COGS N Bjork Analysis

COGS
&
BJORK ANALYSIS
CONTENTS
 Introduction
 Bjork analysis
 COGS hard and soft tissue analysis
 Conclusion
Dr. Karamdeep Singh 2
INTRODUCTION
 Both analysis are very important from diagnostic point of view.
 Bjork analysis as name indicates given by Arne Bjork in 1947 and 1951.
 COGS analysis is a result of a joint work done by an Orthodontist

(Burstone) and an Oral Surgeon (Legan ).

BJORK ANALYSIS

BJORK ANALYSIS
 Arne Bjork gave Bjork analysis in 1947 and 1951.
 He investigated effects of variations in jaw growth on prognathism and

relationship between facial form and occlusion.
 He devised facial diagram in which linear and angular configurations

determine amount and distribution of facial prognathism.

BJORK ANALYSIS
 Sample:-
322 Swedish boys (12 year old) and 281 Swedish conscripts (21-23
years old) were selected.

LANDMARKS USED IN ANALYSIS
 Nasion (N)  Gonial angle (KK)
 Sella (S)  Infra-dentale (Ir)
 Articularis (Ar)  Apex of ANS(SP)
 Gnathion (Gn)  DD
 Prosthion (Pr)

 DD is also called as chin angle, point of intersection between a line

tangent to base of mandible and a line tangent to ID.

S. Measurements Landmarks Boys Boys Adults Adults
no mean SD mean SD
1 Upper jaw: basal prog. S-Na-ANS 85.77 3.85 88.16 4.18
2 Upper jaw: alveolar prog. S-Na-Pr 83.68 3.67 84.83 4.13
3 Lower jaw: alveolar prog. S-Na-Id 80.01 3.56 82.25 4.37
4 Lower jaw: basal prog. S-Na-Pog 78.92 3.63 81.69 4.43
5 Upper 1 axis-occ. plane Upper 1-occ. 58 4.97 64 6.62
6 Lower 1 axis-occ. plane Lower 1-occ. 70.45 6.24 73.59 7.89
7 Saddle angle Na-S-Ar 122.90 4.85 123.06 5.33
8 Joint angle S-Ar-Go 142.96 6.21 143.27 6.91
9 Jaw angle (gonial angle) Ar Go-Mp 131.09 6.11 130.85 7.31
10 Chin angle Id Pog-Mp 68.58 5.4 64.24 6.43

11 Cranial base length Ar-Na 91.84 3.92 98.09 4.42
12 Cranial base: horizontal part Na-S 68.75 2.97 73.22 3.26
13 Cranial base: vertical part Ar-S 34.35 2.85 37.02 3.32

9
14 Ramus height Ar-Go
Dr. Karamdeep Singh
42.13 3.6 53.23 5.15
S.no. Measurements landmarks Boys Boys Adults Adults
mean SD mean SD
15 Corpus length Go-Pg 72.84 4.12 80.66 5.16
16 Facial height 113.12 5.42 128.28 6.66
17 Upper jaw length ANS-PNS 51.69 2.83 56.82 3.16
18 Ratio upper/lower jaw ANS-PNS/Go-Pg ------ ----- ------ ------
19 Occ plane inclination Na-Ar to occ. 37.64 3.89 34.82 4.44
20 Upper 6 angle Ar-Na-upper 6 43.88 2.87 47.81 2.93
21 Lower 6 angle Ar-Na- lower 6 45.29 2.8 49.51 3.58
22 Upper dental arch length Is-upper 6 29.66 2.82 28.02 2.94
23 Lower dental arch length Ii-lower 6 24.27 2.29 22.72 2.43
24 Diff in alv. Prog. Pr-Na-Id ------ ----- 2.6 2.3

25 Diff in basal prog. ANS-Na-Pog ------ ----- 6.5 4
26 Max prog. SNA 81.3 3.3 82 3.6
27 Mandibular prog. SNB 77.8 3.3 79.3 3.7
28 Diff in max-mand. ANB 3.4 2.3 2.7 2.6
29 A-B – occ. Plane Inf.post. Angle 92.6 4.5 91.5 4.6
30 Overjet Is-io 4.1 2.2 3.4 2.3
31 Overbite Dr. Karamdeep Singh Ii-io 2.6 1.8 2.1
10 1.9
BJORK’S FACIAL DIAGRAM
 Bjork’s facial diagram include :-

› Line from apex of ANS (SP) to N
› To Center of sella (S) to articulare (Ar)
› To gonial angle (KK)
› To chin angle (DD)
› To pogonion (Pg)
› And end up at infra dentale (ID)
Changes in any angle or line of facial diagram produces effects of

facial prognathism.

