Evaluation of reliability of profile photographs for treatment planning, compared to cephalometric evaluation in orthodontic patients

262 subjects will be included in this study.

 1. Cephalometric measurements of orthodontically untreated patients

 2. Photographic measurements of  orthodontically untreated patient

 Patients who come for fixed orthodontic treatment  in Department Of Orthodontics, Manubhai Patel Dental College, Hospital & O.R.I., Vadodara  will be considered for this study. Lateral cephalograms and standardized profile photographs  will  be obtained  from 262 subjects of  orthodontically untreated patients. Parents or legal guardians will be  previously informed about the procedures and given  their written agreement to the investigation.

 PHOTOGRAPHIC PROCEDURE:

Standardized right profile photographs will be  taken in the natural head position (NHP), with maximum intercuspation and lips at rest. Glasses will be  removed and hair will be  piled high on the head to ensure that the patient’s forehead, neck, and ears will clearly visible. Adhesive dots will be placed on anatomic landmarks obtained by palpation.

Anatomic landmarks:

1.N’ indicates soft tissue nasion;

2.Tr’ indicates tragion;

3.Or’, soft tissue orbitale;

4.A’, soft tissue subspinale;

5.B’, soft tissue supramentale;

6.Go’, soft tissue gonion;

7.Pog’, soft tissue pogonion;

8.Me’, soft tissue menton;

9.Sn’, subnasale.

The Me’ point will be marked with an

adhesive styrofoam bead to allow better visibility by the camera.

To obtain an NHP(Natural head position), a 75× 30 cm mirror will be  hung on a tripod, which allow vertical adjustments according to the subject’s height. Patients will be  asked to keep feet slightly apart and arms relaxed and to stand a step behind a line drawn 120 cm from the mirror. To achieve the ‘‘orthoposition,’’ patients will be  instructed to tilt their head up and down with decreasing amplitude until they felt relaxed, take  a step forward, and keep looking straight ahead   into the reflection of their eyes in the mirror. A protractor will be  placed on the tip of the nose and the soft tissue pogonion.

 Â·         The same digital camera  with the same lens and flash  will be  used for all photographic records. It will be  secured on a tripod for stabilization and will be adjusted according to the subject’s height.

 CEPHALOMETRIC PROCEDURE:

 Cephalometric radiographs will be taken in an  NHP (Natural head position)  with maximum intercuspation and lips at rest.  A chain with a 200 g weight will be  hung at its end will be suspended in front of the patient, in the midsagittal plane, to register the  VER (Vertical reference line).  While achieving an NHP (Natural head position), a modified protractor will be  placed on the tip of the nose and the soft-tissue pogonion to check if the same position  will be achieved during photographic record.

 All lateral cephalograms will be traced from the standardized SORDEX machine (PONOD+ model) with distance of 5 feet from object to film will be exposed with 72Kvp,10mA, and  14 seconds of exposure time with help of Digora software.