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    Methods of Cephalometric Superimposition - A Review

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    Aniket Potnis
    The document discusses various methods of cephalometric superimposition that are used to analyze changes in a patient's dentofacial structures over time. It describes techniques for superimposing cranial base structures, the maxilla, and mandible. Common methods include using the sella-nasion line, Broadbent triangle, Basion horizontal, and Bjork's structural method. The document also mentions Ricketts superimposition and pitchfork analysis techniques.

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    Methods of Cephalometric Superimposition - A Review

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    Aniket Potnis
    418 views4 pages
    The document discusses various methods of cephalometric superimposition that are used to analyze changes in a patient's dentofacial structures over time. It describes techniques for superimposing cranial base structures, the maxilla, and mandible. Common methods include using the sella-nasion line, Broadbent triangle, Basion horizontal, and Bjork's structural method. The document also mentions Ricketts superimposition and pitchfork analysis techniques.

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    Methods of Cephalometric Superimposition - A Review

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    The document discusses various methods of cephalometric superimposition that are used to analyze changes in a patient's dentofacial structures over time. It describes techniques for superimposing cranial base structures, the maxilla, and mandible. Common methods include using the sella-nasion line, Broadbent triangle, Basion horizontal, and Bjork's structural method. The document also mentions Ricketts superimposition and pitchfork analysis techniques.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    418 views4 pages

    Methods of Cephalometric Superimposition - A Review

    Uploaded by

    Aniket Potnis
    The document discusses various methods of cephalometric superimposition that are used to analyze changes in a patient's dentofacial structures over time. It describes techniques for superimposing cranial base structures, the maxilla, and mandible. Common methods include using the sella-nasion line, Broadbent triangle, Basion horizontal, and Bjork's structural method. The document also mentions Ricketts superimposition and pitchfork analysis techniques.

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    The article discusses various methods of cephalometric superimposition including those using cranial base structures, maxillary structures, and 3D approaches.

    The article discusses methods like Decoster method, Broadbent triangle, Sella-Nasion line, Basion horizontal, Basion-Nasion plane, Bjork's structural method, and maxillary superimposition methods.

    Anatomical structures used as reference points include sella turcica, nasion, foramen caecum, frontal bone, anterior nasal spine, palatal plane, pterygomaxillary fissure, and infratemporal fossa.

    Review Article DOI: 10.18231/2455-6785.2016.

    0003

    Methods of cephalometric superimposition - A review

    Sara Asif1, Mohammad Tariq2,*


    1JR – III, 2Professor department of orthodontics Dr. Z. A. Dental College AMU, Aligarh

    Corresponding Author:
    Email: jmi786jmi@gmail.com

    Abstract
    In 1931, Broadbent(7,8) and Hofrath(12) introduced the technique of radiographic cephalometry. Since then, clinicians and
    researchers have adopted and routinely used this valuable tool on orthodontic patients in order to analyse underlying dentofacial
    relationships. Cephalometrics Superimposition is used to gain a better understanding of the facial changes that accompany growth
    and/or orthodontic treatment.

    Keywords: Cephalometrics, Superimposition.


    follows the linear extention of the original sella-nasion
    Introduction line.(21)
    A cephalometric superimposition is an analysis of
    lateral cephalograms of the same patient taken at
    different times. It isused to evaluate a patient's growth
    pattern between different ages and to evaluate changes
    in the dentoalveolar and basal relationships after a
    course of orthodontic or surgical treatment.
    Cephalometric procedures and evaluations are
    considered in the light of; pretreatment objectives,
    orthodontic treatment modalities used, long-term
    follow-up of the treatment results and during the
    retention and post-retention periods.
    Over the time various methods of superimposition
    have been developed. The aim of this article is to
    provide an overview of the various cephalometric
    techniques.

