Computerized cephalometric systems
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Computerized cephalometric systems were introduced in the 1970s and are now widely used in orthodontics for diagnostic and treatment evaluation purposes. They allow orthodontists to visualize the facial effects of treatment, design ideal facial structures, and predict outcomes of growth, orthodontic movement and orthognathic surgery. Key advantages over manual techniques include increased speed, removal of human error, easier storage and retrieval of data, and improved prediction of surgical outcomes. Landmark identification and analysis can be performed digitally. Contemporary computerized cephalometrics have become essential for orthodontic diagnosis and treatment planning.
Computerized cephalometric systems
- 2. INTRODUCTION • Cephalometric radiography was introduced in 1930’s and computerized cephalometry in 1970’s. • Used in Orthodontics for diagnostic, prognostic and treatment evaluation. www.indiandentalacademy.com
- 3. Communication with patients through graphic imaging. Visualize facial effects of treatment before final decisions are made. Allows the Orthodontist to design the face first and measure what is needed to get there. COMPUTERS HAVE FACILITATED www.indiandentalacademy.com
- 4. COMPUTER APPLICATIONS IN PREDICTION • It offers treatment planing manipulations such as growth estimation, orthopedic intervention, orthodontic tooth movement and orthognathic surgery. • Can be used for case diagnosis and treatment planing. • Can be used for formulation of computer generated treatment plans, so called visual treatment objectives (VTO’s) or surgical treatment objectives (STO’s).www.indiandentalacademy.com
- 7. ADVANTAGES OVER MANUAL TECHNIQUE • Faster than manual technique. • Removes human error except for errors of landmark identification. • Facilitates the use of double digitization of the land marks and the significantly increases the reliability of the analysis.www.indiandentalacademy.com
- 8. Contd... • Easy storage and retrieval of cephalometric values and tracing. • Cephalometric data can be combined with patient’s files, photographs and dental casts. • In Orthognathic surgery computerized cephalometric prediction of the surgical outcome on hard tissue and soft tissue profile are better than manual technique.www.indiandentalacademy.com
- 11. TECHNICAL PRINCIPLES • It can be divided in to two components 1. Data Acquisition 2. Data Management • Data acquisition is achieved by various means including ionizing radiation, magnets, sound and light. www.indiandentalacademy.com
- 12. IMAGE ACQUISITION • Three methods are available 1. The phosphor plate technique 2. Direct receptor technique 3. Transparency scanner technique www.indiandentalacademy.com
- 13. THE PHOSPHOR PLATE TECHNIQUE • Uses Photo stimulable phosphor plates instead of film. • Conventional X-ray tube is used to expose the plate. • The sensitivity of the plate allows a reduction in x-ray exposure up to 90%. • Plates are reusable.www.indiandentalacademy.com
- 14. DIRECT RECEPTOR TECHNIQUE • Photo sensitive such as a CCD in place of x-ray film. • Conventional x-ray tube is used. • The sensor transfers its data through a thin cable directly to an interface board in a computer • Data are converted to a gray scale image and saved to the disk. www.indiandentalacademy.com
- 15. TRANSPARENCY SCANNER TECHNIQUE • Simplest and least expensive method. • X-ray film is scanned by a light source. • The transmitted light is detected by a CCD and is digitized into gray scale intensities. www.indiandentalacademy.com
- 16. DIGITIZATION • A process by which analog information is converted into digital form. • Digitizer is an inexpensive, accurate tool for digitizing cephalograms. • Digitizers may be opaque, translucent or transparent. www.indiandentalacademy.com
- 17. Two modes of digitization • Two modes of digitization 1. Point mode 2. Stream mode • Point mode digitization refers to the discrete location of individual landmarks. • Stream mode digitization : A process in which a stream of coordinate pairs is recorded as the user traces a radiographic contour and is controlled by programmable options.www.indiandentalacademy.com
