zygion149
Condylion149
Gonion150
Ch150
Cheilion151
Alare151
Exocanthion151
Sella152
Sella entrance153
Basion153
Anterior Nasal Spine154
xiv
Cuspid 169
Crista galli160
Top of nasal septum161
NC162
Zyg-Zygoma162
zygion163
mi172
Zygomatic arch163
Zygomatic suture point164
Jugal process 164
Mandibular molar173
Menton173
Articulare174
Maxillare165
malare174
Antegonial Tubercles175
Antegonion175
Opisthion179
Foramina spinosum180
Odontoid181
Gonion point187
Pterygomaxillary fissure182
Condylion medialis188
Condylion lateralis188
Condylion Anterioris189
Condylion posterioris190
Angulare point184
Analysis194
Analysis198
Analysis196
xv
Index...................................................................................................................................................... 211
Contents
Section
Cephalometry in Orthodontics
Chapter
Cephalometry in
Orthodontics
Types of Cephalogram
There are following two types of cephalograms
1. Lateral cephalogram: Lateral cephalogram provides a
lateral view of the skull (Fig. 1.1). It is taken with the
head in a standardized reproducible position at a specified
distance from the source of the x-ray. Lateral cephalogram
commonly is used for cephalometric analysis.
2. Frontal cephalogram: This provides an antero-posterior
view of the skull (Fig. 1.2).
Technical Aspects
traced. The anterior surface of the frontal and nasal bones are
then traced followed by tracing the outline of the maxilla and
from the anterior nasal spine along the floor of the nasal cavity
back to posterior nasal spine from posterior nasal spine.
Bibliography
1. Bennett GC, Kronman JH. A cephalometric study of mandibular
development and its relationship to the mandibular and occlusal planes.
Angle orthodont.1970;40:119-28.
2. Bjork A. Prediction of mandibular growth rotation. Am J Orthodont.
1969;55:585-99.
3. Broadbent BH. A new X-ray technique and its application to
orthodontics, Angle Orthod. 1931;1:45-66.
4. Brodie AG, Downs WB, Goldstein A, Myer E. Cephalometric appraisal of
orthodontic results: A preliminary report. Angle orthodont. 1938;8:261-5.
5. Downs WB, Variations if facial relationship: Their significance in
treatment and prognosis. Am J Orthod. 1948;34:812.
6. Downs WB. Analysis of the dentofacial profile. Angle Orthod. 1956;
26:191.
7. Downs WB. Analysis of the dento-facial profile. Angle orthodont.
1956;26:191-212.
8. Houston WJB. The analysis of error in orthodontics measurements. AM
J Orthod. 1983;83:382-90
9. Jacobs. Introduction to Radiographic Cephalometry, Lea and Febiger,
Philadelphia. 1985.
10. Jacobson A. Radiographic cephelometry: From basics to video imaging,
Chicago 1995, Quintessence Pub Co.
11. Jacobson A. The appraisal of jaw disharmony. Am J Orthod. 1975;
67:125-38.
12. Jakobson S. Cephelometric evaluation of treatment effect on ClassIIDivision I malocclusions. Amer J Orthodont. 1967;53:446-57.
13. Moorrees, CFA, Lebret L. The mesh diagram and cephalometricss.
Angle Orthodont. 1962;32:214-31.
14. Rickets RM, Bench RW, Hilgers JJ, Schulhof R. An overview of
computerized cephalometrics. Am J Orthodont. 1972;61:1-28.
15. Steiner CC. The use of Cephalometrics as an aid in planning & assessing
orthodontic treatment. Am J Orthod. 1960;46:721.
16. Subtelny JD. Cephalometric diagnoss, growth and treatment: something
old, something new? Am J Orthodont. 1970;57:262-86.
17. Susomi R. A cephalometric evaluation of dentofacial growth in mandi
bular protrusion subjects. J Osaka Univer. Dent. CSch. 1969;9:25-35.
18. Thomas M Graber, Robert L Vanarsdall. Orthodontics current principles
and techniques, Mosby year book Inc. 1994.
19. Tweed CH. The diagnosis facial triangle in the control of treatment
objectives. Am J Orthodont. 1969;55:667.
Section
Classification of Cephalometric
Landmarks
Chapter
Classification of
Cephalometric Landmarks
Point B
Menton, etc.
10
Orbitale
Temporale
Nasion
Supra-orbitale
Roof of orbit
Frontozygomatic suture
Frontale
Frontomaxillary nasal suture
Temporale
Neck of crista galli
Medio-orbitale
Sphenoethmoidal point
Ethmoidale
Dorsum sella
Floor of sella
Clenoidale
Spheno-occipital synchondrosis
Pterygoid point
Pterygomaxillary fissure
Foramen spinosum point
Sella
Sphenoethmoidal point
Basion
Opisthion
Boltons point
Spheno-occipital synchondrosis
Infradentale
Point B
Pogonion
Gnathion
dd
Menton
Gonion
Articulare
kk
Condylion
11
cv2ap
cv2ip
cv2ia
cv3sp
cv3ip
cv3sa
cv3ia
cv4sp
cv4ip
cv4sa
cv4ia
cv5sp
cv5ip
cv5sa
cv5ia
cv6sp
cv6ip
cv6sa
cv6ia
Nasal crown
Pronasale
Point T
3. Soft tissue cephalometric landmarks or points related to lips
Upper lip
Soft tissue subspinale
Labrale superius
Philtrum
Cuspid bow
Vermilion border of upper lips
Lower lip
Labrale inferius
Soft tissue point B
Upper and lower lips
Stomion
- Stomion superius
- Stomion inferius
4. Soft tissue cephalometric landmarks/points related to chin
Soft tissue pogonion
Soft tissue menton
Soft tissue gnathion.
Section
Cephalometric Landmarks
Related to Cranial Bones
ChApTER
Cephalometric Landmarks
Related to Frontal Bone
Abbreviation
Type
Origin
Nasion
N or Na
Unilateral
Anatomic
Supra-orbitale
SOr
Bilateral
Anatomic
Roof of orbit
RO
Bilateral
Anatomic
Frontomaxillary nasal
suture
FMN
Unilateral
Anatomic
16
Definition
Figures 3.3A to D: (A) Nasion on lateral cephalogram; (B) Magnified image showing nasion on the lateral cephalogram;
(C) Nasion on graphic illustration; and (D) Magnified image of nasion on graphic illustration
17
Supra-Orbitale
According to TM Graber
Nasion is the junction of the nasal and frontal bone as seen on
the profile of the cephalometric roentgenogram.2
Type
Nasion is a unilateral, anatomic, hard tissue cephalometric
landmark (Point).
Origin
Nasion is a hard tissue cephalometric landmark of anatomic
origin.
Definition
According to Viken Sassouni
Abbreviation
Type
Origin
18
Figures 3.4A to D: (A) Supra-orbitale on lateral cephalogram; (B) Magnified image showing supraorbitale on the lateral cephalogram;
(C) Supra-orbitale on graphic illustration; and (D) Magnified image of supra-orbitale on graphic illustration
Definition
The roof of the orbital cavity is formed by the bone between
the anterior cranial fossa above and the orbital cavity below.
Type
Roof of the orbital cavity (Figs 3.5A to D) is a bilateral,
anatomic hard tissue lateral cephalometric landmark.
Frontonasal/Frontomaxillary
Nasal Suture
Abbreviation
FMNFrontomaxillary suture is abbreviated using English
alphabets and is expressed as capital or upper case F, M and
N and are written continuously without any space between the
alphabets.
Definition
19
Figures 3.5A to D: (A) Roof of orbit on lateral cephalogram; (B) Magnified image showing roof of orbit on the lateral cephalogram;
(C) Roof of orbit on graphic illustration; and (D) Magnified image of roof of orbit on graphic illustration
Figures 3.6A to D: (A) Frontomaxillary suture on lateral cephalogram; (B) Magnified image showing frontomaxillary suture on the lateral
cephalogram; (C) Frontomaxillary suture on graphic illustration; and (D) Magnified image of frontomaxillary suture on graphic illustration;
20
Type
References
Chapter
Cephalometric landmarks
related to ethmoid bone
Abbreviation
Type
Origin
Temporale
Te
Bilateral
Anatomic
NC
Unilateral
Anatomic
Medio-orbitale
mo
Bilateral
Anatomic
Sphenoethmoidal point
SE
Unilateral
Anatomic
Ethmoidale
Eth
Unilateral
Anatomic
Temporale
Abbreviation
Figure 4.1: Ethmoid bone
22
Definition
Temporale (Figs 4.3A to D) is the intersection of the shadows
of the ethmoid and the anterior wall of the infra-temporal
fossa.
Type
Temporale (Figs 4.3A to D) is a bilateral, anatomic, hard
tissue cephalometric landmark.
Figures 4.3A to D: (A) Temporale on lateral cephalogram; (B) Magnified image showing temporale on the lateral cephalogram;
(C) Temporale on graphic illustration; and (D) Magnified image of temporale on graphic illustration
23
Abbreviation
NCNeck of Crista Galli is abbreviated using English alpha
bets and is expressed as capital or upper case N and C and is
written continuously without any space between the alphabets.
Definition
Medio-orbitale
Type
Neck of crista galli is an anatomic, unilateral, hard tissue
cephalometric landmark.
Abbreviation
Definition
24
Type
Type
Sphenoethmoidal Point
Abbreviation
Ethmoidale
Abbreviation
Definition
According to Robert E Moyers
Figures 4.6A to D: Sphenoethmoidale: (A) Sphenoethmoidale on the lateral cephalogram; (B) Magnified image
showing sphenoethmoidale on the lateral cephalogram; (C) Sphenoethmoidale on graphic illustration; and
(D) Magnified image of sphenoethmoidale on graphic illustration
25
Figures 4.7A to D: Ethmoidale: (A) Ethmoidale on the lateral cephalogram; (B) Magnified image showing
ethmoidale on the lateral cephalogram; (C) Ethmoidale on graphic illustration; and (DMagnified image
of ethmoidale on graphic illustration
Definition
References
Type
Ethmoidale is an anatomic, unilateral, hard tissue cephalo
metric landmark.
CHAPTER
Cephalometric Landmarks
Related to Nasal Bone
The nasal bone (Fig. 5.1) (Os nasale in Latin), are paired
bones that lie in the midline above the nasal fossae between
the frontal processes of the maxilla. They articulate superiorly
with the frontal bone at the fronto-nasal suture.
Nasion
Abbreviation
Abbreviation Type
N OR Na
Unilateral
Orgin
Anatomic
Frontonasal/frontomaxillary
nasal suture
Rhinion
FMN
Unilateral
Anatomic
Rh
Unilateral
Anatomic
27
Definition
According to TM Graber
Type
Origin
Nasion is a hard tissue cephalometric landmark of anatomic
origin.
