ORTHODONTICS 2

RESEARCH ACTIVITY PART 3 OF 3

Dr. Aileen Carlos

Paragua, Gem Hanna C.

DEN196
March 13, 2022
1. When was Ceph Xrays used
in Dentistry? And by who?
Radiographic Cephalometry was
invented by Hofrath of Germany and
Broadbent of the United States in
1931.

They simultaneously published

methods to obtain standardized
head radiographs in the angle
orthodontist and in Fortscritte
der Orthodontie, respectively.
 2) Differentiate Lateral Cephalometric Radiograph from PA Ceph
with regards to patient positioning and indications for use.
Lateral Ceph Patient Positioning PA Ceph
▪ Most common in dentistry ▪ 2nd most common in dentistry
▪ image receptor parallel to sagittal plane ▪ X-ray tube behind the patient’s head,
▪ Patient orientation: Head in “natural Image receptor in coronal plane
position”, Frankfort plane horizontal, ▪ Patient orientation: natural head
mouth closed, centric occlusion, lips position, Franfort plane perpendicular to
relaxed image receptor
 2) Differentiate Lateral Cephalometric Radiograph from PA Ceph
with regards to patient positioning and indications for use.
Indications
Lateral Ceph PA Ceph
✓ Evaluation of craniofacial ✓ Presence of facial asymmetries
morphology and growth ✓ Crossbites
✓ Orthodontic diagnosis (skeletal ✓ Orthognathic surgery
and dental relationships) ✓ Others: Cranial vault fractures,
✓ Orthodontic Treatment Planning investigation of frontal sinuses,
✓ Treatment progress lesions in posterior third of
body/rami, conditions affecting
cranium (Paget’s, Mult Myeloma,
Hyperparathyroidism)
 3) Describe the proper positioning in taking a Lateral Cephalometric
Radiograph. (Include distance measurements and correct head position requirement)

✓ Distance between X-Ray Source and Midsagittal plane of patient: 5ft

✓ Object-film distance: 15cm
✓ Film size: 8x10 inches
✓ Patient: Positioned with ear rods in external acoustic meatus, made to bite at Maximum
Intercuspation, Lips at rest, Frankfort plane parallel to floor, Midsagittal plane vertical and
parallel to film
 4) Describe the different ypes of Cephalometric Points.
(ie. Anatomic and Constructed)

Cephalometric Landmarks

Based on location Based on type

Soft Tissue Hard Tissue Anatomical Constructed

Bilateral Midsagittal
 Cephalometric Landmarks
Anatomical Landmarks Represent actual anatomic structures of the skull

Constructed Landmarks Obtained secondarily from anatomic landmarks/structures

Soft Tissue Landmarks Landmarks situated on the skin

Hard Tissue Landmarks Situated on the bone (also referred as “osseous”, “bony”)

Bilateral Landmarks Structures that can be found on both right and left sides

Structures that are situated in the midsagittal area of the

Midsagittal Landmarks skull
5) Define each of the ff points:
Na, Or, ANS, point A, point B, Pog, Gn, Me, Go, Ar, Ba, Po, S, PNS
 Landmark: Na

Most anterior point midway

between the frontal and
nasal bones on the fronto-
nasal suture
 Landmark: Or / Orbitale

Most inferior point

of each infraorbital
rim
Landmark: ANS / Anterior Nasal Spine

Most anterior
midpoint of the
anterior nasal spine
of the maxilla
 Landmark: Point A

Point of maximum
concavity in the
midline of the
alveolar process of
the maxilla
 Landmark: Point B

Point of maximum
concavity in the
midline of the
alveolar process of
the mandible
 Landmark: Pog / Pogonion

Most anterior
midpoint of the chin
on the outline of the
mandibular
symphysis
 Landmark: Gn / Gnathion

Most anterior and

inferior point on
the contour of the
mandibular
symphysis
 Landmark: Me / Menton

Most inferior
midpoint of the chin
on the outline of the
mandibular
symphysis
 Landmark: Go / Gonion
Point at each mandibular angle
that is defined by dropping a
perpendicular from the
intersection point of the tangent
lines to the posterior margin of
the mandibular vertical ramus
and inferior margin of the
mandibular body or horizontal
ramus
 Landmark: Ar / Articulare

Intersection of the posterior

border of the vertical mandibular
ramus and the outer margin of
the cranial base
 Landmark: Ba / Basion

Most anterior point of the great

foramen (foramen magnum)
 Landmark: Po / Porion

Most superior point of each

external acoustic meatus
 Landmark: S / Sella

Midpoint of the entrance of the

sella turcica
Landmark: PNS / Posterior Nasal Spine

Most posterior midpoint of the

posterior nasal spine of the
palatine bone.