BJORK’S FACIAL DIAGRAM

BJORK ANALYSIS
 Shape of skull is determined by shape of cranium, cranial base and facial

skeleton.
 Angle formed between line at nasion is measured to 4 points on facial

profile:-
› ANS
› PR
› ID
› Pg

BJORK ANALYSIS
 Position of head is denoted by angle formed by a line bisecting another

line through anterior and posterior margins of foramen magnum to cranial
base plane through SN.

BJORK ANALYSIS

INTERPRETATION OF BJORK
ANALYSIS
ES
ES
CHANG
CHANG
AR
LINEAR
ANGUL

ANGULAR CHANGES IN BJORK
ANALYSIS
 Reduction of angle at sella :- forward displacement of jaws with increase
in prognathism of facial profile.

ANALYSIS
 Reduction of angle at articulare:- increases degree of prognathism and
shortens height of upper part of face.

ANALYSIS
 Reduction of gonial angle:-reduces mandibular and facial prognathism.

ANALYSIS
 Reduction of chin angle:-reduces mandibular prognathism.

LINEAR CHANGES IN BJORK
ANALYSIS
 Shortening of S-N line:- increase prognathism

ANALYSIS
 Shortening of S-Ar line:- increases prognathism, shortens height of face

ANALYSIS
 Increase in line from Ar-KK:- increases mandibular prognathism

CONCLUSION
 It is a simple but a comprehensive analysis which measures both skeletal

and dental landmarks.
 There are few unique measurements such as DD angle, shape of cranium,

head.

C.O.G.S ANALYSIS
C.O.G.S. ANALYSIS
Soft tissue Hard tissue

COGS analysis
analysis analysis

C.O.G.S. ANALYSIS
 First step in diagnosis of orthognathic surgical patient is to determine the

nature of dental and skeletal defects.
 Patients who require orthognathic surgery usually have facial bones as

well as tooth positions that must be modified by combined orthodontic
and surgical treatment.

C.O.G.S. ANALYSIS
 For this reason, specialized cephalometric appraisal system based on

cephalometric analysis of Indiana university with addition of clinically
significant measurements.
 COGS describes horizontal and vertical position of facial bones by use of

constant coordinate system.
 Standards are based on sample obtained from child research council of

university of Colorado School of Medicine. Sample consisted of 16
females and 14 males

KEY PLANE USED IN ANALYSIS
 Most of data in analysis is measured using a constructed plane called the

horizontal plane (HP),which is a surrogate Frankfort plane, constructed by
drawing a line 7o from SN plane.
 Most measurements will be done either parallel to HP or perpendicular to

HP.

BUT WHY HP?
 As felt by various authors it is very difficult to locate position of porion and

orbitale on cephalograms, so FH plane usually selected is arbitrary.
 Riedel (1952) quoted that if SN plane is chosen then its use may prove difficult.
Owing to anatomic variations related to inclination of cranial base ,SN corrections
are often required.
 But over years, FH plane has been used in orthodontic cases especially of less
severity but in cases of severe deformities and asymmetries, use of true HP is
indispensable.(Profitt)

HOW TO CONSTRUCT TRUE HP
 Ask patient to be relaxed.
 Either upright or sitting position may be used
 Place chain of small spheres hanging alongside anterior side of chassis
 Place patient on cephalostat
 Ask patient to look in mirror placed 5 meters away
 Ask patient to keep lips relaxed.