Figures 5.3A to D: (A) Nasion on lateral cephalogram; (B) Magnified image showing nasion on the lateral cephalogram; (C) Nasion on
graphic illustration; and (D) Magnified image of nasion on graphic illustration
28
Frontonasal/Frontomaxillary Nasal
Suture
Abbreviation
FMNFrontomaxillary suture is abbreviated using English
alphabets and is expressed as capital F, M and N and is written
continuously without any space between the alphabets.
Definition
Frontomaxillary nasal suture (Figs 5.4A to D) is the most
superior point of the suture, where the maxilla articulates
with the frontal and nasal bones.
Figures 5.4A to D: (A) Frontomaxillary nasal suture on lateral cephalogram; (B) Magnified image showing frontomaxillary nasal suture
on the lateral cephalogram; (C) Frontomaxillary nasal suture on graphic illustration; and (D) Magnified image of frontomaxillary nasal
suture on graphic illustration
29
Rhinion
Type
Frontomaxillary nasal suture is a unilateral, hard tissue cephalo
metric landmark.
Abbreviation
RhRhinion is abbreviated using English alphabets and is expressed as capital or upper case R followed by lower case h, and
is written continuously without any space between the alphabets.
Definition
According to Spiro J Chaconas
Type
Origin
Figures 5.5A to D: (A) Rhinion on lateral cephalogram; (B) Magnified image showing Rhinion on the lateral cephalogram; (C) Rhinion
on graphic illustration; and (D) Magnified image of Rhinion on graphic illustration
30
References
1. Graber TM. New horizons in case analysis-clinical cephalometrics. Am
J of Ortho. 1952;38:603-24.
2. Broadbent BH Sr. Boltons standards of dentofacial developmental
growth. The C V Mosby Company. 1975;133-5.
3. Downs WB. Variations in facial relationships. Their significance in
treatment and prognosis. Am J of Ortho. 1948;34:812-39.
4. Moyers RM. Handbook of OrthodonticsYear Book Medical Publishers,
Inc. 1988;251-9.
5. Spiro J Chaconas. Orthodontics-PSG Publishing Company. 1980;37-45.
Chapter
Cephalometric landmarks
related to temporal bone
32
Abbreviation
Type
Origin
Po
Zyg
Ma
Bilateral
Bilateral
Bilateral
Anatomic
Anatomic
Anatomic
Porion
Type
Porion (Figs 6.3A to D) is a bilateral, hard tissue cephalometric
landmark.
Origin
Porion is a hard tissue cephalometric point of anatomic
origin.
PoPorion is abbreviated using English alphabets and is expressed as capital letter or upper case P followed by lower
case o, and is written continuously without any space between
the alphabets.
Abbreviation
Definition
Porion is the most superior point of the external auditory meatus
(the superior margin of the TMJ fossa, which lies at the same
level may be substitute in the construction of the FH).
According to LB Higley
Zygomatic Arch
Abbreviation
ZygZygomatic arch is abbreviated using English alphabets
and is expressed as capital or upper case Z followed by lower
case y and g, and is written continuously without any space
between the alphabets.
The highest point on the roof of the left external auditory meatus.3
Definition
The top of the ear rods Shadows the external auditory meatus.4
Type
Zygomatic arch is bilateral, hard tissue landmark.
Origin
33
Figures 6.3A and D: (A) Porion on lateral cephalogram; (B) Magnified image showing porion on the lateral cephalogram;
(C) Porion on graphic illustration; and (D) Magnified image of porion on graphic illustration
Mastiodale
Abbreviation
MsMastiodale is abbreviated using English alphabets and is
expressed as capital or upper case M followed by lower case
s, and is written continuously without any space between the
alphabets.
Definition
According to Viken sassouni
According to Viken Sassouni, the mastiodale is the lowest
point on the contour of the mastoid process.8
Type
Mastiodale (Figs 6.4A and B) is bilateral, cephalometric landmark.
34
Figures 6.4A and B: (A) Mastiodale on lateral cephalogram; (B) Magnified image showing mastiodale on the lateral cephalogram
Origin
References
Chapter
Cephalometric landmarks
related to sphenoid bone
Abbreviation
Type
Origin
Dorsum of sella
Sp
Unilateral
anatomic
Floor of sella
Si
Unilateral
anatomic
Clinoidale
Cl
Bilateral
anatomic
Spheno-occipital
synchondrosis
SOS
Unilateral
anatomic
pterygoid point
pt
Bilateral
anatomic
Sella
Unilateral
anatomic
Sella entrance
Se
Unilateral
anatomic
Sphenoethmoidal point
Se
Unilateral
anatomic
Foramen spinosum
point
Fsp
Bilateral
anatomic
pterygomaxillary
fissure
ptm
Bilateral
anatomic
36
Dorsum of Sella
Definition
Dorsum of sella is the most posterior point on the internal contour
of the sella turcica or hypophyseal fossa or pituitary fossa.
Type
abbreviation
Figures 7.3A to D: (A) Dorsum of sella on lateral cephalogram; (b) Magnified image showing dorsum of sella on the lateral
cephalogram; (C) Dorsum of sella on graphic illustration; (D) Magnified image of dorsum of sella on graphic illustration
37
Origin
Dorsum of sella is an anatomic hard tissue cephalometric
landmark.
Floor of Sella
Definition
Floor of sella is the lower most point on the inner contour of
the sella turcica or hypophyseal fossa or pituitary fossa.
abbreviation
Type
Figures 7.4A to D: (A) Floor of sella on lateral cephalogram; (b) Magnified image showing floor of sella on the lateral
cephalogram; (C) Floor of sella on graphic illustration; (D) Magnified image of floor of sella on graphic illustration
38
Origin
Definition
Clinoidale
Type
abbreviation
Figures 7.5A to D: (A) Clinoidale on lateral cephalogram; (b) Magnified image showing clinoidale on the lateral
cephalogram; (C) Clinoidale on graphic illustration; (D) Magnified image of clinoidale on graphic illustration
39
Origin
according to TM Graber
Spheno-Occipital Synchondrosis
abbreviation
Type
Origin
Definition
Figures 7.6A to D: (A) spheno-occipital synchondrosis on lateral cephalogram; (b) Magnified image showing spheno-occipital
synchondrosis on the lateral cephalogram; (C) spheno-occipital synchondrosis on graphic illustration; (D) Magnified image of sphenooccipital synchondrosis on graphic illustration
40
The spheno-occipital synchondrosis is very important structure in growth and development of the cranial base in the
growing child.
Definition
According to Robert M Ricketts, the pterygoid point is the
lower lip of the foramen rotundum (represents the position of
the sphenoid bone). Most posterior point on the outline of the
pterygopalatine fossa.4
Type
Pterygoid point (Figs 7.7A to D) is a bilateral, hard tissue
cephalometric landmark.
Pterygoid Point
abbreviation
Origin
Figures 7.7A to D: (A) Pterygoid point on lateral cephalogram; (b) Magnified image showing pterygoid point on the lateral
cephalogram; (C) Pterygoid point on graphic illustration; (D) Magnified image of pterygoid point on graphic illustration
41
Type
Significance (Ref to Chapter 20)
Sella
abbreviation
SSella is abbreviated using English alphabets and is expressed
as capital or upper case S.
Definition
Sella is the midpoint of sella turcica or hypophyseal fossa or
pituitary fossa.
according to TM Graber
The center of pituitary fossa.3
Origin
Sella is a unilateral anatomic hard tissue cephalometric
landmark point.
Sella Entrance
abbreviation
Definition
according to LB Higley
42
Figures 7.8A and B: (A) sella on lateral cephalogram; (b) Magnified image showing sella on the lateral
cephalogram; (C) sella on graphic illustration; (D) Magnified image of sella on graphic illustration
Type
Sella entrance (Figs 7.9A to D) is a unilateral, hard tissue
cephalometric landmark.
Origin
Definition
according to Robert E Moyers
Sphenoethmoidal Point
abbreviation
43
Figures 7.9A to D: (A) sella entrance on lateral cephalogram; (b) Magnified image showing sella entrance
on the lateral cephalogram; (C) sella entrance on graphic illustration; (D) Magnified image of sella entrance
on graphic illustration
Figures 7.10A and B: (A) sphenoethmoidal point on lateral cephalogram; (b) Magnified image showing
sphenoethmoidal point on the lateral cephalogram
44
Figures 7.10C and D: (C) sphenoethmoidal point on graphic illustration; (D) Magnified image of
sphenoethmoidal point on graphic illustration
Type
Sphenoethmoidal point is a unilateral, hard tissue cephalometric landmark.
Pterygomaxillary Fissure
abbreviation
PtmPterygomaxillary fissure is abbreviated using English
alphabets and is expressed as capital or upper case P followed
by small or lower case t and m, written continuously without
any space between the alphabets.
PTMAccording to Robert M Moyers, Pterygomaxillary
fissure is abbreviated using English alphabets and is expressed
as capital or upper case P followed by capital or upper case T
and M, written continuously without any space between the
alphabets.
PTMSAccording to Michael L Riolo, Pterygomaxillary
fissure is abbreviated using English alphabets and is expressed
as capital or upper case P,T,M,S, written continuously without
any space between the alphabets.
Definition
Pterygomaxillary fissure (Figs 7.11A to D) is a bilateral tear
drop shaped area of radiolucency, the anterior shadow of
which represents the posterior surface of the tuberosity of the
maxilla; the landmark is taken where the two edges, front and
back, appear to merge inferiorly.
according to LB Higley
Junction of the Frankfort plane and a line perpendicular to it
from the pterygomaxillary fissure.
according to TM Graber
Type
45
Figures 7.11A to D: (A) Pterygomaxillary fissure on lateral cephalogram; (b) Magnified image showing
pterygomaxillary fissure; (C) Pterygomaxillary fissure on graphic illustration; (D) Magnified image of
pterygomaxillary fissure on graphic illustration
References
1. Viken Sassouni. Orthodontics in dental practice. The CV Mosby
Company. 1971;330-7.
2. Arne Bjork. The face in profiles-Sven. Tandlak Tidskr. 1947;40:32-3.
3. Graber TM. New horizons in case analysis-clinical cephalometrics.
Am J of Ortho.1952;38:603-24.
CHAPTER
Cephalometric Landmarks
Related to Occipital Bone
The occipital bone (Fig. 8.1) forming much of the back and
base of the cranium and is trapezoidal and concave internally.
Basion
Cephalometric landmarks
Abbreviation
Type
Origin
Basion
Ba
Unilateral
Anatomic
Opisthion
Op
Unilateral
Anatomic
Abbreviation
Boltons point
Bo
Unilateral
Anatomic
Spheno-occipital
synchondrosis
SOS
Unilateral
Anatomic
Definition
Basion is the median point of the anterior margin of the
foramen magnum can be located by following the images of
the slope the inferior border of the basilar part of the occipital
bone to its posterior limit.
