Computerized Cephalometrics

Triple “O” International offers the Bimler Elite® computerized cephalometric analysis. The tracing includes a complete diagnostic evaluation.

Radiographs in Orthopedics and Orthodontics

It is important that either a full mouth series of x-rays, or a panoramic x-ray, be taken on all patients that are being evaluated for orthopedic / orthodontic treatment regardless of the stage of dentition, deciduous or permanent. These x-rays are used to determine congenitally missing teeth, the pattern of eruption of un-erupted permanent teeth, impacted teeth, the stage of root resorption of deciduous teeth, the length of the roots of permanent teeth, the inclination of the roots of permanent teeth, and pathological condition of the bone or teeth such as cysts, abscesses, caries or supernumerary teeth.

A lateral radiographic headplate (Cephalometric x-ray) also should be taken in order to determine the relationship of the teeth to each other and to the bones of the skull as well as to determine the skeletal relationship of the cranial base, the maxilla and the mandible.

This radiograph is used as an aid in diagnosis and treatment planning to determine skeletal / dental classifications and to estimate the direction of growth by facial typing.

A good Cephalometric x-ray should show the soft tissue outline of the face (forehead, nose, lips and chin) and of the soft palate and pharynx.

A Cephalometric x-ray is also taken at the end of orthopedic / orthodontic treatment in order to evaluate treatment changes.

The tracings of these before and after x-rays can prove to be one of the most important tools for evaluating the results of treatment.

Orthodontic treatment has come a long way because of the valuable information obtained by studying post treatment Cephalometric x-rays.

It is the goal of every conscientious dentist to provide the patient with the very best possible professional care.

If we are going to enter into the field of orthodontics and orthopedics, we, as doctors, have an obligation to extend our realm of knowledge.

Understanding and applying Cephalometrics is one of these obligations.

We have selected the Bimler Elite® Cephalometric analysis for use in our office, not by chance, but after a great deal of trial and error.

It would serve no constructive purpose to mention those techniques that we have tried and discarded.

However, it is easy for the experienced clinician to understand why some of the most prestigious names in the field of orthopedics and orthodontics have, over the years, discounted the use of the Cephalometric x-ray as a valid diagnostic aid.

The use of statistical data to create what were called “normal relationships” left much to be desired.

The dogmatic adherence to arbitrary values and measurements made it impossible for many open-minded clinicians to accept Cephalometrics as a science.

In fact, it was not unusual to hear a doctor relate to a colleague that he took the Cephalometric radiographs “because everyone else did”, but that he never traced it, and treated his patients by using his clinical observations.

Dr Bimler’s approach to the Cephalometric analysis is unique.

This difference in concept is most likely due to his education as a physician prior to becoming a dentist.

He uses the Cephalometric radiograph in order to better understand the patient’s problem and this makes for a more accurate diagnosis. Most other techniques use their analysis as a treatment goal or as a means of justifying a particular form of therapy.

This is not to imply that the Bimler analysis is perfect.

Nor do we intend to infer that all other techniques are of no value. We simply wish to make the point that for the clinician who utilizes both orthopedic and orthodontic therapy in his practice, the Bimler analysis is the most likely to meet his needs.

For even the most devoted clinician, the first exposure to any Cephalometric technique can be a mind-boggling experience. The Bimler Analysis is not unique in this respect. In fact, due to the in-depth evaluation that is an inherent part of the procedure, the doctors can easily find himself intimidated.

Having found ourselves in this identical situation, we have a few suggestions to offer that the ready may find helpful.

First and foremost, one cannot expect to even begin to understand the relationship of the facial bones without being familiar with the basic anatomy of the skull.

This includes learning all the Cephalometric landmarks and what they represent.

After these are mastered, the next step is to set the basic diagnostic gaol, which can be stated as follows: To understand the patient’s current skeletal relationship in the horizontal and vertical planes.

This goal should be well understood before the clinician seeks to become involved in the more intricate relationships of the analysis.

You will find that when you increase your ability to diagnose the patient as a skeletal Class I, II or III, open, neutral, or closed bite, the overall balance or imbalance of the entire facial complex will become more apparent.

As your level of comprehension increases, so will your appreciation of Dr Bimler’s understanding of facial growth and development.