SEFALOMETRI

Indah Nur Evi,drg.,Sp.Ort

HISTORY

• Cephalometrics introduced for use by orthodontists

in 1931 by Dr. Broadbent in the USA and Hofrath in
Germany independently of one another.
LATERRAL VIEW OF THE SKULL
Cephalometric Analysis

 • Downs (1948)
 • Steiner (1953)
 • Rickets (1960)
 • Tweed(1966)
 • Wits(1975)
 • McNamara(1988)
Definition
 Cephalo: head
 Metric: measurments
 Cephalometry: is the analysis and the interpretation
of standardized radiographs of the facial bones.
 It is a standardized and reproducible form of skull
radiography used extensively in orthodontics to
asses the relationships of the teeth to the jaws, and
the jaws to the rest of the facial skeleton.
The cephalostat
 Head position: the patient’s head is oriented in the
same position relative to the x-ray beam every time
a film is taken, with the use of a cephalostat.
 Ear rods: in the ear canals (external auditory
meatus).
 Frankfort plane: horizontal.
 Teeth: in centric occlusion.
 Lips: in their habitual position.
Fungsi sefalometri
 Mempelajari pertumbuhan dari cranio facial
 Melakukan diagnosa/analisa kelainan cranio facial
 Mempelajari tipe facial
 Merencanakan suatu perawatan ortodonti
 Evaluasi kasus-kasus yang telah dirawat (progress
reports)
 Analisa fungsional
 Melakukan riset/penelitian
Indications for cephalometric evaluation

 Assess facial and dentoskeletal relationships.

 To study growth and growth patterns
 Evaluation of post treatment changes.
 Research purposes and long term follow-up studies.
Cephalometric Tracing
 The cranial base.
 The facial skeleton.
 Soft tissues.
Titik-titik Sefalometri
 S(sella) = terletak di tengah sela tursika/ titik tengah
dr “hypophysial fossa,ditentukan scr visual
(diperkirakan).
 N(nasion)= terletak pada perpotongan bidang sagital
dengan sutura frontonasalis.
 A(subspinale)= titik paling dalam pada kurvatura
alveolaris rahang atas, scr teoritis mrp batas antara
tulang basal maksila dan tlg alveolaris.
 B(supramentale)= titik paling dalam pada kurvatura
alveolaris rahang bawah, scr teori mrp batas tulang
basal mandibula dan tulang alveolaris
 Go(gonion)= titik tengah pada lengkungan
mandibula diantara ramus dan korpus.
 Me(menton)= titik terendah pada dagu.
Cephalometric landmarks
Landmarks

Sella Turcica (S)

The midpoint of the
sella turcica
Orbitale(Or)
The most inferior
anterior point on the
margin of the orbit
Landmarks

Nasion (N)

The most anterior point

of the frontonasal
suture
Landmarks

Anterior Nasal Spine

(ANS)
The tip of the anterior nasal
spine

Posterior Nasal Spine

(PNS)
The tip of the
posterior nasal spine
Landmarks

A point
The most posterior point
on the profile of the
maxilla between the
anterior nasal spine and the
alveolar crest

• B point
The most posterior point on the
profile of the mandible between
the chin point and the alveolar
crest
Landmarks

Pogonion (Pog)
The most anterior point
on the bony chin

Menton (Me)
The lowermost point of
the mandibular symphysis
in the midline
Landmarks

Gnathion (Gn)
The most inferior point on
the mandibular symphysis
in the midline

Gonion (Go)
The most posterior inferior
point on the angle of the
mandible
Landmarks

Porion (Po): superior

point of external
auditory meatus

Machine Porion:
landmark created by ear
post of cephalostat
 Cephalometric lines of reference

REFERENCE LINES

• Frankfort’s Horizontal
(porion to orbitale)
• Sella--‐Nasion line
• Maxillary plane
• Oklusal plane
• Mandibular plane
Frankfort Horizontal Plane
Sella-Nasion Plane (SN)
Maxillary line:

ANS-PNS
Mandibular plane:

Me - Go
Occlusal plane:

Cusp tips of
molars – tip of
lower incisor
ANALYSIS CEPHALOMETRIC
measurement
Skeletal
• the Cranial base;
• the maxilla; the mandible,

Dental
• the maxillary and mandibular dento alveolus

Soft Tissue
•Comparing individual subject’s tracing to
the“ideal”/normal
 skeletal relationships (ant-post)

Angle SNA (82 ± 3)

Prognathism of
maxillary apical
base
 skeletal relationships (ant-post)

Angle SNB (79 ± 3)

Mandibular
prognathism
skeletal relationships (ant-post)

Angle ANB (3 ± 1)
The anteroposterior
apical base
relationship (skeletal
pattern)
variabel yg srg digunakan
 <SNA = menyatakan letak maksila terhadap
kranium. Normal = 82°-84°
 <SNB = menyatakan letak mandibula terhadap
kranium. Normal = 80° - 81°
 <ANB = menyatakan hubungan maksila terhadap
mandibula. Normal = 2°(kelas 1), kelas II = 4°,
kelas III = ANB negatif.
Dentoskeletal relationships
 DENTAL-MAXILLARY INCISOR
U1 TO FH 110 ± 5
deg
U1 TO NA 22deg
U1 TO NA 4mm
 DENTAL-MANDIBULAR ANTERIOR
L1 TO NB 25deg
L1 TO NB 4mm
L1 TO GOGN 91
± 6deg
 DENTAL-UPPER TO LOWER
INCISOR
INTERINCISAL
130 ± 5 deg
Sudut inklinasi insisivus yg normal
 Insisivus-SN = 103° - 117°
 Insisivus-garis maksila = 108° - 111°
 Insisivus-garis mandibula = 90° - 96°
 Catatan = bila sudut inklinasi insisivus-garis maksila
besar, maka?
 Bila sudut inklinasi insisivus-garis mandibula besar,
maka?
Soft Tissue
 SOFT TISSUE ANALYSIS
NASOLABIAL
ANGLE 102 ± 8
deg
L.LIP TO E
PLANE -2
±2mm
Steiner Lip Analysis
Ricketts Lip Analysis
 Daftar pustaka
 Diagnosis Ortodontik, Pambudi rahardjo, AUP,
2008.
 Penggunaan Chephalometri Radiografi dalam
bidang Ortodonti, Hendro Kusnoto, FKG Usakti.
 Three Dimensional Chephalometri, Richard
Jacobson.
 Materi Kuliah Sefalometri, Arya Brahmanta
drg.,Sp.Ort.
 The Atlas and Manual of Chephalometric
Radiography, Thomas Rakosi