30.40 Cephalometric Imaging and Analysis

30.40 Cephalometric Imaging and Analysis

Our Price$320.00$384.00Regular Price

Program
:
Self-Paced
|
College
:
OrthoTraining
|
Credits
:
16.0 CE Credits
|
Faculty
:
Dr. Rebecca poling
|
No. of Courses
:
1 Course
|
Days of Access
:
30 days
|
Target Audience
:
Dental Assistant, Dentist, Resident, Orthodontist

Specifications

Bundle Description

30.40 Cephalometric Imaging and Analysis Course

The Cephalometric Imaging and Analysis Course is actually 8 smaller courses where each one focuses on a special topic about cephalometrics. The run time for the entire course is 4 hours and there are 150 Knowledge Quiz questions which are listed under each smaller course.

This full course trains the individual to be an expert in understanding cephalometrics and explains why the methods that are taught are the best that are known at this time. The learner must pass all 8 smaller courses to develop expertise and earn the full 17 credits of the Cephalometric Imaging and Analysis Course. Individuals who have learned the important concepts from this course will be able to produce a cephalometric image, analyze it, and understand the significance of changes in cephalometric relationships over time.

This is the only orthodontic training program of its kind with multimedia movies demonstrating each step of a procedure, detailed checklists that list each step, and also specify the standard of quality to be achieved for the successful completion of a procedure.

Lessons of the Cephalometric Imaging and Analysis Course

This intensive course about cephalometric imaging and analysis includes 8 Lessons (Presentations and Knowledge Quizzes) in the following topics:

  1. History of Cephalometrics

  2. Producing the Cephalometric Image

  3. Cephalometric Skull Landmarks

  4. Cephalometric Radiographic Tracing by Hand

  5. 40 Common Cephalometric Measures

  6. Producing a Cephalometric Superimposition by Hand

  7. Digitizing and Analysis of a Cephalometric Image

  8. Cephalometrics Summary

Goals:

The goals of this course are to train the student in every aspect of cephalometrics so that at the completion of this course the student will

  1. Know the history of cephalometrics

  2. Produce an accurate and diagnostic cephalometric image

  3. Recognize, identify, and label important cephalometric landmarks on the skull

  4. Hand-trace a cephalometric radiographic image

  5. Identify, construct, measure, interpret the measure, and state the limitations of 40 common cephalometric measures

  6. Produce a cephalometric superimposition by hand and analyze the changes that have occurred during the treatment time period

  7. Digitize and analyze a cephalometric image with accurate results that match the same image that has been traced by hand

  8. Understand and correctly interpret the meaning of selected cephalometric measures for predictive diagnosis and interpretation of the changes that have occurred during a time period from a cephalometric superimposition

Each of the 8 topics has specific objectives that are taught in the presentation and then measured when the student takes the Knowledge Quiz. At the completion of the entire course, the student will be able to fulfill the goals of the course clinically at the standard set in the Steps Checklists and Quality Checklists for this course. Then, the student will be ready to start evaluating and analyzing cephalometric images.

A detailed description of each Cephalometric Lesson is provided on the introductory page for the topic.

Lessons of the Cephalometric Imaging and Analysis Course

Lesson 30.41-The History of Cephalometrics

Presentation: 20 minutes Run Time, Knowledge Quiz: 10 Questions1 CE Credit

Welcome to this course in Cephalometrics. This course was written by Dr. Robert Little, Professor Emeritus at the University of Washington, Department of Orthodontics, Seattle, Washington. Dr. Little taught a version of this course to orthodontic residents for many years. Dr. Rebecca Poling, an orthodontist, assisted in the production of this course.

Resources- Resources for this lesson that are included in the presentation are:

  1. The Cephalometrics History Script which is a script of the narration of this presentation.

  2. A list of Cephalometrics Reference articles that are useful for this course in cephalometrics.

  3. Copies of the original articles written by many of these pioneers about cephalometric assessment. Read these articles for a better understanding of the development of the standards that were set for completing a cephalometric analysis. These articles are very interesting. We are at another point in time where we have developed a new assessment tool, the 3-D scanner, and face similar challenges in developing standards of measurement that these pioneers faced almost a century ago.