47
According to TM Graber
Type
Origin
Figures 8.3A to D: (A) Basion on lateral cephalogram; (B) Magnified image showing basion on the lateral
cephalogram; (C) Basion on graphic illustration; (D) Magnified image of basion on graphic illustration
48
Opisthion
Abbreviation
OpOpisthion is abbreviated using English alphabets and is
expressed as capital letter or upper case O followed by small
letter or lower case p and is written continuously without any
space between the alphabets.
Definition
Opisthion is the posterior edge of the foramen magnum.
Type
Opisthion (Figs 8.4A to D) is a unilateral, hard tissue
cephalometric landmark.
Origin
Opisthion is an anatomic, hard tissue cephalometric landmark.
Boltons Point
Abbreviation
According to TM Graber
Definition
Figures 8.4A and B: (A) Opisthion on lateral cephalogram; (B) Magnified image showing opisthion on the
lateral cephalogram
49
Figures 8.4C and D: (C) Opisthion on graphic illustration; (D) Magnified image of opisthion
on graphic illustration
According to TM Graber
Type
Figures 8.5A and B: (A) Boltons point on lateral cephalogram; (B) Magnified image showing Boltons point on the
lateral cephalogram
50
Figures 8.5C and D: (C) Boltons point on graphic illustration: (D) Magnified image of Boltons point on
graphic illustration
Origin
Boltons point is an anatomic hard tissue cephalometric
landmark/point.
Spheno-Occipital Synchondrosis
Type
Spheno-occpital synchondrosis (Figs 8.6A to D) is a unilateral,
hard tissue cephalometric landmark.
Origin
Spheno-occipital synchondrosis is an anatomic hard tissue
cephalometric landmarks.
Abbreviation
Figures 8.6A and B: Spheno-occipital synchondrosis on lateral cephalogram; (B) Magnified image
showing spheno-occipital synchondrosis on the lateral cephalogram
51
Figures 8.6C and D: (C) Spheno-occipital synchondrosis on graphic illustration; (D) Magnified image of
spheno-occipital synchondrosis on graphic illustration
References
1. Ricketts RR. Provocations and perceptions in cranio-facial orthopedics
dental science and facial art. Rocky Mountain Inc. 1989;797-803.
2. Graber TM. New horizons in case analysis-clinical cephalometrics. Am
J of Ortho. 1952;38:603-24.
Chapter
Cephalometric landmarks
related to Zygomatic bone
Abbreviation
Type
Origin
Orbitale
Or
Bilateral
Anatomic
Temporale
Te
Bilateral
Anatomic
Orbitale
Abbreviation
OrOrbitale is abbreviated using English alphabets and is
denoted as capital letter or upper case O followed by small
letter or lower case r and is written continuously without any
space between the alphabets.
53
Definition
According to TM Graber
Orbitale is the most inferior point on the lower border of the
left orbit.2
Type
Origin
Figures 9.2A to D: (A) Orbitale on lateral cephalogram; (B) Magnified image showing orbitale on the lateral cephalogram;
(C) Orbitale on graphic illustration; (D) Magnified image of orbitale on graphic illustration
54
Temporale
Abbreviation
TeTemporale is abbreviated using English alphabets and is
expressed as capital or upper case T followed by small letters
or lower case e and is written continuously without any space
between the alphabets.
Definition
Temporale (Figs 9.3A to D) is the intersection of the shadows of
the ethmoid and the anterior wall of the infratemporal fossa.
Figures 9.3A to D: (A) Temporale on lateral cephalogram; (B) Magnified image showing temporale on the lateral cephalogram;
(C) Temporale on graphic illustration; (D) Magnified image of temporale on graphic illustration
55
References
Type
Temporale is a bilateral, hard tissue cephalometric landmark.
Origin
Temporale is an anatomic hard tissue cephalometric landmark.
Section
Cephalometric Landmarks
Related to Facial Bones
and Dentition
ChapteR
10
Cephalometric Landmarks
Related to Maxilla
Abbreviation
Type
Origin
aNS
Unilateral
anatomic
Unilateral
anatomic
apMax
Unilateral
anatomic
prosthion
pr
Unilateral
anatomic
pNS
Unilateral
anatomic
Pterygomaxillary fissure
Ptm
PTM
PTMS
Bilateral
anatomic
Key ridge
KR
Unilateral
anatomic
Orbitale
Or
Bilateral
anatomic
According to TM Graber
The tip of the anterior nasal spine as seen on the X-ray film in
norma lateralis.3
Definition
60
Figures 10.2A to D: (A) Anterior nasal spine on lateral cephalogram; (B) Magnified image showing anterior nasal spine on the lateral
cephalogram; (C) Anterior nasal spine on graphic illustration; and (D) Magnified image of Anterior nasal spine on graphic illustration
Type
Radiographic Appearance
Origin
Anterior nasal spine is an anatomic hard tissue cephalometric
landmark.
61
Definition
Anterior nasal spine is used as one of the reference points Point A (Figs 10.3A to D) is the deepest point on the curved
in the construction of occlusal plane and is used for the bony outline between the anterior nasal spine (ANS) and
assessment of horizontal growth pattern using FH-palatal prosthion (Pr).
plane angle (ANS-PNS).
Point A
Abbreviation
Point A: Point A is abbreviated using English alphabets and is Deepest point on the curve of the bone between the anterior
nasal spine and dental alveolus. Also termed SS or subspinale
expressed as A itself.
(below the spine).6
C
D
Figures 10.3A to D: (A) Point A on lateral cephalogram; (B) Magnified image showing point A on the lateral cephalogram; (C) Point A
on graphic illustration; and (D) Magnified image of point A on graphic illustration
62
According to TM Graber
Origin
Prosthion
Abbreviation
Pr: Prosthion is abbreviated using English alphabets and is
expressed as capital letter or upper case P followed by small
letter or lower case r and is written continuously without any
space between the alphabets.
Definition
Prosthion (Figs 10.4A to D) is the lowermost anterior point
of alveolar process of pre-maxilla in the midline between two
maxillary central incisors.
63
Figures 10.4A to D: (A) Prosthion on lateral cephalogram; (B) Magnified image showing prosthion on the lateral cephalogram;
(C) Prosthion on graphic illustration; and (D) Magnified image of prosthion on graphic illustration
Type
According to TM Graber
Origin
64
According to TM Graber
Abbreviation
Definition
Posterior Nasal Spine (Figs 10.5A to D ) is the intersection of
a continuation of the anterior wall of the pterygopalatine fossa
and the floor of the nose.
Figures 10.5A to D: (A) Posterior nasal spine on lateral cephalogram; (B) Magnified image showing posterior nasal spine on the lateral
cephalogram; (C) Posterior nasal spine on graphic illustration; and (D) Magnified image of posterior nasal spine on graphic illustration
65
Type
According to TM Graber
fissure. The Ptm line connects right and left Ptm points. The
Ptm access is the perpendicular bisector of the Ptm line.11
Abbreviation
Ptm: Pterygomaxillary fissure is abbreviated using English
alphabets and is expressed as capital or upper case P followed
by small or lower case t and m, written continuously without
any space between the alphabets.
PTM: According to Robert. M. Moyers, Pterygomaxillary fissure
is abbreviated using English alphabets and is expressed as capital
or upper case P followed by capital or upper case T and M,
written continuously without any space between the alphabets.4
PTMS: According to Michael L Riolo, Pterygomaxillary
fissure is abbreviated using English alphabets and is expressed
as capital or upper case P, T, M, S, written continuously
without any space between the alphabets.9
Definition
Pterygomaxillary fissure (Figs 10.6A to D) is a bilateral tear
drop shaped area of radiolucency, the anterior shadow of
According to LB Higley
Type
Origin
Pterygomaxillary fissure is an anatomic hard tissue cephalometric landmark.
66
Figures 10.6A to D: (A) Pterygomaxillary fissure on lateral cephalogram; (B) Magnified image showing pterygomaxillary
fissure on the lateral cephalogram; (C) Pterygomaxillary fissure on graphic illustration; and (D) Magnified image of
pterygomaxillary fissure on graphic illustration
Key Ridge
Abbreviation
KR: Key ridge is abbreviated using English alphabets and is
expressed as capital or upper case K, and R, and is written
continuously without any space between the alphabets.
According to TM Graber
Definition
The key ridge (Figs 10.7A to D) is the lowermost point on
the contour shadow of the anterior wall of the infratemporal
fossa.
Type
Key ridge is a bilateral, hard tissue cephalometric landmark.
67
Figures 10.7A to D: (A) key ridge on lateral cephalogram; (B) Magnified image showing key ridge on the lateral cephalogram; (C) key
ridge on graphic illustration; and (D) Magnified image of key ridge on graphic illustration
Origin
Definition
Orbitale
Abbreviation
Or: Orbitale is abbreviated using English alphabets and is expressed as capital or upper case O, followed by small or lower
case r and both alphabets are written continuously without any
space between them.
According to TM Graber
The most inferior point on the lower border of the left orbit.3
68
Type
Leslie G Farkas
Origin
Orbitale is the lowest point on the lower margin of the each orbit.
It is identified by palpation and is identical to the bony orbitale.13
Figures 10.8A to D: (A) Orbitale on lateral cephalogram; (B) Magnified image showing orbitale on the lateral cephalogram;
(C) Orbitale on graphic illustration; and (D) Magnified image of orbitale on graphic illustration
69
References
1. Viken Sassuoni. Orthodontics in dental practice. The CV Mosby
company. 1971;330-7.
Chapter
11
Cephalometric Landmarks
Related to Dentition
D
B
C
D
E
CE
Central incisors
Lateral incisors
First molars
Canines
Second molars
71
Cephalometric
landmarks
Abbreviation
Type
Origin
Incision superius
incisalis
Isi
Unilateral
Anatomic
Incision superius
apicalis
Isa
Unilateral
Anatomic
Incision inferius
incisalis
Iii
Unilateral
Anatomic
Incision inferius
apicalis
Iia
Unilateral
Anatomic
Anterior point of
occlusion
APocc
Unilateral
Anatomic
Posterior point of
occlusion
PPocc
Unilateral
Anatomic
Maxillary central
incisor
U1
Unilateral
Anatomic
U6
Bilateral
Anatomic
Mandibular central
incisor
L1
Unilateral
Anatomic
Mandibular first
molar
L6
Bilateral
Anatomic
mi
mi
Bilateral
Anatomic
ms
ms
Bilateral
Anatomic
Definition
Type
Incision superius incisalis is a unilateral, hard tissue cephalo
metric landmark.
Origin
Incision superius incisalis is a unilateral, anatomic, hard tissue
cephalometric landmark.
72
Figures 11.1A to D: (A) Incision superius incisalis on lateral cephalogram; (B) Magnified image showing incision
superius Incisalis on the lateral cephalogram; (C) Incision superius incisalis on graphic illustration; (D) Magnified
image of incision superius Incisalis on graphic illustration
73
Type
Incision superius apicalis is a unilateral, anatomic, hard tissue
cephalometric landmark.