    Methods of superimposition of cranial base


    structures Fig. 1
    Decoster method: According to Decoster, the bony
    anatomy of the anterior contour of the cranial base i.e. Basion horizontal by Coben: Basion is used as the
    the anterior half of the sella turcica to the foramen point of reference. The line from Basion drawn
    caecum and the internal outline of the frontal bone are parallel to the original FH, of the several radiographs,
    stable support for superimposition. Later Richardson establishes the constant SN-FH relationship and the
    found that DeCosters cribriform plane was only Basion Horizontal plane of the series.Each subsequent
    moderately successful as far as reproducibility was coordinate tracing film may be superimposed by
    concerned. Its applicability did not favor the usage of simply aligning the co-ordinate grids that have been
    this line.(11) especially designed for this purpose.(9,10)

    Broadbent triangle: The Broadbent triangle (Na-S- Basion-nasion plane Ricketts


    Bo) and its registration point R were among the first Rickett’s proposed the Basion-Nasion plane as
    structures used for superimpositions to determine an area of registration for overall evaluation of the
    overall changes. With this method, the two tracings are dentofacial changes. The superimposition area as the
    oriented so that the R points are registered and the Ba-Na line with registration at CC point helps to
    Bolton planes (Bo-Na) are parallel.(7,8) evaluate changes in facial axis, direction of chin
    growth, and upper molar position.(14-16)
    Sella –nasion line: Orients the two tracings on the
    Sella-nasion line with registration at Sella.Provides
    composite view of the amount of growth change. It is
    accurate as long as the growth change at nasion

    Indian Journal of Orthodontics and Dentofacial Research, October-December 2016;2(4):145-148 145


    Mohammad Tariq et al. Methods of cephalometric superimposition - A review

    Bjork’s structural method  The structural superimposition on the anterior


    surface of the zygomatic process of the maxilla.

    Methods of mandibular superimposition


    A number of areas have been suggested for
    superimpositions, including: Lower border of the
    mandible; Tangent to the lower border of the
    mandible; and Constructed mandibular plane between
    Menton and Gonion. However, these methods are not
    very accurate and significant remodelling occurs at
    mandibular border.
    From their implant studies, Bjork(1) and Bjork and
    Skieller( 4) have indicated that the following structures
    are relatively stable and could be used; The anterior
    contour of the chin, Inner contour of the cortical plates
    at the inferior border of the symphysis and any distinct
    trabecular structure in the lower part of the symphysis,
    Posteriorly, the contours of the mandibular canal,
    Fig. 2 Lower contour of a mineralized molar germ.

    Fig. 3

    Longitudinal growth studies by Björk using


    metallic bone markers shown that certain structures in
    the anterior cranial base are stable after a certain age.
    These stable anatomical structures in the anterior
    cranial base are used as reference structures when Fig. 4
    radiographs from different age stages are
    superimposed.(1-6) Ricketts superimposition method-
    It is used to differentiate the changes in normal
    Methods of maxillary superimposition growth and those due to treatment mechanics. This
    The maxillary base superimposition involves technique involves five superimposition areas; the
    superimposing alon the various structures mentioned chin, the maxilla, the teeth in the maxilla, the teeth in
    below.(20) the mandible, the facial profile.(15-18)
     Palatal plane registered at anterior nasal spine
    (ANS.) Pitchfork analysis
     Nasal floors with the films registered at the Johnston in 1985, described the different
    anterior surface of the maxilla. treatment strategies o correct Class II malocclusion
     Palatal plane registered at the pterygomaxillary where the data is recorded in a pitch fork manner. All
    fissure. measurements are executed parallel to the mean
    functional occlusal plane and are given signs
     Outline of the infratemporalmfossa and the
    appropriate to the nature of their contribution to the
    posterior portion of the hard palate.
    molar and overjet changes or correction.(13)
     Registering the maxilla on the common Ptm co-
    ordinate, maintaining the Basion Horizontal
    relationship.
     Best fit of the internal palatal structures.
     Superimposition on metallic implants.

    Indian Journal of Orthodontics and Dentofacial Research, October-December 2016;2(4):145-148 146


    Mohammad Tariq et al. Methods of cephalometric superimposition - A review

    interpretations become a guessing game rather than the


    science that cephalometrics is supposed to be. Though
    now a days the quest for the development of a better
    and more accurate 3D technique is captivating the
    interest of many clinicians, conventional
    cephalometric superimposition methods are still
    considered to be the gold standard.

    References
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    human mandible: Longitudinal radiographic study by
    the implant method. / Dent Res12:400-11.
    2. Bjork A, Skieller V (1977a) Growth of the maxilla in
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    4. Bjork A, Skieller V (1983) Superimposition of profile
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    Conclusion
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    21. Steiners CC .Cephalometrics in clinical practice Angle
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    Indian Journal of Orthodontics and Dentofacial Research, October-December 2016;2(4):145-148 148

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