Lesson 1--History of Cephalometrics-Goals and Objectives-

Goals-The goals of this lesson are

  1. To familiarize you with the development of the cephalometer and

  2. To describe to you the contributions made by the pioneers in cephalometrics

Objectives-At the conclusion of this course the student will:

  1. Describe the development of the cephalometer including the role of Holfrath

  2. Describe the unique features of B. Holly Broadbent’s original cephalometer

  3. Summarize the contributions of the following pioneers in cephalometric assessment:

  1. B. Holly Broadbent

  2. Allan Brodie

  3. William Downs

  4. Charles Tweed

  5. Richard Riedel

  6. Cecil Steiner

  7. Arne Bjork

  8. Robert Ricketts

  9. Reed Holdaway

Lesson 30.42-Producing the Cephalometric Image

Presentation: 20 minutes Run Time, Knowledge Quiz: 11 Questions1 CE Credit

Resources -The Resources that are included in this presentation are:

a. Chapter 2: Producing the Cephalometric Radiograph Script

b. CEPH01-Producing the Ceph Headfilm Steps Checklist

c. CEPH02-Ceph Headfilm Quality Checklist

 

Goal: At the conclusion of this lesson the student will be able to produce an excellent cephalometric headfilm and/or demonstrate proper patient positioning in a digital cephalometer.

Objectives-At the conclusion of this lesson the student will be able to:

a. Identify each part of the cephalometer and describe its purpose

b. Describe types of x-ray film and types of cassettes, or digital image positioning

c. Demonstrate placement of film into the cassette and placement of the cassette into the holder on the cephalometer or the digital image positioning

d. Identify, prepare, and position the patient in the ear rods of the machine

e. Discuss the importance of placement of the ear rods in the ear canal relative to Porion

f. Demonstrate positioning the patient in the ear rods correctly

g. Demonstrate sliding the film cassette inward

h. Demonstrate Nasion Guide positioning

i. Demonstrate adjusting the cephalometric settings

Lesson 30.43-Cephalometric Skull Landmarks

Presentation: 35 minutes Run Time, Knowledge Quiz: 24 Questions3 CE Credits

Resources -The Resources for this lesson are:

  1. Chapter 3: Cephalometric Landmarks Script

  2. List of landmark structures

Goal and Objectives-

Goal: At the conclusion of this course the student will be able to identify selected structures on a cephalometric image and relate them to bony anatomy on a skull

Objectives

At the conclusion of this course the student will be able to identify the following 24 landmarks on a cephalometric image and relate them to the anatomy of the skull:

  1. Basion (Ba)

  2. Cranial Base

  3. Sella Turcica (S)

  4. Greater Wings of the Sphenoid Bone

  5. Nasion (N or Na)

  6. Orbitale (Or)

  7. Key Ridges

  8. Porion (Po)

  9. Pterygomaxillary Fissure (PTM)

  10. Maxilla (Mx)

  11. Anterior Nasal Spine (ANS)

  12. A-Point (A)

  13. Upper 1 (U1 or 1)

  14. Upper 6 (U6 or 6)

  15. Mandible (Mn)

  16. Articulare (Ar)

  17. Gonion (Go)

  18. Menton (Me)

  19. Inner Contour of the Symphysis

  20. Pogonion (Pg)

  21. Gnathion (Gn)

  22. B-Point (B)

  23. Lower 1 (L1 line over 1)

  24. Lower 6 (L6 or line over 6)

Lesson 30.44-Cephalometric Radiographic Tracing by Hand

Presentation: 20 minutes Run Time, Knowledge Quiz: 34 Questions2 CE Credit

Resources -The Resources for this lesson are:

  1. Chapter 4: Cephalometric Tracings Script that contains the notes of the narration of each slide.

  2. CEPH-03-Ceph Tracing Steps Checklist lists the steps for performing an accurate tracing or digitizing of a headfilm

  3. CEPH-04-Ceph Tracing Quality Checklist is a checklist for you to use to check the quality of your tracing or digital marking of a headfilm for measuring to diagnose a patient’s skeletal and dental relationships.

  4. After working with many orthodontic residencies, one problem they all had was correct diagnosis of a cephalometric headfilm. This was usually due to the fact that the person who had digitized the film did not know the exact landmarks to be digitized which resulted in poor correlation with other diagnostic records. The saying was, “Garbage in, garbage out.” which really was a waste of time and effort.

  5. Three articles are also available under the Resources Link. The first article by William Downs was published in the AJO in 1948 and contains a Glossary of many of the structures that are traced on a headfilm. The second article is by Richard Riedel which was published in the Angle Orthodontist in 1952 and describes the use of the ANB measure to diagnose a skeletal Class II pattern. He also presents findings regarding the use of other measures in diagnosing some different skeletal and dental relationships. Finally, the third article is by Wendell Wylie published in the Angle Orthodontist also in 1952 which focuses on identifying and diagnosing patients with a vertical growth pattern. Some of the salient points in these 3 articles have been highlighted.