HOW TO CONSTRUCT TRUE HP

C.O.G.S. SOFT TISSUE ANALYSIS
 “Used along with the other diagnostic aids, this soft tissue
evaluation will enable the clinician to achieve good facial
esthetics for his or her patients.”- Legan & Burstone
 Soft tissue covering bone and teeth is highly variable in its thickness, and
this variation may be greater than variation found in position of teeth and
bones.

C.O.G.S. SOFT TISSUE ANALYSIS
 Hard tissue measurements can deviate considerably from facial form

patient expresses with soft tissues.
 Burstone in 1978 developed system of soft tissue analysis for planning

treatment for patient requiring orthognathic surgery/ treatment.
 But in 1980 he reduced analysis to relevant measurements and few added

which are particularly significant to surgical patients.

 Glabella (G)  Labrale inferius (Stm-i)
 Columella point (Cm)  Mento-labial sulcus (Si)
 Subnasale (Sn)  Soft tissue pogonion (Pg’)
 Labrale superius (Ls)  Soft tissue gnathion (Gn’)
 Stomion superius (Stm-s)  Soft tissue menton (Me’)
 Horizontal reference plane (HP)  Cervical point (C)

CEPHALOMETRIC LANDMARKS

SNo Variable Landmarks Mean SD
FACIAL FORM
1 Facial convexity angle G-Sn-Pg’ 12 4

2 Maxillary prognathism G-Sn (HP)* 6 3
3 Mandibular prognathism G-Pg’ (HP)* 0 4
4 Vertical height ratio (G-Sn)/ Sn-Me’ (HP) + 1 …..
5 Lower face –throat angle Sn-Gn’-C 1000 70
6 Lower vertical height-depth ratio Sn-Gn’/C-Gn’ 1.2 …..
LIP POSITION AND FORM
1 Naso-labial angle Cm-Sn-Ls 1020 80

2 Upper lip protrusion Ls-(Sn-Pg’) 3 1
3 Lower lip protrusion Li-(Sn-Pg’) 2 1
4 Mentolabial sulcus Si -(Li-Pg’) 4 2
5 Vertical lip-chin ratio Sn-Stm / Stm-Me’(HP) 0.5 ….
6 Maxillary incisor exposure Stm- incisor incisal edge 2 2
7 Inter-labial gap (Stm –s)-(Stm-I) 2 2
Facial form measurements
COGS soft tissue

analysis
Lip position and

form

FACIAL FORM
Facial convexity
(G-Sn-Pg’)
Lower vertical height Max.

depth ratio prognathism
(SN-Gn’/C-Gn’) (G-Sn)
Lower face Mand. Prognathism

throat angle
(G-Pg’)
(SN-Gn’-C)
Vertical height ratio

(G-Sn/SN-Me’)
FACIAL FORM
 Facial contour angle formed by G-Sn-Pg’
 As it becomes smaller or negative profile is class- III skeletal & dental

relation.
 A positive angle shows class-II relation.
 Clockwise angle is positive& counterclockwise negative

FACIAL FORM

FACIAL FORM
 Line perpendicular is dropped from HP is dropped from glabella and

relation of maxilla or mandible is determined.
 Distance to subnasale from this line measured parallel to HP describes

excess or deficiency in AP dimension.
 Negative number suggests max retrusion and positive shows maxillary

protrusion.

FACIAL FORM

FACIAL FORM
 Position of pogonion is measured parallel to HP from perpendicular
dropped from glabella.
 It gives indication of mand retrognathism or prognathism.
 More negative value, more mand retrusion.
 If Pg’ is positioned posteriorly, then it could be because of small hard

tissue chin, small mandible, average sized mandible positioned
posteriorly, thin soft tissue chin or combinations of these.

FACIAL FORM
 Lower face throat angle is formed by lines Sn-Gn’ and Gn’-C.
 Throat angle is helpful in planning treatment to correct AP dysplasias.
 Obtuse angle warns surgeon not to reduce prominence of chin, so as also

suggested by Worms, class III patients of such type shouldn’t have
mandibular set back, rather max advancement, mand sub apical surgical
procedure should be done.