Origin
Definition
The upper incisor apex is the root tip of the maxillary central
incisor. In cases where the root is not yet completed, the
midpoint of the growing root tip is marked.3
74
Definition
Incision inferius incisalis (Figs 11.3A to D) is the incisal edge
of the most prominent mandibular central incisor.
Figures 11.3A to D: Incision inferius incisalis (A and B) on lateral cephalogram, (C and D) on graphic illustration
75
Type
Incision inferius incisalis is a unilateral, anatomic, hard tissue
cephalometric landmark.
Definition
Incision inferius apicalis (Figs 11.4A to D) is the root apex
of the most anterior mandibular central incisor; if this point
is needed only for defining the long axis of the tooth, the
midpoint on the bisection of the apical root width can be
used.
The lower incisor apex is the root apex of the most prominent
lower incisor.4
Type
76
Abbreviation
APoccAnterior point of occlusion is abbreviated using
English alphabets and is expressed as capital or upper case A
and P followed by small letters or lower case o, c and c and
written continuously without any space between the alphabets.
Definition
Anterior point of occlusion (Figs 11.5A to D) for the occlusal
planeA constructed point, the midpoint of the incisor overbite
in occlusion.
Type
Anterior point of occlusion is a unilateral, constructed, hard
tissue cephalometric landmark.
77
Definition
Posterior point of occlusion (Figs 11.6A to D) for the occlusal
planethe most distal point of contact between the most
posterior molars in occlusion (Rakosi).
Type
Posterior point of occlusion is a bilateral, anatomic hard tissue
cephalometric landmark.
78
79
Definition
Maxillary central incisor (Figs 11.7A to D) is the most labial
point on the crown of the maxillary central incisor.
Type
Maxillary central incisor is a unilateral, anatomic, hard tissue
cephalometric landmark.
80
Definition
Maxillary first molar (Figs 11.8A to D) is the tip of the
mesiobuccal cusp of the maxillary first permanent molar.
Type
Maxillary first molar is a bilateral, anatomic, hard tissue
cephalometric landmark.
Definition
Mandibular central incisor (Figs 11.9A to D) is the most labial
point on the crown of the mandibular central incisor.
Type
Mandibular central incisor is a unilateral, anatomic, hard
tissue cephalometric landmark.
81
Definition
Type
82
mi
Type
mi is a bilateral, hard tissue cephalometric landmark.
Abbreviation
mimi is abbreviated using English alphabets and is expressed
as lower case m and i and written continuously without any
space between the alphabets.
Definition
mi (Figs 11.11A to D) is the mesial contact of the lower molar
projected normal to the plane of occlusion.
83
Figures 11.11A to D: mi
Definition
ms
Type
ms is a bilateral hard tissue cephalometric landmark.
Abbreviation
msms is abbreviated using English alphabets and is expressed
as lower case m and s and written continuously without any
space between the alphabets.
84
Figures 11.12A to D: ms
References
1. Arne Bjork. The face in profiles-Sven. Tandlak Tidskr. 1947;40:32-3.
2. Robert M Moyers. Handbook of OrthodonticsYear Book Medical
Publishers, Inc. 1988;251-9.
3. Michael L Riolo. An atlas of craniofacial growth: Cephalometric
standards from the university school growth study, the University of
Michigan. Center for human growth and development. The University
of Michigan. 1974;12-21.
4. Bhatia SN, Leighton BC. A manual of facial growth. Oxford University
Press. 1993;10-5.
Chapter
12
Cephalometric Landmarks
Related to Mandible
Abbreviation
Type
Origin
Infradentale
Id
Unilateral
anatomic
point B
part B
Unilateral
anatomic
pogonion
pog
Unilateral
anatomic
Gnathion
Gn
Unilateral
anatomic
dd
dd
Unilateral
anatomic
Menton
Me
Unilateral
anatomic
Gonion
Go
Unilateral
anatomic
Articulare
ar
Bilateral
anatomic
kk
kk
Unilateral
anatomic
Condylion
Cd
Bilateral
anatomic
Parts of Mandible
The mandible consists of:
A curved, horizontal portion, the body.
Two perpendicular portions, the rami, which unite with
the ends of the body nearly at right angles.
Alveolar process, the tooth bearing area of the mandible.
Condyle, superior (upper) and posterior projection from
the ramus, which makes the temporomandibular joint with
the temporal bone.
Coronoid process, superior and anterior.
Projection from the ramus. This provides attachment to
the temporalis muscle.
86
Articulations
Definition
Infradentale
Abbreviation
87
Type
Point B
Abbreviation
88
According to TM Graber
Definition
According to TM Graber
Type
Point B is a unilateral, anatomic, hard tissue cephalometric
landmark.
Robert E Moyers
The most anterior point on the contour of the chin, pogonion
usually is located by drawing a tangent perpendicular to the
mandibular plane or by a tangent dropped to the chin from nasion.
Significance
Point B is used as one of the reference points in the construction
of plane and angle for the assessment of anteroposterior
relationship of the mandible in relation to anterior cranial base
using S-N-B angle.
Pogonion
Abbreviation
PogPogonion is abbreviated using English alphabets and is
expressed as capital or upper case P followed by lower case or
small letters o and g and are written continuously without any
space between the alphabets.
Type
Pogonion is a unilateral, anatomic, hard tissue cephalometric
landmark.
89
Significance
Definition
Pogonion is used as one of the reference points in the construction of plane and angle for the assessment of anteroposterior relationship of the mandible in relation to anterior cranial
base using S-N-Pog angle (Facial angle).
Gnathion
According to TM Graber
Gnathion is the most outward and everted point on the profile
curvature of the symphysis of the mandible.
Abbreviation
90
Arne Bjork
Lowest point of the mandibular symphysis.
Type
Gnathion is a unilateral, constructed or derived, hard tissue
cephalometric landmark.
91
Figures 12.6A to D: dd
Significance
Definition
dd
Abbreviation
dddd is abbreviated using English alphabets and is expressed
as lower case or small letters d and d and written continuously
without any space between the alphabets.
Type
92
Significance
Type
Menton
Abbreviation
Tracing of Menton on the lateral
Cephalogram
93
Significance
Gonion
Abbreviation
GoGonion is abbreviated using English alphabets and is
expressed as capital or upper case G followed by lower case
or small letter o and is written continuously without any space
between the alphabets.
Significance
Definition
Articulare
Type
Gonion (Figs 12.8A to D) is a unilateral, anatomic, hard tissue
cephalometric landmark.
Abbreviation
Definition
Articulare (Figs 12.9A to D) is the point of intersection the
dorsal contours of the processus articularis mandibulare and
os tempoarle. The midpoint, a is used where double projection
gives rise to two points, a1 and a2.
Type
Articulare is a bilateral, anatomic, hard tissue landmark.
94
kk
Abbreviation
Significance
Definition
Type
kk (Figs 12.10A to D) is a bilateral hard tissue cephalometric
landmark.
95
Significance
kk is used as one of the reference points in the construction of
plane and angle in the Bjork cephalometric analysis.
Condylion
Abbreviation
Definition
According to Clifton T Forsberg
Condylion medialis (Figs 12.11A to D)The tangent point to
each medial condylar border of a line drawn parallel to each
mandibular body line.
96
Figures 12.10A to D: kk
Type
97
Significance
Condylion is used as one of the reference points in the construction of plane and angle for the assessment of the following:
Section
Cephalometric Landmarks
Related to Cervical Bones
Chapter
13
Cephalometric landmarks
related to hyoid bone
Like the mandible, the hyoid bone (Figs 13.1A and B) is also
a horse-shoe shaped bone suspended in the neck.
Abbreviation
Type
Origin
Hyoid
Hy or H
Unilateral
Anatomic
Hyoid
Abbreviation
HyHyoid is abbreviated using English alphabet and is
expressed as capital or upper case H followed by lower case or
small y, and both are written continuously without any space
between the alphabets.
102
Definition
Hyoid (Figs 13.2A to D) is the most superoanterior point on
the body of the hyoid bone.
Type
Hyoid is a unilateral, anatomic, hard tissue cephalometric
landmark.
Reference
1. Ricketts RR. Provocations and perceptions in cranio-facial orthopedics
dental science and facial art. Rocky Mountain Inc. 1989;797-803.
Chapter
14
Cephalometric landmarks
related to Vertebrae
Radiographic anatomy of
cervical vertebrae (fig. 14.1)
Anteroinferior to the occipital condyle, which appears as a
curved radio-opaque line, the anterior arch of the atlas can be
identified as a small triangular radio-opaque area. The apex
of the triangle faces the posterior border of the mandibular
ramus, while its base faces the odontoid process of the
axis. The central mass of the atlas, which appears as radioopaque area superimposed on the radio-opaque shadow of the
odontoid process. Posterosuperior to the inferior articular facet
is the superior articular facet, which can be identified as radioopaque area. Its superior border is concave and corresponds
with the contour of the occipital condyle. Next to the superior
articular facet is the posterior arch with the posterior tubercle.
At the superior border of the posterior arch is a groove for the
vertebral artery and the first cervical nerve.
The odontoid process and the body of the axis appear as a
triangular radio-opaque area. The odontoid process represents
the apex of the triangular points toward the occipital condyle.
The spinous process of the axis appears as a radio-opaque
projection extending superiorly.
The radiographic appearance of the third cervical vertebra
(C3) to the seventh cervical vertebra (C7) is similar. The body
of the each of these cervical vertebrae appears as wedge shaped
radio-opaque area situated behind the pharyngeal space.
Posterior to the body is the spinous process. The transverse
processes, the superior articular process and the inferior
articular process appear as radio-opaque area superimposed
on the shadow of the body and the spinous process. The
body of each cervical vertebra is separated from the adjacent
ones by the intervertebral disc, which appears as radiolucent
strip. At the midpoint between the third and fourth cervical
vertebrae is the hyoid bone, which is separated anteriorly.
Abbreviation
Type
Origin
cv2ap
cv2ap
Unilateral
Anatomic
cv2ip
cv2ip
Unilateral
Anatomic
cv2ia
cv2ia
Unilateral
Anatomic
cv3sp
cv3sp
Unilateral
Anatomic
cv3ip
cv3ip
Unilateral
Anatomic
cv3sa
cv3sa
Unilateral
Anatomic
cv3ia
cv3ia
Unilateral
Anatomic
cv4sp
cv4sp
Unilateral
Anatomic
cv4ip
cv4ip
Unilateral
Anatomic
cv4sa
cv4sa
Unilateral
Anatomic
cv4ia
cv4ia
Unilateral
Anatomic
cv5sp
cv5sp
Unilateral
Anatomic
cv5ip
cv5ip
Unilateral
Anatomic
cv5sa
cv5sa
Unilateral
Anatomic
cv5ia
cv5ia
Unilateral
Anatomic
cv6sp
cv6sp
Unilateral
Anatomic
cv6ip
cv6ip
Unilateral
Anatomic
cv6sa
cv6sa
Unilateral
Anatomic
cv6ia
cv6ia
Unilateral
Anatomic
104
cv2ip
Abbreviation
cv2ipcv2ip is abbreviated using English alphabet and English
numeric and is expressed as small letters or lower case c,v
followed by English numeric 2 and then it is followed with
English alphabets lower case i and p and all of them are written
continuously without any space between the alphabets.
