Soft tissue clinical

And
cephalometric analysis

Beauty IS in the eyeS of the beholder

Margaret Hungerford - 1878

IS BEAUTY QUANTIFIABLE ??

YES, BEAUTY PROBABLY IS UNDERSTANDABLE

AND QUANTIFIABLE TO SOME EXTENT

Facial attractiveness Recognition of beautiful face comes from

within.
Translating to treatment goals is
problematic.
Recognizing beauty is not practiced nor it
is difficult
Rules not understood nor reqd.
Corroborated by health professionals and

Orthodontic treatment - change in

the face.
Patient judges the outcome - facial
esthetics.

Pre and Post

Treatment photos

- Orthodontists and maxillofacial and

plastic
surgeons
- study of human face and profile
- search of guidelines for optimum
treatment rules
- Treatment planning of facial esthetics not
easy
- Plus we have to take care of the whole
mouth too!!

Ancient

times

istorically human form measurements.

1 - self portrayal in sculpture, drawing and paintin

2 - relation of physique - health, temperament an

behavioral traits.

Paleolithic age some 35,000 years ago

Egyptians

Greeks

The Egyptian culture - monuments and tombs

some 5,000years ago as also the Greeks and
the Romans using a well detailed system called
the Canons which is used even in todays
times!
1st to use mathematics in art

THE CANONS

Unit
length of foot
18 Horiz lines

DIVINE
P R O P O RT I O N
Greek mathematician :

thagoras (560-480 B.C.) proved that the golden sec

as the basis for proportions of human figure
A

cannot be represented as finite number but an

approximation of - 1 : 1.618
has been said to possess inherent esthetic value

Dr. Eddy Levin introduced to dentistry in 1978

Sariputra

Indian Contribution

Alekhyalaksana

Ancient Indian Scriptures

Of Architecture,
also describes
Measurements of
face in great details

RENAISSANCE
TO
20TH
C E N T U RY

NHP

Leonardo da Vinci (1451 1519)

Albrecht Durer
Petrus Camper
Spix
Welcker
Hellman
Korkhaus
Bjork

2 0 T H C E N T U RY

Craniometry to Cephalometry

Van Loon
Paul Simon
Piccani
1922
Carrera
1931 Broadbent
Hofrath
Lucien de Coster

Ceph analysis used as standard bcoz

- easy to
procure
measure
compare
Hard tissue structures

And the belief that treating the ceph treats the face

- Therefore a comprehensive detailed clinical analys

is a must along with ceph analysis
-Paradigm shift

Facial examination

Clinical

Cephalometric

ALL OF THE FOLLOWING

DISCUSSION IS
NOT ONLY FOR
ORTHODONTIC TREATMENT
PLANNING
BUT IS EQUALLY APPLICABLE FOR
SURGICAL ORTHODONTIC
PLANNING.

FACIAL KEYS TO ORTHODONTIC DIAGNOSIS

AND TREATMENT PLANNING. PART I & II
Arnett & Bergman
AM J ORTHOD ORTHOP 1993; 103:299-312
AM J ORTHOD ORTHOP 1993; 103:395-411

Aims
- To present an organized, comprehensive
clinical
analysis
- to discuss soft tissue changes asso with
orthodontic
/ surgical treatment

Clinical Analysis

A comprehensive analysis
as been proposed by
Arnett and Bergman.

extbook titled

FRONTAL VIEW

CLINICAL ANALYSIS
PROFILE VIEW

FRONTAL
VIEW
&
PROFILE VIEW

- NHP,
- Centric relation,
- Relaxed lip posture

NHP

People dont walk around with

FH plane parallel to the floor!!

Natural Head Position (NHP)

NHP has 2* SD compared to 4* - 6* SD for FH plane

Modified NHP
To mask class II / class III pattern
e. g. -

Centric relation

1st tooth contact

Centric occlusion maximum

intercuspation

. Pt. in 45* sitting position

2.