FACIAL FORM

FACIAL FORM
 Lower face vertical height/depth ratio is useful in determining feasibility

of reducing or increasing prominence of chin.
 This ratio is little larger than 1 ,if too large then patient has relatively short
neck, and anterior projection of chin shouldn't be reduced.
 Ratio of middle third and lower third face height is measured

perpendicular to HP. Ratio of G-Sn is 1,so ratio value less than 1 shows
larger lower third of face.

LIP POSITION & FORM
 Naso labial angle is important angle for evaluating AP maxillary

dysplasia.
 Acute naso-labial angle allows for surgically retracting maxilla or

maxillary incisors, whereas obtuse suggests need for maxillary
advancement.
 AP lip position is evaluated by line from subnasale to soft tissue Pog and
amount of lip protrusion or retrusion is measured as perpendicular
distance from this line to most prominent point of both lips.

LIP POSITION & FORM

LIP POSITION & FORM
 Mento labial sulcus is measured from depth of sulcus perpendicular to

Li-Pg’.
 Sulcus of about 4mm is average
 Mento labial sulcus can be deep because of:-
› Flared lower incisors,

› extruded upper incisors that roll out of lower lip
› Abnormal morphology of lip

LIP POSITION & FORM
 Deep mento-labial sulcus can be reduced by:-
› Up righting lower incisors
› Intruding max incisors
Advanced genioplasty can deepen sulcus and reduction genioplasty

can reduce depth.
Lower third of face can be divided into thirds, length of upper lip or
distance Sn-Stm –S should be 1/3 of total Sn-Me’.
Ratio of Sn-Stm-s/Stm-i—Me’ should be 1:2,when ratio becomes

smaller than half ,a vertical reduction genioplasty should be
considered.

LIP POSITION & FORM
 Distance of upper lip to max incisors is key factor in determining vertical

position of maxilla.
 2mm of max incisor show below upper lip with lip at rest is normal
 Deep bite and open bite cases should be properly diagnosed so as to

determine area of fault, and should be treated accordingly.

LIP POSITION & FORM
 Inter-labial gap or vertical distance between upper and lower lip ranges
from slightly touching to 3mm apart (Burstone).
 In Patients with vertical maxillary excess ,level of maxilla is raised to

shorten face height will decrease large inter labial gap and allow patient to
close lips without muscle strain.

LIP POSITION & FORM

SUMMARY
 If facial improvement is one of the major objectives of surgical procedure,

it is necessary that soft tissues be measured directly.
 Especially in cases of orthognathic surgery ,soft tissue analysis are of

prime importance.

C.O.G.S. HARD TISSUE ANALYSIS
 “A cephalometric analysis especially designed for patient

who requires maxillofacial surgery was developed to use
landmarks and measurements that can be altered by
common surgical procedures. Because measurements are
primarily linear ,they may be readily applied to prediction
overlays and study vast mountings and may serve as basis
for evaluation of post treatment stability.”- Burstone, James,
Legan.

 Sella (S)  Anterior nasal spine(ANS)
 Nasion (N)  Menton (Me)
 Articulare (Ar)  Gnathion (Gn)
 Pterygomaxillary fissure(PTM)  Posterior nasal spine (PNS)
 Subspinale (A)  Mandibulr plane (MP)
 Pogonion (Pg)  Nasal floor (NF)
 Supramentale (B)  Gonion (Go)

