Ricketts Analysis - Cedees Smart Notes

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Ricketts 12-Factor Analysis
Cedees Faculty
SMART NOTES
Cedees Smart Notes www.bdsnext.com
Ricketts 12-Factor Analysis

1. Ricketts studied the human mandible and found that it underwent arcial growth rather than
linear growth.
2. Though the term VTO was given by Holdaway, it was Ricketts who gave cephalometric VTO
to predict the growth and treatment changes.
3. Ricketts divided the face into four separate areas as Chin, Denture, Profile, Soft Tissue
Evaluation
LANDMARKS USED EXCLUSIVELY BY RICKETTS
 Xi point: Geometric center of the mandibular ramus

 PT point: Junction of foramen rotundum and pterygomaxillary fissure
 DC point: A point selected in the center of the neck of the condyle where the basion-nasion
plane intersects it
 PM point: Protuberance menti point selected in the anterior border of symphysis of mandible
between B point and pogonion where the curve changes contour from convex to concave
 CC point: Intersection of basion-nasion plane and the facial axis
Summary of various measurements in Ricketts Analysis:
Variable Measurement Norm (age 9)
1. Facial axis 90 degrees
2. Facial (angle) depth 87 degrees
3. Mandibular plane to FH 26 degrees
4. Lower facial height 45 degrees
5. Mandibular arc 26 degrees
6. Convexity of point A 2 mm
7. Mandibular incisor to A-PO plane ± 1 mm
8. Mandibular incisor inclination to A-PO plane 22 degrees
9. Upper molar to PTV 12 mm
10. Inter-incisal angle 130 degrees
11. Maxillary depth 90 degrees
INDIA’s BEST and Oldest MDS Coaching Centre since 17 years……………..

I. Measurements to locate Chin in Space
1. Facial Axis Angle
The posterior angle between the Ba–Na plane and the facial axis defines the growth pattern of the
mandible. The average value is 90°. The angle indicates the direction of growth of chin. A smaller angle
shows opening of the mandibular angle and is seen in vertical growth of mandible
2. Facial Depth Angle

The angle between the FH plane and the facial plane (Na–Pog) is the facial angle or facial depth.
The average value is 87°. It is an indication of anteroposterior position of the chin in space. It confirms
whether the Class II or Class III skeletal base is due to the position of the mandible.
3. Mandibular Plane
The angle between the mandibular plane (tangent to the lower border of mandible) and FH plane is
termed the mandibular plane angle. The angle is 26° at 9 years of age.
4. Lower Facial Height

The angle between Xi–PM (corpus axis) and Xi–ANS shows the lower facial height. It indicates the
divergence of the oral cavity. The normal angle is 45°.
5. Mandibular Arc
The mandibular arc is the angle between DC–Xi (condylar axis) and corpus axis. The average is 26°.
The angle closes in vertically growing mandible and is an indication of obtusely growing mandible.
6. Convexity of Point ‘A’

This is a linear measurement from point A to facial plane (Na–Pog) . The average is 2 mm
II. Measurements to locate Denture in Space
7. Lower Incisor to A–Pog Line

This is the distance measured from the lower incisor edge to A–Pog line (denture plane).
8. Lower Incisor Inclination

This is the angle formed by the intersection of the long axis of the lower central incisors and the A–Pog
plane. The clinical norm is 22.
9. Upper Molar to PTV

It is the distance between the pterygoid vertical and the most distal point of the upper first permanent
molar measured parallel to the occlusal plane. Pterygoid vertical is the perpendicular tangential to the
posterior border of pterygomaxillary fissure.
The clinical norm is age of the patient + 3 mm.
10. Interincisal Angle

It is the measured angle between the long axis of the upper and lower incisors. The clinical norm is 130

III. Measurements to determine the Profile
11. Maxillary Depth

This is the angle formed by the FH plane and the Na–A line. It indicates anteroposterior position of the
maxilla. The normal value is 90°. A high angle indicates protrusion of maxilla while an angle lesser than
90° indicates retrusion of maxilla.
IV. Soft tissue Evaluation
12. Lower Lip and E Line (Fig. 21.20)

Lower lip proclination is the measured distance between the lower lip and the esthetic plane (nose–
chin). E plane is drawn connecting the tip of the nose and soft tissue pogonion
Reference Images:
A- Upper molar to PTV

B- Mandibular incisor to A-PO plane

E- line ( Ricketts)
One of the main pitfalls of Ricketts’ analysis is that he has neither considered the position nor
inclination of the maxillary incisor.
In the current trend of esthetics - oriented orthodontic practice, the positions of the upper lip and
maxillary incisor are very critical in determining the profile and smile line of the patient.

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Ricketts 12-Factor Analysis

Ricketts 12-Factor Analysis

LANDMARKS USED EXCLUSIVELY BY RICKETTS

 Xi point: Geometric center of the mandibular ramus

Summary of various measurements in Ricketts Analysis:

Variable Measurement Norm (age 9)

1. Facial axis 90 degrees

2. Facial (angle) depth 87 degrees

3. Mandibular plane to FH 26 degrees

4. Lower facial height 45 degrees

5. Mandibular arc 26 degrees

7. Mandibular incisor to A-PO plane ± 1 mm

8. Mandibular incisor inclination to A-PO plane 22 degrees

9. Upper molar to PTV 12 mm

10. Inter-incisal angle 130 degrees

11. Maxillary depth 90 degrees

INDIA’s BEST and Oldest MDS Coaching Centre since 17 years……………..

I. Measurements to locate Chin in Space

1. Facial Axis Angle

2. Facial Depth Angle

4. Lower Facial Height

6. Convexity of Point ‘A’

II. Measurements to locate Denture in Space

7. Lower Incisor to A–Pog Line

8. Lower Incisor Inclination

9. Upper Molar to PTV

The clinical norm is age of the patient + 3 mm.

10. Interincisal Angle

INDIA’s BEST and Oldest MDS Coaching Centre since 17 years……………..

III. Measurements to determine the Profile

11. Maxillary Depth

IV. Soft tissue Evaluation

12. Lower Lip and E Line (Fig. 21.20)

A- Upper molar to PTV

INDIA’s BEST and Oldest MDS Coaching Centre since 17 years……………..

INDIA’s BEST and Oldest MDS Coaching Centre since 17 years……………..

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