Goal: At the conclusion of this course the student will be able to identify 35 specific structures on a cephalometric headfilm, accurately trace or digitize these 35 structures, so that accurate measurements of the relationships among these structures can be made, to generate a correct diagnosis of the skeletal and dental pattern of the patient.


 

Objectives-

  1. As just mentioned in the Goal of this course, the student will be able to trace or digitize structures on a headfilm so that measures can be made to diagnose the skeletal and dental relationships of the patient. If structures are NOT accurately traced or digitized, the final diagnosis will not be correct and will lead to poor treatment planning that will produce an unacceptable result. So, accuracy is critical in this procedure.

  2. At the conclusion of this course the student will be able to identify and trace the following structures on a cephalometric headfilm:

 

1. Soft Tissue Profile

2. Posterior Cranium

3. Bone of the Forehead or Glabella

4. Nasion and the Nasal Bone

5. Sella Turcica

6. Anterior Cranial Base

7. Greater Wings of the Sphenoid Bone

8. Ethmoid Triad Detail

9. Both Orbits of the Eyes Including Orbitale

10. Both Key Ridges

11. Both Pterygomaxillary Fissures

12. Both Porions or Both Ear Rods

13. Basion

14. Articulare

15. Anterior Nasal Spine

16. A Point

17. Floor of the Nose

18. Palate

19. Posterior Nasal Spine

20. Internal Structures of the Palate

21. Maxillary Central Incisors

22. Both Maxillary First Molars

23. Most Anterior Mandibular Incisor

24. Mandibular Alveolar Bone and B Point

25. Pogonion

26. Gnathion

27. Menton

28. Mandibular Symphysis Internal Structures

29. Head of Each Condyle

30. Each Mandibular Ramus Posterior Borders

31. Gonion of Each Mandibular Border

32. Both Mandibular Borders

33. Both Mandibular Canals

34. Both Mandibular First Molars

35. The Lower Border of Both Third Molar Follicles

 

A note about learning from passing the quizzes…

  1. The most important concepts to take away when you learn this module is that you must identify and correctly trace or digitize the 35 structures listed in this module. You also must know the name of each structure (including both sides, if the structure is bilateral) and how to name and spell the name correctly. This may seem trivial and excessively detailed, but it is valuable information to remember when you are working clinically to know that you are being as accurate as possible in your procedure.

  2. The quiz questions regarding a group of structures have been randomized so you will learn to recall their names out of context, out of order on the list. You will also learn to spell these names. Unfortunately, you will need to memorize this content. As your knowledge of these landmarks and tracing points grows, you will start to recognize patterns in a patient’s facial structures without the need for a ceph headfilm. Then, when you examine a patient you will recognize the type of skeletal pattern the patient has and conclude how difficult that patient will be to treat orthodontically.

  3. After you have viewed this presentation and passed all of the quiz questions, you should definitely rest your brain with sleep. Then all of this new learning will be transferred to your cortex for long-term storage. When you take the Knowledge Quiz, you should try to answer each question without reference to the script or tracing checklist. If you can pass the Knowledge Quiz by just recalling what is stored in your brain, you will be much more likely to recall the correct information when you are in clinic without looking it up. You will have learned it once and for all!

Lesson 30.45 - 40 Common Cephalometric Measures

Cephalometrics - Chapter Five- 40 Common Cephalometric Measures –written and produced by Dr. Robert Little and Dr. Rebecca Poling.

Presentation: 60 minutes Run Time, Knowledge Quiz: 48 Questions5 CE Credits

Resources -The Resources for this course are:

  1. Chapter 5: Cephalometric Measures Script that contains the notes of the narration of each slide.

  2. CEPH-05A-Ceph Measures Steps Checklist lists the steps for measuring and analyzing 40 common ceph relationships.

  3. CEPH-06A-Ceph Measures Quality Checklist is a checklist for you to use to check the quality of your measuring a ceph image to diagnose a patient’s skeletal and dental relationships.

  4. Ceph Grid of 40 Measures-This is a summary grid of the 40 measures taught in this course. Print out or have handy on your computer as you learn this course. At the end of this course you should be able to look at this grid and visualize the position of the angle or millimeters of the measure. You should also recognize the shape of a normal relationship as well as the diagnostic indications of an abnormal relationship measure. Finally, you should be able to list some limits of the measure that make it inaccurate.

