SpeedyCeph Knowledgebase
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Introduction
Welcome to the SpeedyCeph Knowledgebase! SpeedyCeph was designed with the help of AI to be an easy-to-use, yet complex, online cephalometric analysis service. SpeedyCeph is perfect for both orthodontists and general dentists because it combines the advanced features of Dr. Ceph with simple per ceph pricing.
This knowledgebase is meant to describe the general operation of the SpeedyCeph system, and also cephalometrics in general. We will show how variables and constructed landmarks are measured and cover some notable figures in the field of orthodontics. SpeedyCeph is constantly being improved and updated with features from Dr. Ceph. Check out our Development Roadmap!
Getting Started
Purchase a SpeedyCeph analysis on our store to get started tracing cephs. Prices of ceph tracings are based on the complexity of the analysis. Simple analyses, like the ABO, are $20 and complex analyses, like the OSU, are $30. Add your analysis to the cart and go to the Checkout page. At the bottom of the Checkout page is the Patient Details section where you can enter patient information and upload an X-Ray. Within 24 hours of receiving your X-Ray we will trace it for you and send the tracing and analysis results to your email.
Orthodontics
Classes of Malocclusion
Measured from the distal surface of the lower molar to the distal
surface of the upper molar along the occlusal plane.
Class I: The normal position of the upper and lower molars
to each other.
Class II: When the lower molar is seen to lie posterior
(backward or distal) to the upper molar. Also referred to as
distocclusion.
Class II, Division 1: Class II molars and an abnormal
overjet of the incisors. The lower lip is usually displayed under
the upper anterior teeth and the upper lip is sometimes short.
Class II, Division 2: Class II molars with retrusive, or
posteriorly inclined upper anterior teeth. The lower lip is well
formed and both are adequate in length.
Class III: When the lower molar is too far forward of the
upper by at least one cusp. Also referred to as mesiocclusion.
Cephalometrics
Hand tracing every ceph is time consuming, whereas computerized cephalometry is very fast, thus enabling the orthodontist to obtain a more comprehensive diagnostic picture. The need for templates and retracings of acetate overlays is eliminated. An analysis can be performed in a fraction of the time compared to a normal manual registration because it is only necessary to identify the radiological points at the press of a button. The calculations are displayed within seconds. This process removes human error except for errors of landmark identification.
Notable Figures in Orthodontics
Burstone
The Cogs analysis was developed by Dr. Charles J. Burstone when it was presented in 1978 in an issue of AJODO. This was followed by Soft Tissue Cephalometric Analysis for Orthognathic Surgery in 1980 by Arnette et al. In this analysis, Burstone et al. used a plane called horizontal plane, which was a constructed of Frankfurt Horizontal Plane.
Jarabak
The Jarabak analysis was developed by Dr. Joseph Jaraback in 1972. The analysis interprets how the craniofacial growth may affect the pre and post treatment dentition. The analysis is based on 5 points: Nasion (Na), Sella (S), Menton (Me), Go (Gonion) and Articulare (Ar). They together make a Polygon on a face when connected with lines. These points are used to study the anterior/posterior facial height relationships and predict the growth pattern in the lower half of the face. Three important angles used in his analysis are: 1. Saddle Angle Na, S, Ar 2. Articular Angle S-Ar-Go, 3. Gonial Angle Ar-Go-Me. In a patient who has a clockwise growth pattern, the sum of 3 angles will be higher than 396 degrees. The ratio of posterior height (S-Go) to Anterior Height (N-Me) is 56% to 44%. Therefore, a tendency to open bite will occur and a downward, backward growth of mandible will be observed.
Sassouni
The Sassouni analysis, developed by Dr. Viken Sassouni in 1955,
states that in a well proportioned face, the following four planes
meet at the point O. The point O is located in the posterior cranial
base.This method categorized the vertical and the horizontal
relationship and the interaction between the vertical proportions of
the face.The planes he created are: Palatal Plane (ANS-PNS) Occlusal
Plane (Down's occlusal plane) Mandibular Plane (Go-Me) Plane
parallel inferior border of sella and is parallel to supraorbital
plane Supraorbital plane (Anterior clenoid to roof of orbits) The
more parallel the planes, the greater the tendency for deep bite and
the more non-parallel they are the greater the tendency for open
bite. Using the O as the centre, Sassouni created the following arcs
Anterior Arc - Arc of a circle between the anterior cranial base and
the mandibular plane, with O as the center and O-ANS as the radius.
Posterior Arc - Arc of a circle between anterior cranial base and
mandibular base with O as centre and OSp as radius. Basal Arc - From
A point should pass through B point Midfacial Arc - From Te and
should pass tangent to the mesial surface of the maxillary first
molar.