Definition
The most inferoposterior point on the body of the second
cervical vertebra.
Type
Significance
This cephalometric landmark/point is used as a reference point
in the cervical vertebrae maturity indicator (CMVI) method.
cv2ap
Abbreviation
cv2apcv2ap is abbreviated using English alphabet and
English numeric and is expressed as small letters or lower
case c,v followed by English numeric 2 and then it is followed
with English alphabets lower case a and p and all of them are
written continuously without any space between the alphabets.
Definition
The apex of the odontoid process of the second cervical
vertebra.
Type
cv2ap (Figs 14.3A and B) is a unilateral, anatomic, hard tissue
cephalometric landmark.
Significance
This cephalometric landmark/point is used as a reference point
in the cervical vertebrae maturity indicator (CMVI) method.
105
Figures 14.2A and B: cv2ip-The most inferoposterior point on the body of the second cervical vertebra
Figures 14.3A and B: cv2ap-The apex of the odontoid process of the second cervical vertebra
106
cv3sp
Abbreviation
Abbreviation
Definition
Definition
Type
Type
Significance
Significance
cv2ia
Figures 14.4A and B: cv2ia-The most inferioanterior point on the body of the second cervical vertebra
107
Figures 14.5A and B: cv3sp-The most superoposterior point on the body of the third cervical vertebra
cv3ip
cv3sa
Abbreviation
Abbreviation
Definition
Definition
Type
Type
Significance
Significance
108
Figures 14.6A and B: cv3ip-The most inferoposterior point on the body of the third cervical vertebra
Figures 14.7A and B: cv3sa-The most superoanterior point on the body of the third cervical vertebra
109
cv4sp
Abbreviation
Abbreviation
Definition
Definition
Type
Type
Significance
Significance
Figures 14.8A and B: cv3ia-The most inferioanterior point on the body of the third cervical vertebra
cv3ia
110
Figures 14.9A and B: cv4sp-The most superoposterior point on the body of the fourth cervical vertebra
cv4ip
cv4sa
Abbreviation
Abbreviation
Definition
Definition
Type
Type
Significance
Significance
111
Figures 14.10A and B: cv4ip-The most inferoposterior point on the body of the fourth cervical vertebra
Figures 14.11A and B: cv4sa-The most superoanterior point on the body of the fourth cervical vertebra
112
cv5sp
Abbreviation
Abbreviation
DEFINITION
Definition
Type
Type
Significance
Significance
cv4ia
Figures 14.12A and B: cv4ia-The most inferoanterior point on the body of the fourth cervical vertebra
113
Figures 14.13A and B: cv5sp-The most superoposterior point on the body of the fifth cervical vertebra
cv5ip
cv5sa
Abbreviation
Abbreviation
Definition
Definition
Type
Type
Significance
Significance
114
Figures 14.14A and B: cv5ip-The most inferoposterior point on the body of the fifth cervical vertebra
Figures 14.15A and B: cv5sa-The most superoanterior point on the body of the fifth cervical vertebra
115
cv6sp
Abbreviation
Abbreviation
Definition
Definition
Type
Type
Significance
Significance
Figures 14.16A and B: cv5ia-The most inferoanterior point on the body of the fifth cervical vertebra
cv5ia
116
Figures 14.17A and B: cv6sp-The most superoposterior point on the body of the sixth cervical vertebra
cv6ip
cv6sa
Abbreviation
Abbreviation
Definition
Definition
Type
Type
Significance
Significance
117
Figures 14.18A and B: cv6ip-The most inferoposterior point on the body of the sixth cervical vertebra
Figures 14.19A and B: cv6sa-The most superoanterior point on the body of the sixth cervical vertebra
118
cv6ia
Abbreviation
cv6iacv6ia is abbreviated using English alphabet and English
numeric and is expressed as small letters or lower case c,v
followed by English numeric 6 and then it is followed with
English alphabets lower case i and a and all of them are written
continuously without any space between the alphabets.
Definition
Type
cv6ia (Figs 14.20A and B) is a unilateral, anatomic, hard
tissue cephalometric landmark.
Significance
This cephalometric landmark/point is used as a reference point in
the cervical vertebrae maturity indicator (CMVI) method.
Figures 14.20A and B: cv6ia-The most inferoanterior point on the body of the sixth cervical vertebra
119
120
Contd...
Stage
Name
Changes in vertebrae
Stage 5
Maturation
Stage 6
Completion
Changes in vertebrae
Stage 1
Initiation
Stage 2
Acceleration
Stage
Stage 3
Transition
Stage 4
Deceleration
Bibliography
1. Anderson Dl, Thompson GW, Popovich F. Interrelationship of dental
maturity, skeletal maturity, height and weight from age 4 to 14 years,
Growth. 1975;39:453-62.
2. Bowden BD. Epiphyseal changes in the hand/wrist area as an indicator
of adolescent. Aust Orthod J. 1976;4:87-104.
3. Fishman LS. Radiographic evaluation of skeletal maturity. Angle
Orthodont. 1982;88-112.
4. Grave, Brown. Skeletal ossification and adolescent growth spurt. Am J
Orthod. 1976;69-80.
5. Houston WJB, Miller JC, Tanner JM. pRediction of the timing of the
adolescent growth spurt from ossification events in hand/wrist films,
Brit J Ortho. 1979;6:145-52.
6. Moore, Moyer, Dubois. Skeletal maturation and craniofacial growth.
Am J Orthod. 1990;33-40.
7. Revelo, Fishman. Evaluation of ossification of midpalatal suture. Am J
Orthod. 1994;288-92.
Section
Cephalometric landmarks
related to Pharynx
Chapter
15
Cephalometric landmarks
related to Pharynx
Abbreviation
Type
ANS or ans
Unilateral
Anatomic
PNS or pns
Unilateral
Anatomic
Nasopharynx
Anterior pharyngeal
wall
apw
Unilateral
Anatomic
Posterior pharyngeal
wall
ppw
Unilateral
Anatomic
Pterygomaxillary
fissure
Ptm
Unilateral
Anatomic
Superior pharyngeal
wall
spw
Unilateral
Anatomic
Tip of uvula
Unilateral
Anatomic
Uo
Unilateral
Anatomic
Point on the
pharyngeal side of
the soft palate
Up
Unilateral
Anatomic
Upper point of
tongue
ut
Unilateral
Anatomic
Oropharynx
The oropharynx is the middle part of the pharynx situated
between the soft palate and the superior border of the epiglottis.
Anteriorly, it opens to the oral cavity and is bordered by the
posterior one-third of the tongue. At the lateral boundaries of
the opening of the oral cavity into the oropharynx, the palatine
tonsils are lodged in the tonsilar fossae.
Laryngopharynx
The laryngopharynx is the lower part of the pharynx. It extends
from the superior border of the epiglottis to the inferior border
of the sixth cervical vertebrae, where it becomes continuous
with the esophagus. The upper part of the laryngopharynx is
open anteriorly to the larynx via the patent inlet.
Origin
124
spwSuperior pharyngeal wall is abbreviated using English alphabet and is expressed as small letters or lower case, s, p and w and
written continuously without any space between the alphabets.
Significance
In Mc Namara Analysis
Upper pharynx
Upper pharyngeal width is measured from a point on the
posterior outline of the soft palate to the closet point on the
pharyngeal wall. This measurement is taken on the anterior
half of the soft palate outline. The average nasopharnyx is
approximately 1520 mm in width. A width of 2 mm or less in
this region indicates airway impairment.
Lower Pharynx
Lower pharyngeal width is measured from the point of
intersection of the posterior border of the tongue and the
inferior border of the mandible to the closet point on the
posterior pharyngeal wall. The average measurement is 11
to 14 mm independent of age. Greater than average lower
pharyngeal walls is of possible anterior positioning of the
tongue, either as a result of habitual posture or due to tonsillar
enlargements A lower than average lower pharyngeal wall
indicates the posterior positioning of the tongue.
Section
ChapTer
16
Definition
Abbreviation
GSoft tissue glabella is abbreviated using English
alphabet and is expressed as upper case G.
Figures 16.1A to D: (A) Soft tissue glabella on lateral cephalogram; (B) Magnified image showing soft tissue glabella on the lateral
cephalogram; (C) Soft tissue glabella on graphic illustration; (D) Magnified image of soft tissue glabella on graphic illustration
128
Type
Glabella is a unilateral soft tissue cephalometric landmark.
Abbreviation
Significance
Glabella is used as one of the reference points in the construction of facial angles.
Definition
Soft tissue nasion (Figs 16.2A to D) is the concave or retruded
point in the tissue overlying the area of the frontonasal suture.
Figures 16.2A to D: (A) soft tissue nasion on lateral cephalogram; (B) Magnified image showing soft tissue nasion on the lateral
cephalogram; (C) Soft tissue nasion on graphic illustration; (D) Magnified image of soft tissue nasion on graphic illustration
129
Type
Type
Significance
Significance
Nasal Crown
Abbreviation
PnPronasale is abbreviated using English alphabet and is
expressed as capital (upper case) P followed by lower case
n written continuously without any space between alphabets.
Abbreviation
Pronasale
Definition
Figures 16.3A to D: (A) Nasal crown on lateral cephalogram; (B) Magnified image showing nasal crown on the lateral cephalogram;
(C) Soft tissue nasal crown on graphic illustration; (D) Magnified image of nasal crown on graphic illustration
130
Figures 16.4A to D: (A) Pronasale on lateral cephalogram; (B) Magnified image showing pronasale on the lateral cephalogram;
(C) Pronasale on graphic illustration; (D) Magnified image of pronasale on graphic illustration
Definition
Pronasale (Figs 16.4A to D) is the most prominent or anterior
point of the nose.
Point T
Abbreviation
Type
Type
Pronasale is a unilateral soft tissue cephalometric landmark.
Significance
Significance
131
Figures 16.5A to D: (A) Point T on lateral cephalogram; (B) Magnified image showing point T on the lateral cephalogram; (C) Point
T on graphic illustration; (D) Magnified image of point T on graphic illustration
Definition
Alar crease junction is the most posterior point of the curved
line formed by the alar crease.
Type
Definition
Significance
Subnasale
132
Figures 16.6A to D: (A) Alar crease junction on lateral cephalogram; (B) Magnified image showing Alar crease junction on the lateral
cephalogram; (C) Alar crease junction on graphic illustration; (D) Magnified image of Alar crease junction on graphic illustration
Figures 16.7A to D: (A) Subnasale on lateral cephalogram; (B) Magnified image showing subnasale on the lateral cephalogram;
(C) Subnasale on graphic illustration; (D) Magnified image of subnasale on graphic illustration
133
Type
Stomion
Stomion superius
Stomion inferius
Significance
Subnasale helps in the assessment of nasal tip projection
and nasal height.
