Cephalometric analysis: manual tracing of a lateral cephalogram

Cephalometric analysis remains a preferred tool in the diagnosis and treatment planning of orthodontic and of orthognathic surgical cases.A cephalometric tracing can be prepared and analysed manually or by a computer using cephalometric tracing software.A number of software programmes on cephalometric analyses have been introduced but their widespread use has been restricted by cost factors, especially in situations having a constraint on resources.This report will give a step-by-step procedure to enable the identification of cephalometric points and planes used in orthodontic diagnosis and treatment planning and to facilitate the manual tracing of a lateral cephalogram.Cephalometrics ...literally "head measuring"... is the recording and interpretation of measurements of the skull made on standardized radiographs of the living head.Since the introduction of cephalometry by Broadbent and Hofrath in the 1930s, 1,2 the cephalometric technique has been regarded as a most important tool for orthodontists and maxillo-facial surgeons engaged in studying dental malocclusions and the underlying skeletal discrepancies.Applications for cephalometric analysis include case diagnosis, treatment planning, prediction of growth and the evaluation of treatment results.3 Manual tracing of cephalometric films is performed by identifying radiographic landmarks on acetate overlays and using these reference points to construct lines, planes and angles to enable the measurement of linear and angular values, using a millimetre scale and a protractor.This manual process can be time-consuming and the measurements obtained may be subject to error.Whilst advances in computer science have led to the widespread application of computers in cephalometry, 4 offering enhanced accuracy, nevertheless, the skills of manual analysis are still required.To enable the manual tracing of a cephalogram showing a true lateral view of the skull, and the identification of many of the cephalometric points and planes used in orthodontic diagnosis and treatment planning.• Acetate tracing paper: a sheet 210 mm x 160 mm.• Viewing box • Protractor • 300 mm ruler • Tracing template