. Use warm double thickness

piece of pink base plate wax

3. Guide opening & closing to

1st tooth contact
4. Trim the wax bite till
buccal
surfaces of teeth
5. Repeat step 3.
3.

4.

3.

6.

7.

6. Wash the wax bite in cold

water
7. Repeat step 3.

Bite open wax bites

llows lips to adapt non-compressed position

n cases skeletal or dental discrepancy
compression of upper lip with teeth in occlus

Relaxed lip posture

Ask pt to relax
Stroke lips gently
Multiple measurements
Use casual observation

ensures ST diagnosis accuracy

surgical plans will be correct
- as ST demonstrated irt hard tissue
- no muscular compensation

Reqd to assess vertical disharmony

nclusion of a trait
Dependant on high
significance to successful
ortho & surgical treatment.

19 Facial keys

FRONTAL VIEW

eneral outline form

Wide or narrow, short or long, or round

ygomaic arch, mand angle, body, chin
igonial width 30% - zygomatic width

Midline assessments
- establishing the midline of the face
- reliability of philtrum

Horizontal reference lines

Mandibular deviations and occlusal cants

VERTICAL ASSESSMENT FACIAL THIRDS

- MIDDLE AND LOWER THIRDS RARELY EQUAL

- MID TO LOWER THIRD RATIO LESS IMP
THAN VERTICAL RELATIONSHIPS AMONG STRUCTURES
WITHIN LOWER THIRD OF FACE

ULL
+
INTER L GAP
+
LLL

Normal ratio - 1 : 2.2

Proportionate lips harmonize, regardless of length

UPPER I CROWN LENGTH

DENTAL OVERBITE

-MAX CENTRAL I 9.5 11.5mm

- OVERBITE

UPPER INCISOR EXPOSURE - LIPS AT REST

EXPOSURE OF UPPER I AND GINGIVAL

TISSUE WHEN SMILING

Normal - 3 quarters of incisor length

CLOSED LIP POSITION

- Reveals disharmony between skeletal
and soft tissue lengths
- With balanced lip and skeletal lengths,
- lips should close from a relaxed,
separate position without
- lip, mentalis or alar base strain

UPPER & LOWER VERMILLION BORDERS

SUMMARY

PROFILE VIEW

NHP
CENTRIC RELATION
RELAXED LIPS

HIGH MIDFACE AREA

- GLABELLA - ORBITAL RIM
- SUBPUPIL - CHEEKBONE
- FLAT

- NORMAL

- PROMINENT

- COVER REST
OF FACE WITH
SHEET OF PAPER

MAXILLARY AREA
- NASAL BASE - UPPER LIP SUPPORT
- NASAL PROJECTION

UPPER LIP PROMINENCE

MANDIBULAR AREA

OWER LIP - ST POG - THROAT LENGTH & CONTOU

- OVER JET

SUMMARY

SOFT TISSUE CLINICAL

AND
CEPHALOMETRIC ANALYSIS

Dr. SumiT Gupta

Previous Session Recap..

History
ancient times to present
We stand on our forefathers shoulders

evious Session Recap.

- Craniometry Cephalometry
- Intro of cephalometry / inventors
- Paradigm shift to Soft Tissue
planning
rather than planning
for the hard tissues alone

evious Session Recap.

- Analysis is clinical (Frontal & Profile)

- Middle 3rd & Lower 3rd
- High midface, Maxillary region
Mandibular region
- Arnett & Bergman 1993
2-part article
- 19 facial keys
- Arnett et al 1999 STCA

evious Session Recap.

- A comprehensive analysis
has been proposed by
Arnett and McLaughlin.
Textbook titled
- NHP / Modified NHP
- Centric relation / occlusion
- Bite-open wax bite

ALL OF THE above & the FOLLOWING

DISCUSSION was / is
NOT ONLY valid FOR
ORTHODONTIC TREATMENT PLANNING
BUT IS EQUALLY APPLICABLE FOR
SURGICAL ORTHODONTIC PLANNING.