Subnasale is also used as one of the reference points in
the construction of following planes for the assessment of
following:
Burstones B line used to assess the relationship of
upper and lower teeth to the upper and lower lip.
Height of upper lip (SnLs) can be assessed.
Definition
Figures 16.8A to D: (A) Subspinale on lateral cephalogram; (B) Magnified image showing subspinale on the lateral cephalogram;
(C) Subspinale on graphic illustration; (D) Magnified image of subspinale on graphic illustration
134
Type
Type
Significance
Significance
Abbreviation
Philtrum
Labrale Superius
Definition
Labrale superius (Figs 16.9A to D) is the most anterior point
on the margin of the upper membranous lip.
Figures 16.9A to D: (A) Labrale superius on lateral cephalogram; (B) Magnified image showing labrale superius on the lateral
cephalogram; (C) Labrale superius on graphic illustration; (D) Magnified image of labrale superius on graphic illustration
135
Stomion
Abbreviation
StoStomion is abbreviated using English alphabet and is
expressed as capital S followed by small t and o.
Definition
Stomion (Figs 16.13A to D) is the median point of the oral
embrassure when the lips are closed.
Type
Stomion is a unilateral soft tissue cephalometric landmark.
136
Figures 16.13A to D: (A) Stomion on lateral cephalogram; (B) Magnified image showing stomion on the lateral cephalogram;
(C) Stomion on graphic illustration; (D) Magnified image of stomion on graphic illustration
Significance
Stomion is established only at rest when teeth are in centric
occlusion and centric relation. Presence of stomion indicates
averagely positioned upper and lower teeth.
Labrale Inferius
Abbreviation
Abbreviation
Definition
Definition
Type
Labrale inferius is a unilateral soft tissue cephalometric
landmark.
Significance
Labrale inferius is also used as one of the reference points
in the construction of following planes for the assessment of
following:
Type
Soft tissue point B or soft tissue submentale is a unilateral soft
tissue cephalometric landmark.
Significance
Soft tissue point B or soft tissue submentale is used in the
assessment of deepness of submental.
137
Figures 16.14A to D: (A) Labrale inferius on lateral cephalogram; (B) Magnified image showing labrale inferius on the lateral
cephalogram; (C) Labrale inferius on graphic illustration; (D) Magnified image of labrale inferius on graphic illustration
Figures 16.15A to D: (A) Soft tissue point B on lateral cephalogram; (B) Magnified image showing soft tissue point B on the lateral
cephalogram; (C) Soft tissue point B on graphic illustration; (D) Magnified image of soft tissue point B on graphic illustration
138
Figures 16.16A to D: (A) Soft tissue pogonion on lateral cephalogram; (B) Magnified image showing soft tissue pogonion on the lateral
cephalogram; (C) Soft tissue pogonion on graphic illustration; (D) Magnified image of soft tissue pogonion on graphic illustration
Type
Definition
Soft tissue pogonion (Figs 16.16A to D) is the most prominent
or anterior point on the soft tissue chin in the midsagittal plane.
Significance
Soft tissue pogonion is used to the prominence of the chin.
Soft tissue pogonion is also used as one of the reference
points in the construction of following planes for the
assessment of following:
Steiners S line used to assess the relationship of
upper and lower teeth to the upper and lower lip.
Ricketts E-line used to assess the relationship of
upper and lower teeth to the upper and lower lip.
Burstones B line used to assess the relationship of
upper and lower teeth to the upper and lower lip.
Holdaway H line used to assess the relationship of
upper and lower teeth to the upper and lower lip.
139
Figures 16.17A to D: (A) Soft tissue gnathion on lateral cephalogram; (B) Magnified image showing soft tissue gnathion on the lateral
cephalogram; (C) Soft tissue gnathion on graphic illustration; (D) Magnified image of soft tissue gnathion on graphic illustration
Definition
Abbreviation
Type
SECTION
3D Cephalometric
Landmarks
3D Cephalometric Landmarks
CHAPTER
17
3D Cephalometric
Landmarks
Vertex
Abbreviation
VVertex is abbreviated using English alphabet and is
expressed as capital or upper case V.
Definition
Vertex (Fig. 17.1) is the most superior point of calvarium in
center line.
Type
Vertex is an anatomic, unilateral, soft tissue cephalometric
landmark.
Significance
Vertex is used as one of the reference points in the construction
of angles and planes in 3D cephalometric analysis.
Definition
Soft tissue nasion (Fig. 17.2) is the concave or retruded point
in the tissue overlying the area of the frontonasal suture.
Figure 17.2: Soft tissue nasion (Image created with the Invivo5
software by Anatomage Inc.)
144
Type
Soft tissue nasion is a unilateral, soft tissue cephalometric
landmark.
Significance
Pronasale
Abbreviation
PnPronasale is abbreviated using English alphabets and is
expressed as capital (upper case) P followed by lower case
n written continuously without any space between alphabets.
Definition
Pronasale (Figs 17.3A and B) is the most prominent or
anterior point of the nose.
Type
Pronasale is a unilateral, soft tissue cephalometric landmark.
Significance
Pronasale is used as one of the reference points on the
construction planes and angles in 3D cephalometric analysis.
Subnasale
Abbreviation
SnSubnasale is abbreviated using English alphabets and is
expressed as capital (upper case) S followed by small (lower
case) n written continuously without any space between them.
Figures 17.3A and B: Pronasale (Image created with the Invivo5 software by Anatomage Inc.)
145
Definition
Subnasale (Fig. 17.4) is the point at which the nasal septum
between the nostrils merges with the upper cutaneous tip in
the midsagittal plane.
Type
Definition
Soft tissue subspinale (Fig. 17.5) is the point of greatest
concavity in the midline of the upper lip between subnasale
(Sn) and labrale superius (Ls).
Type
Significance
Significance
Figure 17.5: Soft tissue subspinale (Image created with the Invivo5
software by Anatomage Inc.)
146
Labrale Superius
Definition
Stomion (Fig. 17.7) is the median point of the oral embrassure
when the lips are closed.
Abbreviation
LsLabrale superius is abbreviated using English alphabets
and is expressed as capital L followed by small s and is written
continuously without any space between the alphabets.
Type
Definition
Significance
Labrale Inferius
Type
Significance
Labrale superius is also used as one of the reference points
in the construction of planes and angles in 3D cephalometric
analysis.
Stomion
Abbreviation
StoStomion is abbreviated using English alphabets and is
expressed as capital S followed by small t and o and is written
continuously without any space between the alphabets.
Abbreviation
LiLabrale inferius is abbreviated using English alphabets
and is expressed as capital L followed by small i and is
written continuously without any space between the
alphabets.
Definition
Labrale inferius (Fig. 17.8) is the most anterior point on the
lower margin of the lower membrane lip
Type
Labrale inferius is a unilateral soft tissue cephalometric
landmark.
147
Figure 17.9: Soft tissue point B (Image created with the Invivo5
software by Anatomage Inc.)
Significance
Labrale inferius is used as one of the reference point on the
construction planes and angles in 3D cephalometric analysis.
Definition
Soft tissue point B or soft tissue submentale (Fig. 17.9) is the
point of greatest concavity in the midline of the lip between
labrale inferius (Li) and soft tissue pogonion (Pog or Pogs).
Type
Soft tissue point B or soft tissue submentale is a unilateral soft
tissue cephalometric landmark.
Significance
Abbreviation
148
Definition
Soft tissue pogonion (Fig. 17.10) is the most prominent or
anterior point on the soft tissue chin in the midsagittal plane.
Type
Type
Soft tissue gnathion is a unilateral, constructed points, soft
tissue cephalometric landmark.
Significance
Soft tissue gnathion is used as one of the reference point
on the construction planes and angles in 3D cephalometric
analysis.
Orbitale
Abbreviation
Significance
Abbreviation
GnsSoft tissue gnathion is abbreviated using English
alphabets and is expressed as capital G followed by small
n with s in subscript position and is written continuously
without any space between the alphabets.
Definition
Orbitale (Fig. 17.12)Most inferior portion of orbital floor
below the center of eye.
Type
Orbitale is a bilateral soft tissue cephalometric landmark.
Definition
Significance
Figure 17.11: Soft tissue gnathion (Image created with the Invivo5
software by Anatomage Inc.)
149
Zygomatic Prominence
Definition
Zygion (Fig. 17.14)Most lateral point of each zygomatic
arch eye.
Abbreviation
ZpSZygomatic prominence is abbreviated using English
alphabets and is expressed as capital Z followed by small
p with s in subscript position and is written continuously
without any space between the alphabets.
Type
Definition
Type
Significance
Zygomatic prominence is used as one of the reference points
on the construction planes and angles in 3D cephalometric
analysis.
Zygion
Abbreviation
ZysZygion is abbreviated using English alphabets and is
expressed as capital Z followed by small y with s in subscript
position and is written continuously without any space
between the alphabets.
Significance
Condylion
Abbreviation
CosCondylion is abbreviated using English alphabets and is
expressed as capital C followed by small o with s in subscript
position and is written continuously without any space
between the alphabets.
Definition
Type
Significance
150
Figures 17.15A and B: Condylion (Image created with the Invivo5 software by Anatomage Inc.)
Figures 17.16A and B: Gonion (Image created with the Invivo5 software by Anatomage Inc.)
Gonion
Type
Gonion is a bilateral soft tissue cephalometric landmark.
Abbreviation
Significance
Definition
Gos (Figs 17.16A and B)Most everted point of angle of
mandible.
Ch
Abbreviation
ChCh is abbreviated using English alphabets and is
expressed as capital C followed by small h written continuously
without any space between the alphabets.
151
Alare
Definition
Ch (Fig. 17.17)Most lateral border point of chin.
Abbreviation
Type
Significance
Definition
Cheilion
Type
Alare is a bilateral soft tissue cephalometric landmark.
Significance
Definition
Exocanthion
Type
Abbreviation
Abbreviation
Significance
Cheilion is used as one of the reference points on the
construction planes and angles in 3D cephalometric analysis.
152
Definition
Type
Exocathion is a bilateral soft tissue cephalometric landmark.
Significance
Exocathion is used as one of the reference points on the
construction planes and angles in 3D cephalometric analysis.
Sella
Abbreviation
SSella is abbreviated using English alphabet and is expressed
as capital or upper case S.
Definition
Sella (Fig. 17.20) is the midpoint of sella turcica or hypophyseal
fossa or pituitary fossa.
According to TM Graber
The center of pituitary fossa.
According to LB Higley
The center of sella turcica.
The midpoint of the sella turcica arbitrarily determined.
Type
Sella is a unilateral, anatomic, hard tissue cephalometric
landmark.
153
Basion
Sella Entrance
Abbreviation
Definition
Sella entrance (Fig. 17.21) is the mid entrance point of sella
turcica or hypophyseal fossa or pituitary fossa.
