Cephalometric Analysis

In the traditional orthodontics, most orthodontists believe that facial profile will naturally improve by correcting the dental angle and distance to the normal range by referring to the cephalometric analysis. However, it is greatly different in the reality as most of the time, improvement of dental occlusion after orthodontic treatment does not change the facial profile. Sometimes, the facial profile may even worsen. This type of traditional concept is known as hard-tissue paradigm, which adopts the average position of dental-skeletal to decide the final appearance. This approach will try to adjust the cephalometric value of every patient to the mean value.

Would the mean value appropriate for every patient? Does the mean value represent beauty? (As a matter of fact, beauty is frequently a skew from the mean value, especially the individuality of beauty.)

On the other hand, these do not mean that cephalometric analysis is not important. Dr. Hsieh will perform cephalometric analysis on every surgical patient, but the contemporary treatment concept is completely different. Dr. Hsieh will first sketch the optimal facial contour and uses reverse calculation to determine the approach of orthodontic treatment and displacement of facial skeleton, hence achieving the optimal facial appearance. This type of relatively contemporary concept is known as soft-tissue paradigm, which adopts the optimal facial contour, individual’s personalities and preferences to determine the desired appearance. Subsequently, the treatment approach of orthodontic treatment and surgical displacement are determined.

Some people refer this optimal facial contour as the post-surgical simulation which is professionally termed as “visual treatment objective”. Generally, it has the following advantages:

1. It can estimate the lateral facial contour for post-treatment of surgical – orthodontic treatment. Moreover, it allows the surgeon and orthodontist to adjust and customize the most optimal treatment planning according to different needs.
2. It assists the doctor to determine if tooth has to be removed, or which tooth should be removed.
3. It helps to determine if genioplasty or rhinoplasty is required to emphasize the overall aesthetic appeal.
4. It is a good communicate bridge between not only the orthodontist and surgeon but also the surgeon and patient.