- 18. CEPHALOMETRIC ANALYSIS AND TREATMENT PLANING • Cephalometrics - 1. Static function 2. Dynamic function • Static function - Information is derived from the radiographic contours on a current film or collection of films. • Dynamic function - Elements of the cephalometric representation are transformed or manipulated. www.indiandentalacademy.com
- 19. DIFFERENT TYPES OF COMPUTERIZED CEPHALOMETRIC SYSTEMS • RMO’s (Rocky Mountain orthodontics) Jiffy orthodontic evaluation. • The first to provide a computer aided cephalometric diagnosis in 1960. • JOE is a static analysis program. • Tracing of lateral or frontal cephalograms using Ricketts, Jarabak, Sassouni, Steiner and Grummons analyses. www.indiandentalacademy.com
- 20. POR DIOS (Purpose on request Digitizer input output System) • Is capable of solving measuring problems the two dimensional Cartesian coordinate system. • Based on a library of mathematical procedures (i.e. angular and linear) • It uses Cephalometric analysis including Bjork, Burstone, Coben, Downs, Frontal McNamara, Profile, Ricketts, Seiner and Tweed.www.indiandentalacademy.com
- 21. Contd… • Capable to produce occlusograms from photocopies of dental casts. • It is multilingual. • Can produce a database file containing the results of the digitization. www.indiandentalacademy.com
- 22. DENTOFACIAL PLANNER • Computer aided diagnostic and treatment planing software system. • It works with an IBM compatible to 286 or 386processor. • It allows to do superimpositions, estimate facial growth, to simulate the skeletal and soft tissue effects of orthopedic appliances and to stimulate orthodontic tooth movement.www.indiandentalacademy.com
- 23. QUICK CEPH IMAGE • Programme designed especially for high end macintosh computers. • A high resolution monitor should be used. • The Hardware also consists of a black- white camera, camera stand and a colour printer. • It allows the user to take all the patient’s pictures, including intra orals. www.indiandentalacademy.com
- 24. DIGI GRAPH • Is a synthesize of video imaging, computer technology and 3 dimensional sonic digitizing. • Work station equipment measures above 5 feet x 3 feet x 7 feet. • This device uses sonic, digitizing electronics to record cephalometric landmarks by lightly touching the sonic digitizing probe to the patients skin. • Three dimensional www.indiandentalacademy.com
- 25. Digigraph uses sonic digitizing electronics to record cephalometric landmarks by lightly touching the sonic digitizing probe to the patient’s skin. www.indiandentalacademy.com
- 26. TREATMENT VISUALIZATION APPLICATIONS • Applied to cephalometric projections of anticipated growth and treatment response. • Two visualization approaches 1. Image Editing 2. Manipulation of linked photocephalometric pairs. www.indiandentalacademy.com
- 27. Graphic Imaging - Treatment simulations Initial Record High pull H. G 4’s Extraction Growth Forecast Mandibular Advancement www.indiandentalacademy.com
- 28. IMAGE EDITING SYSTEMS • Facial images are modified using a variety of simple image editing tools to stimulate the effects of the treatment on facial form. www.indiandentalacademy.com
- 29. PHOTO CEPHALOMETRIC TREATMENT VISUALIZATION • These are done by linking digitized lateral cephalograms to lateral facial bitmapped imaged for automatic facial transformation. • Treatment visualization applications perform cephalometric prediction and image transformation in a manner that appears tobe virtually simultaneous. www.indiandentalacademy.com
- 30. PHOTO CEPHALOMETRIC TREATMENT VISUALIZATION www.indiandentalacademy.com
- 31. SELECTION OF COMPUTERIZED SYSTEM • User friendly • Should transform all digitized points into x and y co- ordinates, • Compatible with all cephalometric analyses. • Easy to modify and add new points to the system. • Should have a graphic demonstration of the patient’s structures. www.indiandentalacademy.com
- 32. Contemporary diagnosis and treatment planning have been taken to a different level with the advent of computerised cephalometrics. With ever widening technological advances, this will be the future of orthodontic diagnosis, treatment planning, prediction of growth and treatment outcome, be it orthodontic treatment or orthognathic surgery. www.indiandentalacademy.com