Various Soft Tissue cephalometric analyses

have been put forth.
Steiner
Ricketts
McNamara
Merrifields Z angle
Holdaway
Burstone COGS
Arnett, Bergman et al - STCA

SOFT TISSUE CEPHALOMETRIC ANALYSIS

DIAGNOSIS AND TREATMENT PLANNING
OF DENTOFACIAL DEFORMITY
Arnett, Bergman et al
AM J ORTHOD DENTOFACIAL ORTHOP 1999; 116:239-53

Techniques
Natural Head Position (NHP)
Soft Tissue Cephalometric Analysis
(STCA)

approach for obtaining ce

n the Natural Head Positio
N. SLEEVA RAJU ET AL
JOURNAL OF ORTHODONTICS / VOL. 28 / 2001 / 25 - 28
7 6
016 SS wire

KAVO Light
Source 12 V

5
3

4 kg

58

ural

Head

Position''

Recordin g

&

Constru

59

ft

Tissue

Cephalometric

Analys

( S T C A )
46 variables.
3 regions of face.
Linear
measurements
in mm.
Angular
measurements

Facial Divisions
60

3 groups of patients

Group III
Orthognathic cases

Group I
Orthodontics

Group II
Orthodontics with Dental
Compensation & Growth
management

61

Metallic Midface Markers

Soft Tissue
Orbital Rim
Cheekbone

Sub pupil
Nasal base
62

5 (STCA) + 2 (NHP)
markers in place

Neck-throat junction
63

Positioning for Cephalogram

64

Resulting Cephalogram.

Projection
Natural Head
Position

True Vertical
Line

65

Orbital Rim :

Cheekbone :

- High correlation
Deficiency in groups
Protrusion rare
between
Heat cured hydroxyapatite flat or soft
(HCH)
cheekbones and
max retrusion
- Augmentation / HCH

Subpupil Area :
- Le Forte I
- Max rarely moved
post.
concavity of nasal
base
- nasolabial folds ageing

he Nasal Base :

Supp by max
so, presents as nasal base
concavity, flatness, softness
Le Forte I
max rarely moved post

he Nasal Projection :

Can b max A/P position indicator

long nose with normal max projection
rhinoplasty
imp in max adv cases;
dec nasal projection - limits max adv

Parameters of the STCA

.Dentoskeletal Factors 4. True Vertical Line (TVL)

Projections

a) Projections
b) Heights or Lengths

Soft Tissue Thickness

Facial Heights
or Lengths
a) Soft Tissue
b) Hard Tissue

a) High Mid Face

Projections
b) Maxillary Projections
c) Mandibular Projections

5. Harmony Values
a) Total Facial Harmony
b) Soft Tissue Infra Orbital rim
to Jaw Harmony
c) Maxilla to Mandible

Skeletal
&
Dental
factors
Projections
Mx1 inclination
Mx1 projection to TVL
Overjet
Md1 inclination
Md1 projection to TVL
Heights or Lengths
Mx1 exposure relaxed lip
Overbite
Md anterior ht
Posterior height

Soft Tissue Thickness

Thickness
Thickness
Thickness
Thickness

of
of
of
of

UL
LL
ST pog
ST menton

ST thicknesses + 9 sk & dental factor

largely control esthetic balance
of lower 3rd of face

Facial Heights & Lengths

ST heights and lengths

-

ULL
Inter labial gap
UI exposure
LLL
Ht / L of lower 3rd of face
Total facial ht / L

Hard tissue
-

Ht / L of max
Overbite
Md Ht chin L
Angle of Max occlusal plan
to TVL this is a measure
of Posterior ht of max

