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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