S. NO. VARIABLE STD. (M) SD (M) STD. (F) SD (F)
Cranial base
1 Ar-PtM (11 HP) 37.1 2.8 32.8 1.9
2 PtM-N (11 HP) 52.8 4.1 50.9 3
Horizontal (Skeletal)
3 N- A-Pg (angle) 3.9 6.4 2.6 5.1
4 N-A (11HP) 0 3.7 -2 3.7
5 N-B (11 HP) -5.3 6.7 -6.9 4.3
6 N-Pg (11 HP) -4.3 8.5 -6.5 5.1
Vertical ( Skeletal, Dental )
9 N-ANS (Per. HP) 54.7 3.2 50 2.4
10 ANS-Gn (Per. HP) 68.6 3.8 61.3 3.3
11 PNS-N ((Per. HP) 53.9 1.7 50.6 2.2
12 MP-HP (angle) 23 5.9 24.2 5
13 Upper 1 - NF 30.5 2.1 27.5 1.7
14 Lower 1 –NP 45 2.1 40.8 1.8
15 Upper 6 – NF 26.2 2 23 1.3
16 Lower 6 -NP Dr. Karamdeep Singh 35.8 2.6 32.1 58 1.9
S. no. variable Std (M) SD(M) Std(F) SD(F)
Maxilla-mandible
1 PNS-ANS (II HP) 57.7 2.5 52.6 3.5
2 Ar-Go (linear) 52 4.2 46.8 2.5
3 Go-Pg (linear) 83.7 4.6 74.3 5.8
4 B-Pg (II HP) 8.9 1.7 +7.2 1.9
5 Ar-Go-Gn (angle) 119.1 6.5 122 6.9
Dental
6 OP upper –HP (angle) 6.2 5.1 7.1 2.5
7 OP lower –HP (angle) ….. ….. ….. …..
8 A-B (II HP) -1.1 2 -0.4 2.5
9 Upper 1 – NF (angle) 111 4.7 112.5 5.3
10 Lower 1 – MP (angle) 95.9 5.2 95.9 5.7

CRANIAL BASE
 Length of cranial base is measured from Ar-N.
 This is not an absolute value and should be studied along with length of
maxilla and mandible. For example….
 Ar-N is a stable landmark but can be changed by surgeries such as ….
 Ar-PtM shows the horizontal distance between posterior aspects of

mandible and maxilla, greater distance shows….

CRANIAL BASE

HORIZONTAL SKELETAL PROFILE
 These measurements are made parallel to HP, and is important because
most corrections are done in AP plane by surgeries.
Skeletal
facial
convexity
N-B
N-A N-Pg
SKELETAL FACIAL CONVEXITY
 This angle is measured from line N-A and a line A-Pg.
 Gives an indication of overall facial convexity, but not a specific

diagnosis of which is a fault-Maxilla or mandible.
 Positive (clockwise) angle shows convexity
 Negative(counter clockwise) shows concavity

SKELETAL FACIAL CONVEXITY

N-A
 It helps in determining if anterior part of maxilla is protrusive or retrusive.
 Perpendicular from HP is dropped through N.
 Horizontal position of A is measured to this line.
 Positive value shows anterior position to line, negative value shows

posterior position.

N-B
 Helps in determining A-P position of mandible.
 Is measured using same perpendicular to dropped from N.

N-Pg
 Indicated prominence of chin.
 Is useful in planning treatment of augmentation or reduction genioplasty,

of anterior mandibular horizontal advancement or reduction, and of total
mandibular horizontal advancement or reduction
 Is measured using the same perpendicular

HORIZONTAL SKELETAL PROFILE

POINT TO REMEMBER
 Any unusually large or small value that is obtained must be compared

with N-B and B-Pg.(distance from B point to a line perpendicular to MP
through Pg)
 It help in determining if the discrepancy is in alveolar process, chin or

mandible proper.
 Also helps in determining if there is horizontal hyperplasia or hypoplasia.

VERTICAL SKELETAL AND DENTAL
 Both vertical skeletal and dental measurements are divided into anterior
and posterior.
 Vertical discrepancy reflects anterior, posterior or complex dysplasia of

face.
 Is helpful in determining origin of maxillary or mandibular discrepancy is

skeletal, dental or combination.

VERTICAL SKELETAL AND DENTAL
 Problems of this dimension are corrected by:-
› Total maxillary vertical advancement or reduction
› Ant. Max vertical augmentation or reduction
› Post. Max vertical augmentation or reduction
› Mand ramus rotation
› Ramus height reduction

ANTERIOR VERTICAL SKELETAL
MEASUREMENTS
 Anterior vertical measurements are divided into measurements of middle
third face heights and lower third face height.
 Anterior middle third face height is distance from N-ANS perpendicular

to HP. Lower third face height is measured from ANS-Gn.
Middle third
face height
ANTERIOR VERTICAL
MEASUREMENTS
Lower third
face height
POSTERIOR VERTICAL SKELETAL
MEASUREMENTS
 Posterior maxillary height is length of a perpendicular line dropped from
HP intersecting PNS.
 Divergence of mandible posteriorly is shown by HP-MP angle. This angle

relates posterior facial divergence with respect to anterior facial height.
 Post max .height and MP angle define vertical dysplasia of post

components.