Projections to TVL
TVL

- High mid face

- Maxilla

to be moved 1-3mm in cases of maxillary retru

- Apparently long nose
- Depressed or flat
- orbital rims
- cheekbones
- subpupils
- alar bases
- Poor incisor support for UL
- Upright UL
- Thick UL
- Retruded UI(s)

Harmony Values
- Imp for component of beauty

- det by position of each landmar

relative to others
- Horizontal distances btwn 2
landmarks

- If ST pog is strng normal

ST B pt is weak normal
disharmony between 2
can b detected
- Esp aftr large chin augm

- more closer the parts,

more clear the disharmon

Total facial harmony

- Facial angle

- does not identify source of disharmon

- forehead compared to max (pt A)
- forehead to mandi (pt B)

- 3 broad picture of facial disharmony

- abnormal A/P position of jaw/jaws
abnormal relationship to forehead

S T infraorbital rim to Jaw harmony

- Evaluates ST infraorbital rim to

upper and lower jaw
- Clinical exam & STCA to
determine ST orbital rim position
- Jaw / jaws in abnormal A/P
relationship
revealed by abnormal balance
with
ST orbital rim

Maxilla to Mandible harmony

- Esthetics of lower 1/3rd face
- most chngd by treatment
- relation between max base &
chin, ST B & ST A and UL & LL
- If disharmony exists it will b clear
which jaw

- If not clear, Upper/Lower jaw harmony

to forehead & orbital rim will reveal it

Mandibular harmony
- Chin protrusion relative to lower incisor
lower lip, ST B point.

-Indicates chin position to other mandi sts

- Reveals which structure abnormally plac

dec d from mandi I tip to chin may indicate flared lower in

all HT pog, thin ST in chin region, steep occlusal plane.

ation of ST B point to ST pog is 1 indication of chin contour.

malizing these relations is imp, as chin projection is main

sideration for facial balance.

Soft tissue clinical

And
cephalometric analysis

Dr. SumiT Gupta

EDMOND H WUERPEL
A face is beautiful
and shows harmonious features if
the proportions of its individual
components are right

CALVIN CASE

A balanced profile
should be one of the key factors in
deciding the method of treatment
for any form of malocclusion

Angular Profile
Analysis

( SUBTENLY )

skeletal soft tissue and full soft tissue (including

nose)
I

a) S T PROFILE ( N Sn Pog ) AVG VALUE 161

Convexity does not change with age
I

b) TOTAL S T ( N No Pog ) AVG VALUE -137 (M) &

O
133 (F)
Convexity increases with age - anterior growth of
the nose.

UBTENLYS PROFILE THICKNESS ANALYSIS

Soft tissue thickness at the Glabella remains constant

Thickness of Sulcus Labrale Superius increases by
approximately 5 mm
Thickness of Sulcus Labrale Inferius increases by
approximately 2 mm

According to Subtenly there is a greater increase in

maxillary than the mandibular soft tissue profile which
explains why the soft tissue grows more convex with age

Steiner Lip
Analysis
Reference point
Centre of the S
SHAPED CURVE
between the tip of
Nose and Sub Nasal
-SOFT TISSUE
POG
Lips behind this
point - flat
(RETRUSIVE)
Normal
Retrusive

Protrusive

Lips ahead of this

line - too prominent

Ricketts

Lip Analysis

Reference line connects

NOSE TIP to SOFT TISSUE
POGONION - E LINE
Lips are analysed
depending on the distance
of the lips from this line
NORMAL VALUES
UPPER : 2-3 mm
LOWER : 1-2 mm

Burstone B Line

- ST subnasale - ST pog
- UL 3.5mm
- LL 2.2mm

Sushner S2 Line

- ST N ST Pog
- African population lips
ahead

Merrifields Z angle
Chin lip ST to FH plane
= facial balance
Was developed as adjunct to
FMIA
Responsive to max I position
Further defines facial esthetics
Immediate guidance relative to
anterior tooth positioning

If pt has normal FMA, FMIA, Z angle shud be 78*.

