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ORTHODONTIC
DIAGNOSIS
DIAGNOSTIC
TOOLS
DIAGNOSTIC TOOLS
OF AN
ORTHODONTIST
CEPHALOMETRI
CS
LEARNING OBJECTIVES
• To be able to recognize the diagnostic tools of an orthodontist
• To know the components of an orthodontic diagnosis and the
radiographs used in diagnosis
• To be able to know Cephalometrics and cephalograms
• To recognize and apply the uses of Cephalometry
• To understand how to take a cephalogram
• To understand the history of Cephalometrics
• To be able to identify and define hard tissue landmarks
• To be able to identify and define soft tissue landmarks
• To know the different planes used in orthodontic diagnosis
ORTHODONTIC
DIAGNOSIS
CLINICAL EXAMINATION
 Extra-oral
Intra-oral
RADIOGRAPHS
 Lateral Cephalograms
 OPG
 PA Cephalograms
DENTAL CASTS
 RADIOGRAPHS

• LATERAL CEPHALOGRAMS
• OPG
• PA CEPHALOGRAMS
Cephalometric Study in
Orthodontics
CEPHALOMETRY

CEPH HEAD
METRY MEASUREMENT

The study of measuring the head on a

radiograph is known as cephalometrics.
Studying the skeletal bases, dentition and the
soft tissue .
 • Lateral Cephalogram
TYPES OF • Oblique Cephalogram
CEPHALOGRAM • PA Cephalogram
 LATERAL
CEPHALOGRAM:
These are most frequently used in
evaluating the relationship of the

 Dentition
 Osseous skeleton
 Soft tissues
 OBLIQUE CEPHALOGRAM:
•Gives projection of one
side of the face
•Is useful in the analysis of
the developing dentition
• It combines most of the
advantages of the
• lateral jaw view,
• intra oral PA survey,
• OPG.
PA CEPHALOGRAM

•To assess asymmetry

• Comparison of the left
and right side of the face
 LATERAL
CEPHALOGRAM
• HISTORY
•WHY CEPHALOMETRY
•RADIOGRAPHIC ANATOMY
•CEPHALOMETRIC LINES
•CEPHALOMETRIC ANALYSIS
HISTORICAL
BACKGROUND
Craniometry:
based on
measurements of
skulls found
among human
skeletal remains.
• The history of
cephalometric
analysis stems from
Egyptian and Greek
attempts at human body
measurement
(anthropometrics)
HISTORICAL
BACKGROUND
The introduction
of radiographic
cephalometrics in
1934 by Hofrath
(Germany) and
Broadbent (USA)
Cephalogram can be traced through art, science, and
anthropology
HISTORICAL
BACKGROUND
More than 50 different cephalometric analyses
designed to evaluate dentofacial relationships
have been reported in the literature.
Tweed (1946)
Downs (1948)
Steiner (1953)
Sassouni (1955)
Holdaway (1956)
Harvold & Wits
HISTORICAL
BACKGROUND
Ricketts (1960)
Nanda & Sassouni (1965) selected four most
popular analyses and combined them together.
McNamara (1983)
WHY DO WE NEED LATERAL
CEPHALOGRAM?
To study morphology and growth.

To diagnose malocclusion and craniofacial

dysplasia.

To plan orthodontic treatment.

Assess treatment progress and prognosis,

and quality of work.
TAKING THE LATERAL
CEPHALOGRAM
TRACING TECHNIQUE
•The facial profile is customarily placed on the
right side of the tracing sheet
•The tracing is made on the frosted surface of
acetate sheet on an illuminator
•Tracing is begun by marking the points
•The sella tercica along with floor of the
anterior cranial fossa and shadows of greater
wings of the sphenoid are traced
•The soft tissue profile is traced
TRACING TECHNIQUE
The anterior surface of frontal and nasal bone.
The maxilla.
Pterygomaxillary fissure.
Maxillary teeth.
Mandible and mandibular teeth.
Orbit and external ocustic meatus.
AMERICAN BOARD OF
ORTHODONTICS SEQUENTIAL
TRACING COLOUR CODE

Pretreatment (Initial) - Black

Progress- Blue
End of treatment – Red
Retention – Green.
ANATOMY
 NORMA LATERALIS
Skeletal & Dental Points (Landmarks)
1. Sella (Fossa hypophysialis) (S)
2
2. Nasion (Sutura frontonasalis)
1
(N)
3. Porus acustucus externus 3
5 4
4. Orbitale (Or)
6 9
5. Pterygopalatine fossa (Pt)
7 8 10
6. Articulare (Ar) 13 11
12
7. Basion (Ba) 15
14
20
8. Spina nasalis posterior (PNS) 16
17
9. Spina nasalis anterior (ANS)
18
19
10. A point (A)
 NORMA LATERALIS
Skeletal & Dental Points (Landmarks)

112.Max. incisor Incisal Edge

(U1) 2
1
13.Max. First Molar (U6)
3
14.İnfradentale (id) 5 4

15. Mandibular incisor 6 9

incisal edge (L1) 7 8 10
11
16.B point (B) 13 12
15
14
17. Pogonion (Pog) 20
16
18.Gnation (Gn) 17
18
19.Menton (Me) 19

20.Gonion (Go)
 NORMA LATERALIS
Soft Tissue Points
21.Glabella (g) 21
2
22.Nasion (n) 1
22

23.Pronasale (prn) 3
5 4
24.Subnasale (sn) 23
6 9
25.Labrale superior (ls) 7 8 10 24

13 11 25
26.Stomion (sto) 12
15 26
14 27
27.Labrale İnferius (li) 20
16
17
28.Gnathion (gn) 18 28
19
 HORIZONTAL LINES

1. S-N
 HORIZONTAL LINES

1. S-N

2. FRANKFORT HOR.
 HORIZONTAL LINES

1. S-N

2. FRANKFORT HOR.

3.ANS-PNS
 HORIZONTAL LINES

1. S-N

2. FRANKFORT HOR.

3.ANS-PNS

4.OCCLUSAL PLANE
 HORIZONTAL LINES

1. S-N

2. FRANKFORT HOR.

3.ANS-PNS

4.OCCLUSAL PLANE

5. MANDIBULAR PLANE
(Go-Gn)
 HORIZONTAL LINES

1. S-N

2. FRANKFORT HOR.

3.ANS-PNS

4.OCCLUSAL PLANE

5. MANDIBULAR
PLANE (Go-Gn)
 VERTICAL LINES

1. N-A
 VERTICAL LINES

1. N-A

2.N-B
 VERTICAL LINES

1. N-A

2.N-B

3. N-Pg
 VERTICAL LINES

1. N-A

2.N-B

3. N-Pg

4. S-Ar
 VERTICAL LINES

1. N-A

2.N-B

3. N-Pg

4. S-Ar

5. Ar-Go
 VERTICAL LINES

1. N-A

2.N-B

3. N-Pg

4. S-Ar

5. Ar-Go

6. Y axis
 SKELETAL Sagittal
EVALUATION Vertical