Cephalometrics is one of the most useful tools in orthodontics, and it can be valuable during any state of the treatment process. Many orthodontics find cephalometric analysis complicated, and while it is complex, it doesn’t need to be confusing. As long as you understand best practices for completing cephalometric analysis, you are well on your way to using this science effectively in your practice. Here are some tips for getting started:
Morphological analysis are one of the most useful benefits of cephalometric analysis. When used correctly, you can understand whether a specific patient’s malocclusion is caused by dento-alveolar or skeletal deviations, as well as identify whether there is dysplastic development or dentoalveolar compensation. Use analyses to pinpoint the cause as well as the location of issues before treatment planning starts.
The differences in analysis could be attributed to either the patient’s malocclusion or to difference in ethnicity because skeletal patterns vary greatly amongst different ethnicities. It’s important to take this into consideration along with the patient’s age; these orthodontic changes are most prevalent during the early years.
Understand the question you are asking before looking for answers.
If you don’t know what you’re looking for, it can be easy to overlook important issues. Your first analysis of the lateral head film can help you see major issues to work toward forming a treatment plan, but a closer inspection with the goal of discovering specific causes can make a huge difference in the direction of treatment. Look carefully so you can get a comprehensive idea of what a patient needs rather than simply assuming once you find the cause you can apply treatment and get results. It’s important to understand the cause, not just pinpoint it, because multiple issues at work can redirect the results of treatment.
For instance, many patients both treated and untreated suffer to some extent from the forward rotation of the mandible. If you don’t take careful account for the maxillary growth changes of the molar during the treatment you could end up with more problems then you began with. Many of these mandibular growths can be seen and treated preemptively with the predictive powers of the lateral head film.
When it comes to data, more isn’t always better.
Morphological population analyses can be extremely helpful, but don’t let mean or average values take you away from the individual patient’s case. Every patient is different, and while population norms are enormously helpful, they don’t tell the full story. Orthodontists can inadvertently make errors if they only rely on means or norms because there is great variety within any population.
For morphological facial analysis the more is not always the merrier. The more numbers you have when comparing these analyses only confuses the clinician and doesn’t provide much insight. However, using the mean values for this data can help the clinician to make broader goals for treatment. The standard deviation is large to take into account all of the varying ethnicities especially in the U.S. The mean values can be used to see if someone particularly stands out from the average to establish there is a problem; but should not be used for studying individual cases.
Go angular, not linear.
If you are following population norms, it’s better to stick with angular measurements than linear ones. Angular measurements don’t experience enormous variations across size and ages in populations, but linear measurements do. Make sure you account for population differences when drawing comparisons from angular measurements, and if you feel overwhelmed by great differences in measurements, always go back to looking at how the angular measurements compare.
Angular measurements withstand the test of time more consistently than linear ones. Through various tests and studies it’s been found that angular measures of cephalometrics are more consistent in longitudinal studies over a course of time. These angular measurements are less resistant to growth numerically and conceptually.
Don’t forget the power of cephalometric analysis over time.
One cephalometric analysis is very useful for identifying issues and causes before treatment starts, but completing multiple cephalometric analysis during the treatment process helps you spot change over time and make predictions about growth before its too late. Our mouths are constantly changing and growing, even once we think we’re done. It’s important even once the initial treatment is over to keep track of analyses in the long term as well to predict and prevent future issues.
These best practices can be applied to any patient’s treatment program to help you use cephalometrics more effectively. Over time, orthodontists are learning more and more about the power of cephalometrics, so it’s important to stay up to date on how to best apply analysis during treatment planning and assessment. What’s your experience with cephalometrics? Do you have any other tips we should include?