If any 3 not in optimal range
Tooth position alteration to favorably influence facial pattern

Holdaway

1 TOTAL MEASUREMENTS

FACIAL ANGLE
UPPER LIP CURVATURE
SKELETAL CONVEXITY
AT POINT A
H-LINE ANGLE
NOSE TIP TO H LINE
UPPER SULCUS DEPTH
UPPER LIP THICKNESS
UPPER LIP STRAIN
LOWER LIP TO H LINE
0 LOWER SULCUS DEPTH
1 CHIN THICKNESS

Facial angle

FH PLANE - N TO POG

AVG - 90-92*

Greater angle - Protrusive lower jaw

Lesser angle - Retrusive lower jaw

UPPER LIP CURVATURE

FH PLANE TO TIP OF UPPER LIP.

Depth of upper sulcus measured.

AVG VALUE 1.5 4.0 mm

H line angle H-line and N to Pog line

Avg Value- 7- 15 Degrees
Measures upper lip prominence
or retrognathism of the
Soft tissue chin

Skeletal convexity at point A

N-pog Line to Point A
AVG VALUE - +2 TO -2 mm
Assess facial skeletal
Convexity relating to lip
Position

Nose Tip to H-Line

12 mm max

Upper Sulcus
Depth
5 mm

Lower Lip to H
Line
-1 - +2mm
Lower
sulcus depth

5 mm

Soft tissue Chin thickness

10 - 12 mm

Upper lip thickness

a point 2 mm below Point A to
outer border of upper lip.
AVG - 15 mm

Upper lip strain

Lip vermillion border to
labial surface of the Max CI

CEPHALOMETRIC ANALYSIS
FOR
ORTHOGNATHIC SURGERY
(COGS)

HARRY LEGAN AND CHARLES BURSTONE

Journal of Oral Surgery 1980

HORIZONTAL
PLANE

COLUMELLA

CERVICAL
POINT

GNATHION

G to Sn , Sn to Pog
MEAN VALUE - 12*
POSITIVE VALUE CLASS II
NEGATIVE VALUE - CLASS III

ANTERO - POSTERIOR MAXILLARY AND MANDIBULAR

MEASUREMENTS ,
mean value 6 mm

Sn to Gn , Gn to C
MEAN VALUE 100
DEGREES
DECREASE IN VALUE
INDICATES
PROMINENT CHIN

UPPER AND LOWER LIP

PROTRUSION
Sn

Mean Values

Ls
Li

Pog

Ls Sn Pog

3 mm

Li Sn Pog

2 mm

MENTO LABIAL SULCUS

Li
Sm
Pog

Mean Value - 4 mm

NASOLABIAL ANGLE

Mean Value - 102

VERTICAL LIP CHIN RATIO

Mean Value - 1:2

INTER LABIAL GAP

Mean Value - 2 mm
MAXILLARY INCISOR
EXPOSURE

Mean Value - 2 mm

nalysis of tongue position

Criteria for ref line

THREE REFERENCE POINTS

ARE USED

I INCISAL EDGE OF LOWER

INCISORS

Mc DISTAL AND CERVICAL

THIRD OF LAST ERUPTED
MOLAR

V MOST CAUDAL POINT ON

THE SHADOW OF SOFT
PALATE

IV LINE IS BISECTED AT
POINT O WHICH IS THE
MIDPOINT

1) Tongue position

1 root of tongue
2 6 relation of dorsum to
roof of mouth
7 tip of tongue to relative to
lower incisors

- Compare between tongue in

dental occlusion and rest positio

2) Tongue motility

- Assesses actual change in tongu

position, independent of
inter-occlusal space

- Occlusal position is taken as ze

- +ve tongue higher in rest pst

-Root of tongue

- Small space nasal abnormalities

- small tongue
- cl III cases small tongue smtimes,
which is in ant pst, so lrg space
- mouth breathing