Goal: Your goal in this chapter will be to learn the 40 commonly used cephalometric measurements. These are but a small sample of the measurements that have been proposed since the cephalometer was first introduced in the early 1930’s. Understanding these presented in this lesson will prepare you to easily grasp other measurements that may be preferred in your practice.


 

Objectives-At the conclusion of this chapter the you will

  1. Describe how cephalometric measurements are a diagnostic tool of the structures of the head

  2. Identify and name the measures that evaluate the relationships of the

  1. Mandible and the maxilla to the cranium

  2. Mandible to the maxilla

  3. Dentures to each other

  4. Incisors to the alveolus or apical base of the maxilla and mandible

  5. Chin button to the mandible and facial profile

  6. Overall facial proportions, and the

  7. General facial pattern or facial type.

  1. Recognize a “normal” relationship

  2. Explain how a measure is diagnostic of a deviation from “normal”

 

The 40 measures are:

3 Primary Planes of Reference

Sella - Nasion (S - N)

Frankfort Horizontal (FH located from Po to Or)

Facial Plane (N - Pg)

Mandible to Cranium Relationship

Facial Angle (FH - NPgº)

S - N to Facial Plane (SN-Pgº)

S-N Plane to B Point (SNBº)

Maxilla to Cranium

SN Plane to NA (SNAº)

Nasion-A to Frankfort Horizontal (NA-FHº)

Mandible to Maxilla

NA to NB (ANBº)

NA to NB (ANBº) high-angle patient

AB to Nasion-Pogonion (ABNPgº)

AB to Nasion-Pogonion (ABNPgº) high-angle patient

Angle of Convexity (NA-APgº)

Angle of Convexity (NA-APgº) high-angle patient

A-B to Occlusal Plane (AB-OcPlº)

A-B to Occlusal Plane (AB-OcPlº) high-angle patient

Maxillary to Mandibular Dentures

Interincisal Angle (U1-L1º)

Occlusal Plane Angle to FH (OcPl-FHº)

Occlusal Plane Angle to FH (OcPl-FHº) high-angle patient

Occlusal Plane Angle to FH (OcPl-FHº) high-angle patient before and after surgery

Occlusal Plane Angle to SN (OcPl-SNº)

Overbite (OB mm)

Overbite (OB mm) and measuring an openbite

Overjet (OJ mm)

Incisor Position

Lower Incisor to Facial Plane (L1-NPg mm)

Lower Incisor to A - Pg Plane (L1-APg mm)

Lower Incisor Mandibular Plane Angle (L1-MPº or IMPAº)

Lower Incisor Mandibular Plane Angle (L1-MPº or IMPA) high-angle patient

Lower Incisor to Frankfort Horizontal (FMIAº)

Lower Incisor to Occlusal Plane (L1-OcPlº)

Lower Incisor to NB in Degrees (L1 - NBº)

Lower Incisor to NB in Millimeters (L1-NB mm)

Upper Incisor to N - A in Degrees (U1-NAº)

Upper Incisor to N - A in Millimeters (U1-NA mm)

Upper Incisor to S - N (U1-SNº)

Upper Incisor to Frankfort Horizontal (U1-FHº)

Measurements to Chin

Chin button (Pg-NB mm)

Holdaway Ratio (L1-NB mm verses Pg-NB mm)

Facial Proportions

Y Axis to SN (SG-SNº)

Y Axis to Frankfort Horizontal (SG-FHº)

Percent Nasal Height (% NH )

Mandibular Plane Angle to Sella Nasion (MP-SNº)

Mandibular Plane Angle to Frankfort Horizontal (FMAº)

Facial Pattern

"H" Angle (NB to Chin/Upper Lipº)

Upper Lip to Esthetic Plane (U Lip to Nose/Chin mm)

Lower Lip to Esthetic Plane (L Lip to Nose/Chin mm)

Chin to N-FH Perpendicular (“0" Meridian mm)


 

All of the quizzes of this chapter are to help you learn these common measures and become familiar with measurements that are “normal” so that you will recognize when you look at a ceph radiograph, you will see where there is a problem, even without measuring the ceph. When you are an experienced clinician, you will be able to look at a patient, suspect which relationships are not “normal” and then confirm your suspicions with a cephalometric analysis.

A note about learning from passing the quizzes…

The most important concepts to take away when you learn this module is that you must identify and correctly measure or digitize the 40 basic measures listed in this lesson. You also must know the name of each measure, the abbreviation of it, the construction of it, the calculation of it, the meaning or diagnosis of the result, and the limits that might make the measure less accurate. This is a lot of detail, but once you understand the meaning of these 40 common cephalometric measures you will be have much more expertise in diagnosis of the relationships of the hard and soft tissues of the skull.