Center 'O' - a landmark that is the center of the area of
convergence of four planes.
Plane 1: (Parallel Plane)
Posterior Landmark: Clinoidale, (81)
Anterior Landmark: Roof of Orbit, (82)
Reference Landmark: Floor of Sella, (80)
Plane 2: (Palatal Plane)
Posterior Landmark: Posterior Nasal Spine, (45)
Anterior Landmark: Anterior Nasal Spine, (10)
Plane 3: (Occlusal Plane)
Posterior Landmark: Upper Molar Distal Cusp Tip, (23)
Anterior Landmark: Premolar Mesial Contact Point, (46)
Plane 4: (Mandibular Plane)
Posterior Landmark: Gonion, (27)
Anterior Landmark: Menton, (1)
Steiner
Dr. Cecil C Steiner developed the Steiner Analysis in 1953. He used S-N plane as his reference line in comparison to FH plane due to difficulty in identifying the orbitale and porion. Some of the drawbacks of Steiner's analysis includes its reliability on the point nasion. Nasion as a point is known not to be stable due to its growth early in life. Therefore, a posteriorly positioned nasion will increase ANB and more anterior positioned nasion can decrease ANB. In addition, short S-N plane or stepper S-N plane can also lead to greater numbers of SNA, SNB and ANB which may not reflex the true position of the jaws compare to the cranial base. In addition, clockwise rotation of both jaws can increase ANB and counter-clockwise rotation of jaws can decrease ANB.
Tweed
Dr. Charles H. Tweed developed his analysis in 1966. In this analysis, he tried describing the lower incisor position in relation to the basal bone and the face. This is described by 3 planes. He used Frankfurt Horizontal plane as a reference line.
Landmarks
Constructed Landmarks
Geometric Center of Landmarks (Relative to Frankfort
Horizontal) - a landmark that is at the geometric center of four
identifiable landmarks. As used in the Ricketts Analysis to identify
the geometric center of the ramus of the mandible (Xi).
Xi, (500)
Posterior Landmark: Posterior Border of the Ramus, (51)
Anterior Landmark: Anterior Border of the Ramus, (52)
Superior Landmark: Inferior aspect of sigmoid notch, (71)
Inferior Landmark: Inferior to center of sigmoid notch, (72)
Intersection of an Arc and a Plane - a landmark that is the
intersection of an arc and a plane. As used in the Sassouni Analysis
to locate the starting point for the Posterior Arc.
Post Arc & Parallel Plane, (510)
Arc:
Center Landmark: Center 'O', (508)
Reference Landmark: Dorsum Sella, (79)
Modified Plane:
Posterior Landmark: Clinoidale, (81)
Anterior Landmark: Roof of Orbit, (82)
Reference Landmark: Floor of Sella, (80)
Perpendicular Projection to a Plane - a landmark that is
projected onto a plane at the perpendicular. As used in the
Quadrilateral Analysis to identify the posterior end of the mandible
in determining the Mandibular Base Length.
J to GoGn, (507)
Landmark to Project: Point J, (78)
Plane:
Landmark Point 1: Gonion, (27)
Landmark Point 2: Gnathion, (2)
Perpendicular Projection to a Plane using a reference Plane -
a landmark that is projected onto a plane perpendicular to another
plane. As used in the Sassouni Analysis.
Cribiform Perpendicular, (509)
Landmark to Project: Cribiform Point, (85)
Plane 1:
Posterior Landmark: Clinoidale, (81)
Anterior Landmark: Roof of Orbit, (82)
Plane 2:
Posterior Landmark: Floor of Sella, (80)
Anterior Landmark: Floor of Orbit, (84)
Plane to Project to:
Posterior Landmark: Posterior Nasal Spine, (45)
Anterior Landmark: Anterior Nasal Spine, (10)
Intersection of two Planes - a landmark that is the
intersection of two planes. As used in any type of Class III
Prediction Analysis to locate Gonial Intersection.
Gonial Intersection, const, (519)
Plane 1:
Point 1: Articulare, posterior, (31)
Point 2: TangRamus, (142)
Plane 2:
Point 1: Menton, (1)
Point 2: TangGo, (143)
Variables
Two Point Linear Measurement - the linear distance in
millimeters between any two landmarks. Point 1 and Point 2.
e.g. #1 SN
Point 1 = Sella, (35)
Point 2 = Nasion, (38)
Three Point Linear Measurement - the shortest linear distance
in millimeters that Point 3 is from a line connecting Point 1 and
Point 2.
e.g. #22 Upper 1 to NA
Point 1 = Nasion, (38)
Point 2 = Point A, (9)
Point 3 = Upper incisor, incisal edge, (7)
Four Point Linear Measurement - the linear distance in
millimeters of a line from Point 3, perpendicular to a line
connecting Points 1 and 2, to the vertical intersection of Point 4.
