A beautiful smile...
Analysis of Size and Position of the skull, Jaws and Dentition in the vertical and horizontal planes
Use of the Visual-Dx Ceph method invented by Ted Rothstein DDS PhD
The above is a “Lateral Head” X-ray showing a true Skeletal Open Bite (SOB): the open bite shown here was caused by an excess vertical direction of growth at the back of the jaws.
Analytic tools derived from my PhD thesis U. Pa. 1973: Include the “Normal Standard” #3 Fem 14 y/o and the summary and the Visual-Dx Ceph analysis sheet.
Measuring and analyzing begins with by taking a lateral head X-ray of the patient’s skull and jaw:
Then creating a tracing of it and marking off the “natural” and “derived” landmarks typically used by orthodontists (EAM, Ar, S, Na, A, B, Gn, Pog, Gn, Me Go, Ar. etc. the most significant measuring points.
My tracing of the patient’s x-ray
One of six templates: Normal Females age 10, 12; Fem 14 (shown here) and Normal Males 10, Male 12 and Male 14
The Normal for a Female 14 years old
Here is shown a standard TEMPLATE showing a Normal 14 y/o F: In the female skull, growth is 97% complete by Skeletal age 14. + marks show one standard deviation of the landmark point (horizontally and vertically) in a sample N= close to 50 in all six samples.
The tracing is placed over the STANDARD (NORMAL) in a variety of ways to help the student (me) understand what the size and positional deviations are in the individual as represented in the tracing when compared with the standard.
Tracing of patient’s skull superimposed over the Normal Female Template. NOTE: How much the patient’s chin extends vertically down beyond the “Normal” Template chin.
This analysis can measure in angles and distances. But its main advantage is that you can visualize the deviation and report the divergences in “Standard deviations” (Visual-Dx ceph analysis.)
Assembling the positional and size facts.
Purchase price for the set of six standard templates is $300
Not every case requires having a lateral head x-ray (also called a “Cephalometric” X-ray). Any time such an X-ray is taken it is subject to some analysis whose size and angular norms were derived from samples of persons.
The uniqueness of the Normal Templates used in the Visual-Dx Ceph analysis is that the samples were composed of persons sub-grouped by “skeletal” age and gender”. This kind of study has no peer. These norms were used in my PhD dissertation to measure and visually allow me as an orthodontist to describe the true differences among adolescents and some adults who had “buck” (Class II, Division 1 malocclusion) compared to children who were “normal” (Class I).
Dedicated to Marion Wilton Krogman – my PhD mentor U.Pa. 1969-’71 who was the foremost forensic skeleton analyst in the country.
Part 1: AJO Ted Rothstein. DDS. PhD. and Cecile Yoon-Tarlie. DDS- MSI (American Journal of Orthodontics) 2000; 117:320-32)
Part II AJODO (American Journal of Orthodontics and Dentofacial Orthopedics) Rothstein T, Phan XL: Dental and facial skeletal characteristics and growth of females and males with Class II Division 1 malocclusion between the ages of 10 and 14 (revisited). Part II. Anteroposterior and vertical circum-pubertal growth. Am J Orthod Dentofacial Orthop; 2001 Nov; 120 (5):542-55 PMID: 11709673