The embedded quiz questions in the presentation and on the Knowledge Quiz are all “teaching questions” to help you really learn and understand cephalometric evaluation and diagnosis. It is a lot of learning. The learning and retention are important, not the score on the Knowledge Quiz.

After you have viewed this presentation and passed all of the embedded quiz questions, you should definitely rest your brain with sleep. Then all of this new learning will be transferred to your cortex for long-term storage. When you take the Knowledge Quiz, again, try to answer each question without reference to the script or Ceph Measures Grid. If you can pass the Knowledge Quiz by just recalling what is stored in your brain, you will be much more likely to recall the correct information when you are in clinic without looking it up. You will have learned it once and for all!

Lesson 30.46 - Digitizing a Cephalometric Image with Dolphin Software

Presentation: 10 minutes Run Time, Knowledge Quiz: 0 Questions1 CE Credits

This movie was recorded in 2015 by Dr. Poling when she was teaching orthodontic residents at New York University. There are no embedded quiz questions or a Knowledge Quiz. This is just a sample of the procedure of digitizing and then computer analysis of the dental and bony relationships of a patient. In practice, there will be new software programs available that will be more advanced than this sample program.

Lesson 30.47 - Producing a Cephalometric Superimposition Tracing by Hand

Cephalometrics - Chapter Seven- Producing a Cephalometric Superimposition Tracing by Hand –written and produced by Dr. Robert Little and Dr. Rebecca Poling.

Presentation: 20 minutes Run Time, Knowledge Quiz: 10 Questions1 CE Credit

Resources -The Resources for this course are:

  1. Chapter 7: Cephalometric Superimposition Script that contains the notes of the narration of each slide.

  2. CEPH-07A-Ceph Superimposition Steps Checklist lists the steps for performing an accurate Superimposition Tracing or digitizing of a superimposition of two cephalometric images

  3. CEPH-08-Ceph Superimposition Quality Checklist is a checklist for you to use to check the quality of your superimposition of two headfilm tracings for measuring changes in a patient’s skeletal and dental relationships between two time periods.

  4. Check that your cephalometric software that is used to create cephalometric superimpositions actually does accurate superimpositions. The superimposition procedure has been difficult to program in computer software. Otherwise, you will be making incorrect conclusions about the changes that have occurred during the different treatment time periods.

  5. Several articles relevant to the superimposition of cephalometric headfilm tracings.

Goal: Your goal in the following chapter will be to produce accurate cephalometric superimposition tracings. There are a number of superimposition techniques used by orthodontists. Understanding those presented in this chapter will prepare you to easily grasp other methods that may be preferred in your practice.

Rationale-What is the rationale for assessment with a superimposition?

single cephalometric film permits interpretation of the patient's skeletal and facial profile status at only one moment in development and treatment. A series of cephalometric headfilms taken on the same patient over a period of time, also called “serial cephalometric films,” are invaluable to monitor change over time and treatment.

Comparing the tracings of one film against the tracing of a film taken at a later time is done by creating a superimposition and then interpreting the differences between the two films. Interpreting serial headfilms can reveal the following:

  1. Changes of size and position of skeletal structures

  2. Changes in tooth position

  3. Changes in facial profile

  4. The effects of orthodontic treatment on structures of the head

  5. Changes due to relapse after treatment and

  6. Some prediction of future growth or changes with treatment and the prognosis for achieving results with different treatment plans.

This course teaches you the traditional method of hand-tracing a cephalometric superimposition tracing. Today, many cephalometric image digitizing companies may suggest their software does accurate superimposition tracings. Carefully analyze if the cephalometric images are correctly enlarged using a sizing template relevant to the other images that will be included in the superimposition. Also, be certain that the cephalometric images are superimposed accurately on the correct registration points by the computer software program.

Lesson 30.48 - Cephalometric Summary-Putting it all together…

This lesson is a lecture given by Dr. Poling at the AAO Annual Session in 2012. It was written and produced by Dr. Rebecca Poling. The Goal of this presentation is to put all of this information together so you understand the big picture of Cephalometrics.

Presentation: 45 minutes Run Time, Knowledge Quiz: 0 Questions2 CE Credits

Show More

Courses Included In The Bundle

Course Preview certi-img

30.40 Cephalometric Imaging and Analysis

by Dr. Rebecca poling

17.0 CE Credits

8 Lessons

4hr 0min

 30.40 Cephalometric Imaging and Analysis
coming-soon-img