CEPHALOMETRY
DR. ZUBER AHAMED NAQVI
OBJECTIVES
Steiner’s analysis- skeletal
dental
Soft tissue
Tweed analysis
Wits appraisal
STEINER’S ANALYSIS
He proposed the appraisal of
various parts of skull separatelySkeletal
Dental and
Soft tissues
Skeletal analysis relates upper and lower jaws to the skull
and to each other.
Dental analysis relates the upper and lower incisor teeth
to their respective jaws and to each other.
Soft tissue analysis assess the balance and harmony of
the lower facial face.
STEINER’S ANALYSIS
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•
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•
•
Skeletal analysis
SNA Angle- SN plane and a line
joining N to A.
Average value-82 0
Increased –protrusive maxilla.
Decreased – recessive maxilla
• SNB angle- SN plane and a line
joining N to B.
• Average value-80 0
• Increased –protrusive mandible.
• Decreased – recessive mandible
• ANB angle- angle between lines
joining nasion to point A and
nasion to point B.
• Average value- 2 0
• Increased –skeletal class II
malocclusion.
• Decreased – skeletal class III
malocclusion
• Mandibular plane angle- SN
plane and mandibular plane
• ( Go-Gn)
• Average value- 32 0
• Increased –vertical growth
pattern.
• Decreased –horizontal growth
pattern
• Occlusal plane angle- between occlusal plane and
SN plane
• Average value- 14 0
STEINER’S DENTAL ANALYSIS
• Upper incisor to NA ( angle)long axis of upper incisor
and a line joining nasion to
point A.
• Average value- 22 0
• Increased –proclined upper
incisors.
• Decreased – retroclined
upper incisors.
• Upper incisor to NA ( linear)linear measurement between
labial surface of upper incisor
and line joining nasion to
point A.
• Average value- 4 mm
• Increased –proclined upper
incisors.
• Decreased – retroclined
upper incisors.
• lower incisor to NB(
angle)- long axis of lower
incisor and a line joining
nasion to point B.
• Average value- 25 0
• Increased –proclined
Lower incisors.
• Decreased – retroclined
lower incisors.
• Lower incisor to NB ( linear)linear measurement
between labial surface of
lower incisor and line joining
nasion to point B.
• Average value- 4 mm
• Increased –proclined lower
incisors.
• Decreased – retroclined
lower incisors.
• Interincisor angle- long axis of
upper and lower central
incisors.
• Average value- 130-1310
• Increased –angle’s class II
division 1malocclusion.
• Decreased –angle’s class II
division 2 malocclusion.
SOFT TISSUE ANALYSIS
• Lip in a well
balanced face
should touch a line
extending from soft
tissue contour of the
chin to the middle of
an “s” formed by the
lower border of the
nose.
TWEED ANALYSIS
• Three planes that makes a
diagnostic triangle.
I.
Frankfort horizontal plane
II.
Mandibular plane
III. Long axis of lower incisor
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•
•
•
Frankfort mandibular plane angleMean value-250
Incisor mandibular plane angle
Mean value-900
• Frankfort mandibular incisor angle• Mean value-650
WITS APPRAISAL
The purpose of Wits
appraisal is to identify
instances in which the
ANB reading does not
accurately reflect the
extent of anteroposterior
jaw dysplasia.
Shortcomings of ANBThe anteroposterior
spatial relationship of the
jaws relative to the
cranium.e.g. prognathus
face- ANB increases.
Retrusive jaws- ANB
reduced.
WITS APPRAISAL
• Rotational effect of
• jaws relative to cranial
• base on ANB-
• Clockwise rotation- ANB increases.
• Anticlockwise rotation- ANB decreases.
WITS APPRAISAL
• When ANB angle is not
reliable.
• Functional occlusal lane
• AO
• BO
• Distance between AO AND
BO
• In males pint BO ahead of
AO by 1mm.
• In females AO and BO
coincides.
DIGITAL CEPHALOMETRY
• Software's for cephalometry.
REFERENCES
• Radiographic cephalometry: from basics to video
imaging. Alexander Jacobson.
• Contemporary orthodontics. 5th edition. William R
Proffit
• Orthodontics : the art and science. 4th edition. S I
Bhalaji