VERTICAL MEASUREMENTS

VERTICAL DENTAL DYSPLASIA
Anterior component
Posterior component

ANTERIOR VERTICAL DENTAL
MEASUREMENTS
 Ant max dental height is measured from incisal edge of max central
incisor to NF.
 Ant mand. height is measured from incisal edge of mand. incisor to MP.
 These two measurements show eruption of incisors in relation to NF and

MP.

POSTERIOR VERTICAL DENTAL
MEASUREMENTS
 Posterior dental measurement is done from upper 6 to NF, and lower 6 to
MP.
 Upper 6 to NF is done using perpendicular length of a line through max

first molar mesio buccal cusp tip constructed to NF.
 Lower 6 measurement is done using a line through mand. first molar

mesio buccal tip on MP

VERTICAL DENTAL MEASUREMENTS

MAXILLA- MANDIBLE
MEASUREMENTS
 Total effective length of maxilla is distance from PNS- ANS, that is
projected on line parallel to HP.
 Four measurements are done for mandible:-

› Ar- Go
› Go-Pg
› Ar-Go-Gn
› B-Pg

MAXILLA- MANDIBLE
MEASUREMENTS

MAXILLA- MANDIBLE
MEASUREMENTS
 Ar-Go distance gives length of mandibular ramus.
 Go-Pg distance gives mandibular length.
 Ar-Go-Gn angle gives relation of MP to ramus.
 Distance of point B a line perpendicular to MP through Pg, shows

prominence of chin to mandible.

DENTAL MEASUREMENTS
 All dental measurements are related to occlusal plane(OP) ,NF and MP

plane.
 OP is line drawn from buccal groove of both first permanent molars

through a point 1 mm apical of incisal edge in each arch.

DENTAL MEASUREMENTS

DENTAL MEASUREMENTS
 OP angle is angle formed between OP and HP.
 If open bite exists then…..
 Increased OP-HP shows open bite, lip incompetence, increased facial

height, retrognathia.
 Decreased OP-HP angle shows deep bite, decreased facial height.

DENTAL MEASUREMENTS

DENTAL MEASUREMENTS
 AB-OP measurement is constructed by dropping perpendicular line to OP

from points A & B, and then measuring distance.
 This is relation of max and mand apical base to OP.
 If AB distance is large with point B projected post to point A– class- II

occlusion is present.
 It is used in analysis rather than ANB as this measurement uses those lines
which surgeon can use during planning surgical correction.

DENTAL MEASUREMENTS

DENTAL MEASUREMENTS
 Angulations of upper I –NF and lower I to MP is very useful for

evaluating proclination or retroclination of incisors and are also helpful in
evaluating stability for long term of dentition.

SUMMARY
 This analysis can be helpful in diagnostic nature of facial dysplasia and

abnormalities in position of teeth.
 It is based on landmarks that can be altered by various surgical

procedures.

POINT TO REMEMBER
 One could question goal of trying to make everyone fit a cephalometric
standard so one must be sure that patient desires facial characteristics of
north European population.
 Reference plane used in study is purely arbitrary.
 Constructed HP assumes SN plane is normal.
 SO WHAT TO DO FOR BOTH PROBLEMS………?

POINT TO REMEMBER
 It is better to take a photograph of head in a postural horizontal position,

with patient looking straight ahead and head not supported by nasion rod
of cephalometer. The postural horizontal line can be used as HP.
(Moorrees-1958, Mills-1969).
 Is there any study on cephalometric norms of Indian population for hard

and soft tissues….?