Dorsum of tongue rel high cl II malocclusions

- deep overbite dorsum high at back
- low in front

Schwarz
Photographic analysis
1958

vg face Subnasale touches skin N

aw Profile Field). Gn on Orbitale
nteface
etroface
- Disadvantageous

, Pog lies in center of

Straight Avg face T bisects vermillion portion of UL

- touches border of LL

T Mouth tangent
(SN ST Pog)

traight

Facial divergence

- Forehead and UL border

Concave

Convex
- Border of UL ST pog

Frontal View
- Disproportions
- Asymmetries

- Camera to b placed perpendicular to facial midline

- point to remember mild physiologic asymmetry exists
between 2 sides of face

Soft tissue profile in Anatonian Turkish adults :

Part I. Evaluation of horizontal lip position using
different Soft tissue analyses. Erbay EF, Erbay
SK.
Am J Orthod Dentofacial Orthop 2002;121:57-64

To cephalometrically investigate horizontal lip position of

Anatolian Turkish adults using the soft tissue analysis of

Steiner Ricketts Burstone Sushner Holdaway Merrifi

96 adults ( 55 males & 46 females )
Angle Cl I occlusal relationship

Results - U & L lips retrusive Steiner & Ricketts

- Normal Burstones B line
- UL protrusive; LL retrusive Sushner
- LL normal; nose projection greater
Holdaway
- Z angle small Merrifield

Various other
analysis
have been put
forth
by many authors

Stoner analysis AJO 1955

Elassers AO 1951
Negers AJO 1959
Beck & Beck AJO 1970
Lines analysis 1978 AJO
Ricketts AJO 1982
Bowker AO 1959
Burstone AJO 1958
Rakosi AJO 1959
Cox analysis 1971
Spradley analysis AJO 1981
Butow JOMS 1984
Worms Analysis AO 1976
Robison Analysis AJO 1986
Symond Erich 3-D digitization of
face and skull
JOMS 1985

Newer advances and techniques

Digital cephalometry
Laser scanning
Softwares
- Dolphin
- Vistadent
- OPAL

C o n c l u s i o n
Awareness / Growing interest in
looks
Urban lifestyles / Peer pressure
Television / Cinema influence
Rising Incomes of all the groups
Affordability

120

 Enhanced Treatment varieties

Multidisciplinary approach
Orthodontics / Surgery
Use norms to provide quality treatment
for specific ethnic races
Not just a generalized human looking
face

121

 No recipe for Beauty

Beautiful ??
- Poetic frame of mind
Balanced, Pleasant

122

THOMAS AQUINAS
FUNDAMENTAL TRUTH

OF ESTHETICS

THE SENSES DELIGHT IN THINGS DULY

PROPORTIONED

References

Articles

cketts RM. Esthetics, Environment and the law of Lip relatio

m J Orthod 1968;54:272-89

urstone CJ. The integumental profile. Am J Orthod 1958;44:1-

ubtenly JD. A longitudinal study of soft tissue facial structure

heir profile characteristics, defined in relation to underlying
ructure. Am J Orthod 1959;45:481-507

owns WB. Variations in facial relationship: their significance i

eatment and prognosis. Am J Orthod 1948;38:812-40

errifield LL. The profile line as an aid in critically evaluating

cial esthetics. Am J Orthod 1966;52:804-52

oldaway RA. A soft tissue cephalometric analysis and its use

rthodontic treatment planning - Part I.
m J Orthod 1983;84:1-28

shner NI. A photographic study of the soft-tissue profile of ne

pulation. Am J Orthod 1977;72:373-85

rstone CJ. Lip posture and its significance in treatment planni

J Orthod 1967;53:262-84

iner CC. The use of cephalometrics as an aid to planning and

essing orthodontic treatment. Am J Orthod 1960;46:721-35

ett GW, Bergman RT. Facial keys to orthodontic diagnosis an

atment planning. Part I.
J Orthod Dentofacial Orthop 1993;103:299-312

ett GW, Bergman RT. Facial keys to orthodontic diagnosis an

atment planning. Part II.
J Orthod Dentofacial Orthop 1993;395-411

nett GW et al. Soft tissue cephalometric analysis diagnosis

atment planning of dentofacial deformity.
m J Orthod Dentofacial Orthop 1999;116:239-53