Type
Sella entrance is a unilateral, constructed, hard tissue cephalo
metric landmark.
Definition
Basion (Figs 17.22A to D) is the median point of the anterior
margin of the foramen magnum can be located by following
the images of the slope the inferior border of the basilar part
of the occipital bone to its posterior limit.
Abbreviation
According to TM Graber
Type
Basion is a unilateral, anatomic, hard tissue cephalometric
landmark.
154
Figures 17.22A to D: Basion (Image created with the Invivo5 software by Anatomage Inc.)
Definition
Anterior nasal spine (Fig. 17.23) is the tip of bony anterior
nasal spine in the midline or median plane.
155
Type
Anterior nasal spine is a unilateral, anatomic, hard tissue
cephalometric landmark.
According to TM Graber
The tip of the anterior nasal spine as seen on the X-ray film in
norma lateralis.
Radiographic Appearance
Figure 17.23: Anterior nasal spine (Image created with the Invivo5
software by Anatomage Inc.)
Section
PA Cephalometric
Landmarks
PA Cephalometric Landmarks
ChAPter
18
PA Cephalometric
Landmarks
160
Taking Pa Cephalogram
Abbreviation
Type
Origin
Crista galli
Nc
Unilateral
Anatomic
Crista galli
abbreviation
NcCrista galli is abbreviated using English alphabets and is
expressed as capital letter or upper case N and small letter or
lower case c and is written continuously without any space
between the alphabets.
Definition
Neck of crista galli (Figs 18.1A and B) is the neck of
perpendicular lamina of the ethmoid.
Type
Neck of crista galli is a unilateral, anatomic, hard tissue PA
cephalometric landmark.
Abbreviation
Type
Origin
tns
Unilateral
Anatomic
NC
NC
Unilateral
Anatomic
161
Definition
according to athanasios E athanasiou
abbreviation
tnsTop of nasal septum is abbreviated using English
alphabet and is expressed as small letter or lower case t,
n, s and is written continuously without any space between
the alphabets.
The highest point onto the superior aspect of the nasal septum
(Figs 18.2A and B).
Type
Top of nasal septum is a unilateral, anatomic, hard tissue PA
cephalometric landmark.
162
NC
abbreviation
NCNC is abbreviated using English alphabets and is
expressed as capital letter or upper case N, C and is written
continuously without any space between the alphabets.
Abbreviation
Type
Origin
Zygoma
Zyg
Bilateral
Anatomic
Zygion
Zy
Bilateral
Anatomic
Zygomatic arch
ZA
Bilateral
Anatomic
Type
Zygomatic suture
point
Bilateral
Anatomic
Jugal process
Bilateral
Anatomic
Definition
according to Robert M Ricketts
zyg-zygoma
abbreviation
ZygZygoma is abbreviated using English alphabet and is
expressed as capital letter or upper case Z followed by lower
case or small letter y, g and is written continuously without
any space between the alphabets.
Definition
according to Viken Sassouni
Figure 18.3: NC
163
Type
Type
zygion
zygomatic arch
abbreviation
Definition
Definition
abbreviation
164
Type
Jugal Process
abbreviation
JJugal process is abbreviated using English alphabet and is
expressed as capital letter or upper case J.
Definition
Definition
Type
Type
165
Cephalometric landmark
Abbreviation
Type
Origin
Cephalometric landmarks
Abbreviation
Type
Origin
Maxillare
Mx or mx
Bilateral
Anatomic
Isi or is
Unilateral
Anatomic
Isa or ULA
Unilateral
Anatomic
Maxillary molar
um
Bilateral
Anatomic
U6 or A6
Bilateral
Anatomic
Maxillare
abbreviation
Definition
Type
Origin
Iii or ii
Unilateral
Anatomic
Iia or LIA
Unilateral
Anatomic
iif
Unilateral
Anatomic
L6 or A6
Bilateral
Anatomic
mi
mi
Bilateral
Anatomic
Mandibular molar
Im
Bilateral
Anatomic
abbreviation
Type
Maxillare is a bilateral, anatomic, hard tissue PA cephalometric
landmark.
Abbreviation
Cephalometric landmarks
166
Definition
Incision superius incisalis (Figs 18.10A and B) is the incisal
edge of the maxillary central incisor.
Type
Definition
Incision superius apicalis (Figs 18.11A and B) is the root
apex of the most anterior maxillary central incisor; if this
167
point is needed only for defining the long axis of the tooth, the
midpoint on the bisection of the apical root width can be used.
The upper incisor apex is the root tip of the maxillary central
incisor. In cases where the root is not yet completed, the
midpoint of the growing root tip is marked.
The upper incisor apex is the root apex of the most prominent
upper incisor.
Maxillary Molar
Type
Incision superius apicalis is a unilateral, anatomic, hard tissue
cephalometric landmark.
abbreviation
Definition
according to athanasios E athanasiou
The most prominent lateral point on the buccal surface of
the second deciduous or first permanent maxillary molar
(Figs 18.12A and B).
Type
Maxillary molar is a bilateral, hard tissue cephalometric
landmark.
168
Definition
Maxillary first molar (Figs 18.13A and B) is the tip of the
mesiobuccal cusp of the maxillary first permanent molar.
Type
Maxillary first molar is a bilateral, anatomic, hard tissue
cephalometric landmark.
169
Definition
Cuspid
abbreviation
A3Cuspid is abbreviated using English alphabet and numeric
and is expressed as upper case A and numeric 3 and are written
continuously without any space between the alphabets.
Definition
Type
Type
170
Definition
Incision inferius apicalis (Figs 18.16A and B) is the root
apex of the most anterior mandibular central incisor; if this
171
point is needed only for defining the long axis of the tooth, the
midpoint on the bisection of the apical root width can be used.
abbreviation
The lower incisor apex is the root apex of the most prominent
lower incisor.
Type
Definition
Type
abbreviation
Definition
172
Type
Definition
Type
The labial and lingual and cuspal outlines of the crown of the
mandibular permanent first molar appears as radio-opaque
lines on the lateral cephalogram. Trace these outlines of
crown of the mandibular permanent first molar, the tip of the
mesiobuccal cusp of the mandibular permanent molar is the
point of maxillary first molar.
mi
abbreviation
mimi is abbreviated using English alphabets and is expressed
as lower case m and i and is written continuously without any
space between the alphabets.
173
Mandibular Molar
abbreviation
ImMandibular molar is abbreviated using English alphabets
and is expressed as upper case I and lower case m and is written
continuously without any space between the alphabets.
Cephalometric landmarks
Abbreviation
Type
Origin
Menton
Me
Unilateral
Anatomic
Articulare
Ar
Bilateral
Anatomic
Malare
ma
Bilateral
Anatomic
Antegonial tubercle
Ag
Bilateral
Anatomic
Antegonion
Ag
Bilateral
Anatomic
Definition
Menton
Type
Mandibular molar is a bilateral, hard tissue cephalometric
landmark.
174
Type
Menton (see Figs 12.7A and B) is a unilateral, anatomic, hard
tissue landmark.
Significance
Definition
Articulare (Figs 18.22A and B) is the point of intersection the
dorsal contours of the processus articularis mandibulare and
os tempoarle.The midpoint, a is used where double projection
gives rise to two points a1 and a2.
Type
Articulare is a bilateral, anatomic, hard tissue landmark.
articulare
Malare
Significance
abbreviation
abbreviation
ArArticulare is abbreviated using English alphabets and is
expressed as capital or upper case A followed by lower case
175
Definition
Definition
Type
Type
antegonial Tubercles
antegonion
abbreviation
abbreviation
176
Definition
Type
SECTION
10
SV Cephalometric
Landmarks
SV Cephalometric Landmarks
CHAPTER
19
SV Cephalometric
Landmarks
Basion
Opisthion
Abbreviation
Abbreviation
BaBasion is abbreviated as capital or upper case B followed
by small letter or lower case a and is written continuously
without any space between the alphabets.
Definition
Definition
According to Clifton T Forsberg
Type
Type
Origin
Origin
180
Definition
Type
Foramina spinosa points are bilateral hard tissue SV cephalo
metric landmarks/points.
Origin
Foramina spinosa points are an anatomic SV cephalometric
landmarks/points.
Foramina Spinosum
Abbreviation
181
Odontoid
Definition
According to KKK Lew
Abbreviation
Type
Foramina spinosum points are bilateral hard tissue SV cephalo
metric landmarks/points.
Definition
Origin
182
Type
Odontoid is a unilateral hard tissue SV cephalometric
landmark/point.
Origin
Odontoid is an anatomic SV cephalometric landmark/point.
Pterygomaxillary Fissure
Abbreviation
MCFMiddle cranial fossa point is abbreviated as capital
letters or upper case MCF and is written continuously without
any space between the alphabets.
Definition
Abbreviation
Definition
Type
Middle cranial fossa points is a bilateral hard tissue SV
cephalometric landmark/point.
Origin
Middle cranial fossa point is an anatomic SV cephalometric
landmark/point.
Type
Pterygomaxillary fissure is a bilateral hard tissue SV
cephalometric landmark/point.
Origin
Pterygomaxillary fissure is an anatomic SV cephalometric
landmark/point.
183
Definition
According to Clifton T Forsberg
The intersection of the vomer with the PTM line (Figs 19.8A
and B).
Type
Posterior vomer point is a unilateral hard tissue SV cephalo
metric landmark/point.
Origin
Posterior vomer point is an anatomic SV cephalometric
landmark/point.
Abbreviation
PCVPosterior cranial vault points is abbreviated as capital
letter or upper case PVP and is written continuously without
any space between the alphabets.
Definition
According to Clifton T Forsberg
The intersections of the lateral borders of the cranial vault
with a line, parallel to the interspinosum line, which is
drawn across the cranial vault at its section of greatest width
(Figs19.9A and B).
184
Type
Definition
Origin
Posterior cranial vault point is an SV anatomic cephalometric
landmark/point.
Angulare Point
Type
Angulare point is a bilateral hard tissue SV cephalometric
landmark/point.
Abbreviation
Origin
185
Abbreviation
Abbreviation
Definition
Definition
Origin
Origin
Maxillary apical base midline is an anatomic SV cephalometric
landmark/point.
Type
Type
186
Definition
According to Clifton T Forsberg
A point midway between the roots of the mandibular central
Type
Mandibular apical base midline is a unilateral hard tissue SV
cephalometric landmark/point.
Origin
Mandibular apical base midline is an anatomic SV cephalo
metric landmark/point.
187
Origin
First molar point is an anatomic SV cephalometric landmark/
point.
Abbreviation
FMPFirst molar point is abbreviated as capital letter or
upper case FMP and is written continuously without any space
between the alphabets.
Gonion Point
Abbreviation
Definition
Definition
According to Clifton T Forsberg
Type
188
Type
Origin
Condylion Lateralis
Origin
Gonion point is an anatomic SV cephalometric landmark/
point.