e.g. #82 UFH
Point 1 = Porion, (49)
Point 2 = Orbitale, (40)
Point 3 = Point A, (9)
Point 4 = Nasion, (38)
Three Point Angular Measurement - the inside angle formed by
connecting Point 2 to Point 1 and Point 3 to Point 1. Point 1 being
the convergence of the two lines.
e.g. #9 SNA
Point 1 = Nasion, (38)
Point 2 = Sella, (35)
Point 3 = Point A, (9)
Four Point Angular Measurement - the inside angle formed by a
line connecting Point 1 and Point 2 and a line connecting Point 3
and Point 4. Points 1 and 3 being closest to the convergence of the
two lines.
e.g. #13 Mandibular Plane Angle
Point 1 = Porion, (49)
Point 2 = Orbitale, (40)
Point 3 = Gonion, (27)
Point 4 = Menton, (1)
Distance to Vertical - the shortest linear distance in
millimeters that Point 4 is to a line drawn through Point 3
perpendicular to the line connecting Points 1 and 2.
e.g. #53 WITS
Point 1 = Premolar mesial contact point, (46)
Point 2 = Upper molar distal cusp tip, (23)
Point 3 = Point B, (4)
Point 4 = Point A, (9)
Ratio, Two Linear Measurements - the ratio of one linear
measurement (Point 1) to another linear measurement (Point 2). Point
1 divided by Point 2.
e.g. #84 UFH/LFH
Point 1 = Variable #82 - UFH
Point 2 = Variable #83 - LFH
Angle of Two Planes - the inside angle formed where one
linear measurement (Point 1) converges with a second linear
measurement (Point 2).
e.g. #221 Occlusopalatal Angle
Point 1 = Variable #88 - FOP
Point 2 = Variable #172 - Palatal Plane
Difference, Two Lines - the remainder from subtracting the
linear distance of one linear measurement (Point 2) from the linear
distance of another linear measurement (Point 1).
e.g. #61 Maxillomandibular differential
Point 1 = Variable #11 Effective mandibular length
Point 2 = Variable #10 Effective maxilla length
Sum of Measurements - the result obtained from adding up to
three measurements (Points 1, 2, and 3)
e.g. #81 Sum of Saddle, Articular, Gonial angles
Point 1 = Variable #40 - Saddle angle
Point 2 = Variable #41 - Articular angle
Point 3 = Variable #42 - Gonial angle
Midpoint Linear Measurement - the linear distance in
millimeters of a line connecting the midpoints of Point 1 and Point
2 and the midpoints of Point 3 and Point 4.
Arc - an arc drawn with Point 1 being the center of the
circle and Point 2 being the reference point (radius). In the Image
View, Angle 1 is the starting point of the arc. If you want the arc
to draw beginning at the reference point (in this example, N), Angle
1 should be 0. If you want the arc to begin drawing 180 degrees from
the reference point, enter 180 in Angle 1. Angle 2 is the ending
point in degrees that the arc will draw.
e.g. - #176 Anterior Arc
Point 1 = Center 'O', (508)
Point 2 = Nasion, (38)
Bisected Angle - the plane created by bisecting the angle
formed by the intersection of two planes. Points 1 and 2 create the
first plane and Points 3 and 4 create the second plane. Points 1 and
3 being closest to the convergence of the two lines.
e.g. #175 Optic Plane
Point 1 = Clinoidale, (81)
Point 2 = Roof of Orbit, (82)
Point 3 = Floor of Sella, (80)
Point 4 = Floor of Orbit, (84)
Modified Plane - a line drawn parallel to another line or
offset by a specified number of degrees. Points 1 and 2 identify the
reference line. Point 3 is the reference point where the new line
will be drawn through. To specify the number of degrees to offset
the parallel line, in the Image View, Arcs and offset, enter the
number of degrees in Angle 1.
e.g. #171 Parallel Plane
Point 1 = Clinoidale, (81)
Point 2 = Roof of Orbit, (82)
Point 3 = Floor of Sella, (80)
Algebraic Formula - the result obtained from solving an
algebraic equation. The formula can contain other variables. For
example, if you want to include variable #283 in the formula, it
would be written as "var283". All three styles of parentheses "{[("
may be used. If a variable is used in the formula, be sure to
include it in the analysis prior to the variable that uses the
Algebraic Formula.
e.g. #285 Max-Mand Differential
Formula = var283 - {90 + [(var284 - 20) * 0.7]}
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Bibliography and Further Readings
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Lemchen, M.S. (1990) The DigiGraph work station. Part 2. Clinical
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