advances in diagnostic aids / orthodontic courses by indian dental academy

Advances in Diagnostic Aids

• Digital Cephalometry• Videocephalometry• DigiGraph

• CT Scan• MRI

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• Structured Light techinque• Laser scanning

• Stereophotogrammetry• 3-D Study models

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CEPHALOMETRIC RADIOGRAPHS

• X- ray was discovered by Roentgen in1895.• W.A.Prince in 1900 – showed the importance

of radiography as a diagnostic aid in orthodontics.

• Hofrath (Germany) and Broadbent (US) in 1934 provided both, a research and a clinical tool for the study of malocclusion and underlying skeletal disproportion which still remains relatively unchanged today.

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Lateral cephalogram have two purposes: -

1. It reveals details of skeletal and dental relationships that cannot be observed in any other way.

2. It evaluates the precise evaluation of response to the treatment.

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Limitations of 2-dimensional cephalogram

1. It is a two dimensional representation of a three dimensional object.

2. Cephlalometric analyses are based on the assumption of perfect superimposition of the right and left sides, but this is observed infrequently.

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Hand Wrist Radiograph

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Hand Wrist Radiographs

♦ Chronological age is often not sufficient for assessing the developmental stage and maturity of the patient.

♦ Thus, biological age has to be determined.

♦ Hand Wrist radiographs are an effective tool to assess the biological age.

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♦ In the early 1900s, Pryor(1907), Rotch(1908), and Crampton(1908) began tabulating indicators of maturity on sequential radiographs of the growing hand and wrist.

♦ Todd(1937) compiled hand-wrist data that was further elaborated on by Greulich and Pyle(1959) in atlas form.

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♦ Fishman(1979) developed a system of hand-wrist skeletal maturation indicators (SMIs) using four stages of bone maturation at six anatomic sites on the hand and the wrist.

♦ Hagg and Taranger(1980) created a method using the hand-wrist radiograph to correlate certain maturity indicators to the pubertal growth spurt.

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Cervical Vertebrae Maturation Index

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Study Cast Analysis

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♦ Study cast analysis is a three-dimensional assessment of the maxillary and mandibular dental arches and the occlusal relationships.

♦ The importance of this method of evaluation

for orthodontic diagnosis and treatment planning in the past been over-emphasized.

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Symmetric Maxillary Arch

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Midline shift in Maxillary Arch (right)

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Measurement of Palatal Height

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DIGIGRAPH

• It allows any cephalometric point to be located within the three planes of space.

• Digigraph work station is about 5x3x7 feet and requires about 25 feet of working area.

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• Ear rods and forehead and posterior head pieces are used to minimize patient movement.

• The ear rods can be removed so that facial and intraoral images can also be recorded while the patient is sitting in the adjustable chair.

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Videocephalometry

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Step 1

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Step 2

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Digital Radiography

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• In digital radiography, instead of the silver halide grain, the image is constructed using pixels.

• A digital image is a matrix of square pieces, or picture elements (pixels), that form a mosaic pattern from which the original image can be reconstructed for visual display.

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Thank you

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