gan HL, Burstone CJ. Soft tissue cephalometric analysis for

hognathic surgery. J Oral Surgery 1980;38:744-51

u NS, Jayade VP. A modified approach for obtaining cephalog

Natural Head Position. J Orthod 2001;28:25-28

bay EF, Erbay SK. Soft tissue profile in Anatonian Turkish adu
t I. evaluation of horizontal lip position using different Soft ti
alyses. Am J Orthod Dentofacial Orthop 2002;121:57-64

References

Text

books

ntemporary Orthodontics. 3rd edition. Proffit WR with Fields H

thodontics : Current principles and techniques. 3rd edition.

aber TM, Vanarsdall RL.

thodontics : Current principles and techniques. 4th edition.

aber TM, Vanarsdall RL.

diographic cephalometry. From basics to videoimaging.

ted by Alexander Jacobson.

lor atlas of dental medicine. Orthodontic diagnosis.

kosi T, Jonas I, Graber TM.

ndbook of Orthodontics. 4th edition. Moyers RE.

atlas of cephalometric radiography. Rakosi T.

References
SDMCDS
Orthodontics & Dentofacial Orthopedics
Department Studies

va Raju N. A modified approach for obtaining cephalograms i

ural Head Position and cephalometric standards for Indian
ulation based on Natural Head Position. 1996

yana Prasad. An evaluation of the validity of Steiners and

ekmores compromise formulae and Formulation of new set o
promise values as also hard and soft tissue norms for
an population. 1998.

ek B. establishing cephalometric norms, based on Natural He

tion for an Indian population at the ages of 14-15 years for fe
16-17 years for males. 2000.

Merci

131

I n t r o d u c t i o n

Cephalometry ?
Piccani and Carrera 1922
Hofrath and Broadbent 1931
133

The study of the morphological

relationships of various parts of the
face has also developed from its
early period of Craniometry- an
anthropologic three dimensional
method of measuring the skull and
head- to roentgenographic
Cephalometry a two dimensional
radiographic study of the skull. Since
the introduction of radiographic
cephalometry in 1931 by Broadbent
and Hofrath in U.S.A. and Germany
respectively

Somatotype
Hippocrates

Aristotle
Galen
Rostan
Viola
kretschmer

 Pin heads as metallic markers

0.3mm Staedtler Pencil
Kodak 8 x 10 in films

Materials Tracing Sheets

Metal scale
Cellophane tape
Mirror (5 x 3 feet)
Kavo 12 V lamp
016 SS wire

138

Profile Analysis
Proportional Analysis
Ideal profile ; Can be
divided into three equal parts
Frontal Third ( TrN)
Nasal Third (N - Sn )
Gnathic Third ( Sn Gn )
ANTERIOR FACE CAN BE
PROPORTIONED ( N Gn )
Midface - N To Sn - 45%
Lower Face Sn To Gn -55%

Short Upper Lip

Short Lower Lip

Steiner Sticks
- Graphical representation of Steiner analysis msrmnts
- Convenient short hand for presenting msrmnts
-

ANB

Indians spread all over the world

Norms good for
Orthodontists
Plastic Surgeons

144

SOFT TISSUE CEPHALOMETRIC LANDMARKS

SOFT TISSUE NASION

PRONASALE
SUB NASALE
SUB SPINALE
LABRALE SUPERIUS
STOMION
LABRALE INFERIUS
SUB MENTALE
SOFT TISSUE POGONION
SKIN GNATHION