Soft tissue cephalometric norms for
orthognathic surgery in Indian adults
International Journal of Oral and Maxillofacial Surgery,

Volume 36, Issue 11
S. Tippu, M. Subramanium, F. Rahman, U. Akkera

COGS-Soft Tissue
Mean- SD of various parameters of British & Indian

patients
Parameter
P-Value Significance
British Indian
(n=40) (n=40)
Facial Convexity angle 12.00 + 4.00 16.22 + 4.73 < .001 HS
Maxillary Prognathion 6.00 + 3.00 7.67 + 5.09 > .05 NS
Mandibular prognathism 00.00 + 4.00 2.04 + 8.29 > .05 NS
Vertical Height Ratio 1.00 + 0.00 1.00 + 0.11 -
Lower face throat angle 100.00 + 7.00 111.86 + 6.14 < .001 HS
Lower vertical height dept Ratio 1.20 + 0.00 1.19 + 0.21 > .05 NS
Nasolabial angle 102.00 + 8.00 101.91 + 9.66 > .05 NS
Upper lip protrusion 3.00 + 1.00 3.56 + 1.84 > .05 NS
Lower lip protrusion 2.00 + 1.00 2.76 + 2.69 > .05 NS
Mentolabial sulcus 4.00 + 2.00 5.92 + 1.61 < .001 HS
Vertical lip chin ratio 0.50 + 0.00 0.52 + 0.39 > .05 NS
Maxillary incisor exposure 2.00 + 2.00 2.54 + 2.16 > .05 NS
Interlabial gap 2.00 + 2.00 0.34 + 0.85 < .001 HS

But what about hard tissue norms

COGS-Hard Tissue
Comparative Evaluation (Males)
Parameter WHITES INDIAN ‘t’ Value ‘p’ Value
Standard Standard
Cranial base
Ar-PTm 37.1 37.14 0.051 >0.05
Ptm-N 52.8 54.62 1.893 >0.05
Horizontal (skeletal)
N-A-Pog (angle) 3.9 4.1 0.194 >0.05
N-A 0.0 1.08 0.955 >0.05
N-B -5.3 -2.78 2.103 <0.05
N-Pog -4.3 -2.32 1.296 >0.05
Vertical (skeletal, dental)
N-ANS 54.7 55.7 1.406 >0.05
ANS-Gn 68.6 67.77 0.928 >0.05
PNS-N 53.9 55.93 2.269 <0.05
MP-HP (angle) 23.0 20.9 2.085 <0.05
Max incisor to NF 30.5 28.48 3.814 <0.01
Mand incisors to MP 45.0 43.55 2.738 <0.05
Max molars to NF 26.2 23.18 2.542 <0.05
Mand molar to mp 35.6 34.1 2.618 <0.05
Max-Mand
PNS-ANS 57.7 58.2 0.868 >0.05
Ar-Go 52.0 54.77 2.699 <0.05
Go-Pg 83.7 78.28 3.085 <0.01
B-Pg 8.9 7.53 3.562 <0.01
AR-GO-GN (angle) 119.1 123.95 4.158 <0.001
DENTAL
OP upper- HP (angle) 6.2 5.05 0.989 >0.05
OP lower-HP (angle) - - - -
A-B 4.1 -2.78 3.682 <0.01
Max incisor- NF (angle) 111.0 116.6 4.799 <0.001
Mand incisor- MP (angle) 95.9 97.95 1.5188 >0.05

COGS-Hard Tissue
Comparative Evaluation (Females)

Parameter WHITES INDIAN ‘t’ Value ‘p’
Standard Standard Value
Cranial base
Ar-PTm 32.8 34.26 3.737 <0.01
Ptm-N 50.9 54.59 5.428 <0.001
Horizontal (skeletal)
N-A-Pog (angle) 2.6 6.16 6.185 <0.001
N-A -2.0 -2.93 1.373 >0.05
N-B -6.9 -8.99 3.154 <0.01
N-Pog -8.5 -8.35 2.432 <0.001
Vertical (skeletal, dental)