Condylion Medialis
Abbreviation
Abbreviation
CLCondylion lateralis is abbreviated as capital letter or
upper case CL and is written continuously without any space
between the alphabets.
Or
CoLCondylion lateralis is abbreviated as capital letter or
upper case C, small letter o followed by capital letter L
and is written continuously without any space between the
alphabets.
Definition
According to Clifton T Forsberg
The tangent point to each lateral condylar border of a line
drawn parallel to each mandibular body line (Figs 19.17A
and B).
Definition
According to Clifton T Forsberg
The tangent point to each medial condylar border of a line
drawn parallel to each mandibular body line (Figs 19.16A
and B).
Type
Condylion lateralis is a bilateral hard tissue SV cephalometric
landmark/point.
Type
Origin
189
Condylion Anterioris
Abbreviation
CACondylion anterioris is abbreviated as capital letter or
upper case C and A, and is written continuously without any
space between the alphabets.
Definition
According to Clifton T Forsberg
A point on the anterior of each condylar head which is chosen
to represent the mandibular fossa of the temporal bone
(Figs19.18A and B).
190
Type
Definition
Origin
Condylion anterioris is an anatomic SV cephalometric land
mark/point.
Condylion Posterioris
Abbreviation
CPCondylion posterioris is abbreviated as capital letter or
upper case C, P and are written continuously without any
space between the alphabets.
Type
Condylion posterioris is a bilateral hard tissue SV cephalo
metric landmark/point.
Origin
Condylion posterioris is an anatomic SV cephalometric land
mark/point.
SECTION
11
Applications of Cephalometric
Landmarks
CHAPTER
20
Applications of
Cephalometric Landmarks
194
195
196
Figures 20.4A and B: Farkas and coworkers soft tissue cephalometric analysis
197
198
Figures 20.7A and B: Legan and Burstone soft tissue cephalometric analysis
199
200
Angle RAngle formed by the occlusal plane and the ramal plane.
Angle iAngle formed by the occlusal plane and the axis of 1.
Angle rflAngle formed by the occlusal plane and the axis
of 6.
(Bergen)
201
202
203
204
205
206
207
208
209
Index
Page numbers followed by f refer to figure
a
Alar crease junction 128, 131
on graphic illustration 132f
on lateral cephalogram 132f
Angle of convexity 197
Angulare point 184, 184f
Antegonial tubercles 175, 176f
Antegonion 176f
Anterior
nasal spine 10, 59, 123, 155f, 174, 194, 196,
200, 202, 204, 208, 209
on graphic illustration 60f
on lateral cephalogram 60f
pharyngeal wall 123
point of occlusion 10, 76, 77f, 208, 209
for occlusal plane 203, 205
Applications of cephalometric landmarks 191, 193,
Articulare 93, 95f, 174, 175f, 193
Articulation of
ethmoid bone 21
frontal bone 15, 26
temporal bone 31
b
Basion 154f, 179f
on graphic illustration 47f
on lateral cephalogram 47f
Basis cephalometric analysis 207, 207f
Bjork cephalometric analysis 193, 193f
Boltons point 10, 48, 196
on graphic illustration 50f
on lateral cephalogram 49f
c
Cagliari cephalometric analysis 207, 207f
Center of sella turcica 196, 204, 208, 209
Cephalometric
analysis 3
X-ray tracing techniques 4
Cephalostat 4
Cervical
bones 10, 99
point 198
vertebra 103, 104f, 118
vertebral maturation 119f
Cheilion 151
Chieti cephalometric analysis 208, 208f
Clinoidale 38
on graphic illustration 38f
on lateral cephalogram 38f
Coben craniofacial and dentition
analysis 194f
cephalometric analysis 194
Columella point 198
d
Deciduous dentition stage 70
Dentition 71
Di Paolos quadrilateral cephalometric analysis
200, 200f
Dorsum of sella 10, 36
on graphic illustration 36f
on lateral cephalogram 36f
Downs cephalometric analysis 195, 195f
e
Eruption chronology of primary teeth 70
Ethmoid bone 10, 15, 21, 21f, 22f, 26
Ethmoidale 24, 25f
on lateral cephalogram 25f
on graphic illustration 25f
Exocanthion 151, 152
f
Facial bone and dentition 10, 57
Farkas and coworkers soft tissue cephalometric
analysis 196, 196f
First molar point 187, 187f
Fissure 123
Floor of
nose 160
sella 10, 37
on graphic illustration 37f
on lateral cephalogram 37f
Foramina
spinosa points 180, 180f
spinosum 180, 181f
Frontal
bone 10, 26, 15, 15f
on lateral cephalogram 15f
cephalogram 3, 3f
Frontomaxillary
nasal suture 10
on graphic illustration 28f
on lateral cephalogram 28f
suture on
graphic illustration 19f
lateral cephalogram 19f
Frontozygomatic suture 10
g
Glabella 198
Gnathion 89, 90f, 193, 196, 197, 201, 202, 204
Gonion 93, 94f, 150, 150f, 202
point 187, 187f
h
Harvold cephalometric analysis 196, 197f
Hassel and Farman developed method of skeletal
maturation 119f
Hasund cephalometric analysis 200, 200f
Holdaway cephalometric analysis 197, 197f
Hyoid 101, 102f
bone 101, 101f
i
Incision
inferius 194, 201, 202, 203, 204, 205
apicalis 10, 75, 76f, 170, 170f
frontale 171, 171f
incisalis 10, 74, 74f, 169, 170f
superius 194, 201, 202, 203, 205
apicalis 10, 73, 73f, 166, 167f
incisalis 10, 71, 72f, 165, 166f
Infradentale 86, 194
j
Jarabak cephalometric analysis 201, 201f
Jugal process 164, 164f
l
Labrale
inferius 11, 136, 146, 147f, 198
on graphic illustration 137f
on lateral cephalogram 137f
superius 11, 134, 146, 146f, 198
on graphic illustration 134f
on lateral cephalogram 134f
Lacrimal bone 15
Laryngopharynx 123
Lateral cephalogram 3, 3f
Legan and Burstone soft tissue cephalometric
analysis 198, 198f
Lower
face height 197
lip 11
pharynx 124
m
Magnified image of anterior nasal spine on
graphic 60f
Malare 175f
212
Mandibular
apical base midline 186, 186f
central incisor 10, 80, 81f, 195, 202, 203
dental midline 185, 186f
first molar 10, 81, 82f, 171, 171f, 195
length 197
molar 173, 173f
Mastiodale on lateral cephalogram 34f
Mastoid processes 160
Maxilla 26, 59
Maxillary
apical base midline 185, 185f
bone 15, 59f
central incisor 10, 79, 79f, 195, 202, 203
first molar 10, 79, 80f, 168, 168f, 195
molar 167, 168f
McGann cephalometric analysis 209, 209f
Medio-orbitale on lateral cephalogram 23f
Mentolabial sulcus 198
Menton 92, 92f, 173, 174f
Middle cranial fossa points 182, 183f
Mixed dentition stage 70
Nasal
bone 10, 15, 26, 26f, 26f
crown 128, 129
on graphic illustration 129f
on lateral cephalogram 129f, 129f
process 15
Nasion 16, 26, 194-196, 197, 200
on graphic illustration 16f, 27f
on lateral cephalogram 16f, 27f
Nasopharynx 123
Neck of crista galli 10, 23
on frontal cephalogram 23f
Nerve supply to mandible 85
Occipital
bone 10, 46, 46f
condyles 160
Occlusomandibular angle 199
Occlusopalatal angle 199
Odontoid 181, 181f
Opisthion 48, 179, 180f
on graphic illustration 49f
on lateral cephalogram 48f
Orbital plates 15
Orbitale 52, 67, 148, 148f, 194-196
on graphic illustration 53f, 68f
on lateral cephalogram 53f, 68f
Oropharynx 123
p
Palatocranial angle 199
Palatomandibular angle 199
Parital bone 15
Parts of
ethmoid bone 21
frontal bone 15
hyoid bone 101
mandible 85
Permanent dentition stage 71
Pharynx 123
Philtrum 135f
Planed incisor position 136
Planum sphenoidale 160
Pogonion 88, 196, 197, 200, 201, 204
Point
A on
graphic illustration 61f
lateral cephalogram 61f
on oral side of soft palate 123, 124
on pharyngeal side of soft palate 123, 124
T on
graphic illustration 131
lateral cephalogram 131f
Porion 32, 194-196
on lateral cephalogram 33f
Posterior
cranial vault points 183, 184f
nasal spine 10, 64, 123, 208, 209
on graphic illustration 64f
on lateral cephalogram 64f
pharyngeal wall 123, 124
point of occlusion 10, 77, 78f, 208, 209
Vomer point 182, 183f
Prognathion 197
Pronasale 129, 144, 144f
on graphic illustration 130f
on lateral cephalogram 130f
Prosthion 62, 194
on graphic illustration 63f
on lateral cephalogram 63f
Pterygoid point 10, 40
on graphic illustration 40f
on lateral cephalogram 40f
Pterygomaxillary fissure 10, 44, 65, 123, 182,
182f, 195, 200
on graphic illustration 45, 66f
on lateral cephalogram 45f, 66f
r
Rhinion 29
on graphic illustration 29f
on lateral cephalogram 29f
Ricketts cephalometric analysis 198, 199f
Riedel cephalometric analysis 202
Roof of
orbit on
graphic illustration 19f
lateral cephalogram 19f
orbital cavity 17
s
Sassouni cephalometric analysis 199, 199f
Schwartz cephalometric analysis 203, 203f
Sella 10, 41, 152, 195
entrance 41, 153, 153f
on graphic illustration 43f
on lateral cephalogram 43f
on graphic illustration 42f
on lateral cephalogram 42f
Shapes of cervical vertebral bodies 119f
Soft tissue
cephalometric landmarks 11, 125, 127, 128,
133, 138
glabella 127
on graphic illustration 127f
on lateral cephalogram 129f
t
Temporal bone 10, 15, 31, 31f
Temporale on
graphic illustration 22f, 54f
lateral cephalogram 22, 54f
Temporomandibular joint 196
Tip of uvula 123, 124
Top of nasal septum 161, 161f
Tracing
basion on lateral cephalogram 47
Boltons point on lateral cephalogram 50
neck of crista galli on lateral cephalogram 23
of anterior
nasal spine on lateral cephalogram 60, 155
point of occlusion on lateral cephalogram
76
of articulare on lateral cephalogram 94, 174
213
u
Upper
and lower lips 11
lip 11
pharynx 124
point of tongue 123, 124
Uses of cephalometric analysis 3
v
Vermillion 135, 135f
border of upper lips 11
Vertex 143, 143f
w
Wits cephalometric analysis 206
Wylie cephalometric analysis 203, 204f
z
Zygion 149, 149f, 163, 163f
Zygoma 162, 162f
Zygomatic
arch 10, 32, 163, 163f
bone 10, 15, 52, 52f
process 15
prominence 149, 149f
suture point 164, 164f
Index