Document Type : Original Article

Authors

Department of Orthodontics, V S Dental College & Hospital, Bengaluru, India

Abstract

Aim: Frankfurt horizontal and Sella-Nasion lines are the most widely accepted and used landmarks in cephalometric analysis. This study investigates the use of the Orbito-Condylion line extending from the Orbitale to the Condylion as a novel horizontal line for substituting the Frankfurt horizontal line. Similarly, the evaluation of the Orbito-Basion line as an alternative to the Sella-Nasion line in cephalometric analysis was done. We evaluated the reproducibility of the new horizontal lines and measured the angle between the Orbito-Condylion line and the Frankfurt line; and the angle between the Sella-Nasion and Orbitale-Basion line.
Methods: This investigation was carried out on 30 individuals. The Porion, Orbitale, Condylion, Sella, Nasion, and Basion were identified and marked. The angles between the orbito-meatal line (inferior orbital rim to the Porion; the Frankfurt line) and the Orbito-Condylion line (inferior orbital rim to the Condylion) were measured. Likewise, the angles between the Sella-Nasion line (center of sella tursica to Nasion) and the Orbito-Basion line (inferior orbital rim to Basion) were measured.
Results: Significant interobserver and intraobserver bias did not exist. The mean angle between the Frankfurt line and Orbito-Condylion line was 0.5°±2.27° and the mean angle between the Sella-Nasion line and Orbito-Basion line was 3.48°±3.11°.
Conclusion: This study showed the new lines have good reproducibility, reliability, and efficacy. The Orbito-Condylion and Orbito-Basion lines are reliable, reproducible, and easily identifiable, and has the potential as novel standard horizontal lines to supersede or complement the Frankfurt line and Sella-Nasion line in anthropological studies and clinical applications.

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Main Subjects

  1. Broadbent BH. A new x-ray technique and its application to orthodontia. Angle Orthod. 1931;1(2):45-66. doi: 10.1043/0003-3219(1931)001 <0045:ANXTAI>2.0.CO;2.
  2. Devereux L, Moles D, Cunningham SJ, McKnight M. How important are lateral cephalometric radiographs in orthodontic treatment planning?. Am J Orthod Dentofacial Orthop. 2011;139(2):175-81. doi: 10.1016/j.ajodo.2010.09.021. PMID: 21300228.
  3. Pittayapat P, Jacobs R, Bornstein MM, Odri GA, Lambrichts I, Willems G, et al. Three-dimensional Frankfurt horizontal plane for 3D cephalometry: a comparative assessment of conventional versus novel landmarks and horizontal planes. Eur J Orthod. 2018;40(3):239-48. doi: 10.1093/ejo/cjx066. PMID: 29016738.
  4. Ricketts RM, Schulhof RJ, Bagha L. Orientation-sella-nasion or Frankfurt horizontal. Am J Orthod. 1976;69(6):648-54. doi: 10.1016/0002-9416(76) 90147-0. PMID: 1064336.
  5. Lundström A, Lundström F, Lebret LM, Moorrees CF. Natural head position and natural head orientation: basic considerations in cephalometric analysis and research. Eur J Orthod. 1995;17(2):111-20. doi: 10.1093/ejo/17.2.111. PMID: 7781719.
  6. Sundareswaran S, Vijayan R, Nair PS, Vadakkepediyakkal L, Sathyanadhan S. Cephalometric appraisal of the sella turcica-a literature review. Iran J Orthod. 2019;14(1):2-9. doi: 10.5812/ijo.55972.
  7. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476): 307-10. doi: 10.1016/S0140-6736(86)90837-8. PMID: 2868172.
  8. Lundström A, Lundström F. The Frankfurt horizontal as a basis for cephalometric analysis. Am J Orthod Dentofacial Orthop. 1995;107(5):537-40. doi: 10.1016/S0889-5406(95)70121-4.
  9. Madsen DP, Sampson WJ, Townsend GC. Craniofacial reference plane variation and natural head position. Eur J Orthod. 2008;30(5):532-40. doi: 10.1093/ejo/ cjn031. PMID: 18632837.
  10. El Kattan E, El Kattan M, Elhiny OA. A new horizontal plane of the head. Open Access Maced J Med Sci. 2018;6(5):767-71. doi: 10.3889/oamjms.2018.172. PMID: 29875843.
  11. Park JA, Ha TJ, Lee JS, Song WC, Koh KS. Use of the orbito-occipital line as an alternative to the Frankfurt line. Anat Cell Biol. 2020;53(1):21-26. doi: 10.5115/acb.19.136. PMID:32274245.
  12. Koski K. Analysis of profile roentgenograms by means of a newcircle method. Dent Rec. 1953;73:704-13.
  13. Hassan B, Nijkamp P, Verheij H, Tairie J, Vink C, Van der Stelt P, Van Beek H. Precision of identifying cephalometric landmarks with cone beam computed tomography in vivo. Eur J Orthod. 2013;35(1):38-44. doi: 10.1093/ejo/cjr050. PMID: 21447781.
  14. Pancherz H, Hansen K. The nasion-sella reference line in cephalometry: a methodologic study. Am J Orthod. 1984;86(5):427-34. doi: 10.1016/s0002-9416(84) 90036-8. PMID: 6594065.
  15. Sarhan OA. Development of Method to Analyze Human Dento–facial Relationship .Thesis; University of Manchester Library: 2014.
  16. Mills JR. Principles and practice of orthodontics. London: Churchill Livingstone;1982.
  17. Bishara SE, Fahl JA, Peterson LC. Longitudinal changes in the ANB angle and Wits appraisal: clinical implications. Am J Orthod. 1983;84(2):133-9. doi: 10.1016/0002-9416(83)90177-x. PMID: 6576637.
  18. Järvinen S. Relation of the SNA angle to the NSAr angle in excellent occlusion and in malocclusion. Am J Orthod. 1982;81(3):245-8. doi: 10.1016/0002- 9416(82)90058-6. PMID: 6960712.
  19. Järvinen S. Saddle angle and maxillary prognathism: a radiological analysis of the association between the NSAr and SNA angles. Br J Orthod. 1984;11(4):209-13. doi: 10.1179/bjo.11. 4.209. PMID: 6594162.
  20. Zebeib AM, Naini FB. Variability of the inclination of anatomic horizontal reference planes of the craniofacial complex in relation to the true horizontal line in orthognathic patients. Am J Orthod Dentofacial Orthop. 2014;146(6):740-7. doi: 10.1016/j.ajodo.2014.08.012. PMID: 25432255.