N-ANS 50.0 53.66 6.610 >0.05
ANS-Gn 61.3 62.31 1.203 <0.05
PNS-N 50.6 52.16 2.958 >0.05
MP-HP (angle) 24.2 25.74 1.366 <0.01
Max incisor to NF 27.5 27.48 0.058 >0.05
Mand incisors to MP 40.8 39.28 3.563 >0.05
Max molars to NF 23.0 21.13 3.158 <0.01
Mand molar to mp 32.1 30.89 4.385 <0.001
Max-Mand
PNS-ANS 52.6 52.40 0.578 >0.05
Ar-Go 46.8 47.40 0.795 <0.05
Go-Pg 74.3 70.65 2.685 <0.05
B-Pg 7.2 7.54 1.054 >0.05
AR-GO-GN (angle) 122.0 127.03 3.705 <0.01
DENTAL
OP upper- HP (angle) 7.1 9.30 3.045 <0.05
OP lower-HP (angle) - - - <0.01
A-B -0.4 -3.80 4.843 <0.001
Max incisor- NF (angle) 112.5 112.15 0.085 >0.05
Mand incisor- MP (angle) 95.9 98.61 2.333 <0.05
FINAL CONCLUSION
 It is very necessary to know these two types of cephalometric analysis as

one of analysis (COGS) is important tool for cases where orthognathic
surgery is required, i.e. those cases who are in most need of orthodontic
treatment.
 The other (Bjork) analysis is one of the oldest in history but is given by a
man (Bjork) whose vision formed basis of various other analysis such as
Rakosi Jarabak etc.

COGS N Bjork Analysis

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COGS N Bjork Analysis

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COGS

 COGS hard and soft tissue analysis

 Both analysis are very important from diagnostic point of view.

 COGS analysis is a result of a joint work done by an Orthodontist

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 Arne Bjork gave Bjork analysis in 1947 and 1951.

 He investigated effects of variations in jaw growth on prognathism and

 He devised facial diagram in which linear and angular configurations

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 Nasion (N)  Gonial angle (KK)

 Sella (S)  Infra-dentale (Ir)

 Articularis (Ar)  Apex of ANS(SP)

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 DD is also called as chin angle, point of intersection between a line

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2 Upper jaw: alveolar prog. S-Na-Pr 83.68 3.67 84.83 4.13

3 Lower jaw: alveolar prog. S-Na-Id 80.01 3.56 82.25 4.37

4 Lower jaw: basal prog. S-Na-Pog 78.92 3.63 81.69 4.43

5 Upper 1 axis-occ. plane Upper 1-occ. 58 4.97 64 6.62

6 Lower 1 axis-occ. plane Lower 1-occ. 70.45 6.24 73.59 7.89

7 Saddle angle Na-S-Ar 122.90 4.85 123.06 5.33

8 Joint angle S-Ar-Go 142.96 6.21 143.27 6.91

9 Jaw angle (gonial angle) Ar Go-Mp 131.09 6.11 130.85 7.31

10 Chin angle Id Pog-Mp 68.58 5.4 64.24 6.43

12 Cranial base: horizontal part Na-S 68.75 2.97 73.22 3.26

13 Cranial base: vertical part Ar-S 34.35 2.85 37.02 3.32

23 Lower dental arch length Ii-lower 6 24.27 2.29 22.72 2.43

24 Diff in alv. Prog. Pr-Na-Id ------ ----- 2.6 2.3

 Bjork’s facial diagram include :-

Changes in any angle or line of facial diagram produces effects of

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 Shape of skull is determined by shape of cranium, cranial base and facial

 Angle formed between line at nasion is measured to 4 points on facial

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 Position of head is denoted by angle formed by a line bisecting another

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 Reduction of gonial angle:-reduces mandibular and facial prognathism.

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 It is a simple but a comprehensive analysis which measures both skeletal

 There are few unique measurements such as DD angle, shape of cranium,

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Soft tissue Hard tissue

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 First step in diagnosis of orthognathic surgical patient is to determine the

 Patients who require orthognathic surgery usually have facial bones as

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 For this reason, specialized cephalometric appraisal system based on

 COGS describes horizontal and vertical position of facial bones by use of

 Standards are based on sample obtained from child research council of

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 Most of data in analysis is measured using a constructed plane called the

 Most measurements will be done either parallel to HP or perpendicular to