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Maxillofacial Surgery
Clinical Diagnostic Records, Natural Head Position and Craniofacial Anthropometry
Built from Facial Aesthetics — Concepts and Clinical Diagnosis
What’s inside
7 sections · 112 slides
Overview
- What this topic covers
Clinical diagnostic records
What we collect, and what each record actually adds
- Why we keep clinical records
- Records for diagnosis and planning
- Records for checking and sharing
- Looking at the patient beats measuring
- Two X-ray techniques do most of the work
- The panoramic jaw X-ray
- Panoramic view of both jaws
- What the panoramic X-ray answers
- The side-view head X-ray
- Side-view cephalometric radiograph
- Following growth and treatment on film
- Bone age and hidden teeth
- Front-to-back cephalometric radiograph
- Colour photographs, start to finish
- Video captures what a photograph misses
- Video for expression and posture
- Models of the teeth
- Trimmed dental study casts
- Mounting the models the way the jaws move
- Casts mounted on an adjustable articulator
- Digital impressions have taken over
- Digital study models on screen
- What study models are used for
- The Kesling set-up: a wax rehearsal
- Plotting height to time surgery
- Three-dimensional imaging of bone and soft tissue
- Virtual surgical planning from CT data
- Scanning the face without X-rays
Natural head position
The one pose in which a face can honestly be judged
- The head must be held its own way
- How head tilt changes the profile
- The profile seen in natural head position
- Yet NHP is often ignored
The Frankfort plane and where it came from
An agreement about dry skulls that drifted into living patients
- Skull measurers needed one agreed method
- The German horizontal plane on a skull diagram
- What the agreed plane actually was
- The Frankfort plane on a dried skull
- A Scottish objection, straight away
- “
- A horizontal that is not really horizontal
- “
- Frankfort or Frankfurt?
- Leonardo's cranium propped level on a block
- How a borrowed plane leads to a wrong plan
- Anatomy varies from person to person
- Downs sounded the warning early
- Individual variation in Frankfort plane tilt
- The cranial base varies too
- Same profile, different cranial base tilt
- Two similar profiles, two different plane angles
- Natural head position, defined
- Recording a patient in natural head position
- How repeatable is this pose?
Choosing the lines you measure from
From the 0-degree meridian to a true vertical and horizontal
- The zero-degree meridian
- The zero-degree meridian as first drawn
- The same two lines in a Leonardo head study
- The thinking behind the meridian
- It agrees with the faces art calls ideal
- The facial vertical in classical sculpture and Leonardo
- Problem one: the horizontal it hangs from
- Problem two: the point it hangs from
- The fix: true vertical and true horizontal
- True vertical and true horizontal on a patient
- Where to drop the vertical from
- Three ways to set the head position
- Self-balance and the mirror
- The aesthetic, or photographic, position
- Patients disguise their own profile
- Position and posture are not the same word
- Orthoposition: a research pose
Clinical photography
Standard views, honest lighting, and consent
- Why photographs are worth the trouble
- Camera, lens and storage
- Consent before a face is shown
- Choosing a background
- Lighting a standard set-up
- A simpler single-flash alternative
- Setting the patient up
- A chair-side hair tie made from a face mask
- Grid focussing screen in the viewfinder
- The three basic facial views
- Extra views when the bite plane is tilted
- Views from below, above and behind
- Photographing inside the mouth
- The standard intraoral views
- The set of intraoral photographs
- “
Craniofacial anthropometry
Measuring the head and face from named points
- “
- What anthropometry means
- Everything rests on the landmarks
- How landmark names are written
- Craniofacial soft tissue surface landmarks
- Finding trichion when the hairline has receded
- How to read the landmark list
- Craniofacial soft tissue surface landmarks
- Craniofacial soft tissue surface landmarks (continued)
- Craniofacial soft tissue surface landmarks (continued)
- Craniofacial soft tissue surface landmarks (continued)
- Craniofacial soft tissue surface landmarks (continued)
- Craniofacial soft tissue surface landmarks (continued)
- Craniofacial soft tissue surface landmarks (continued)
- Craniofacial soft tissue surface landmarks (continued)
- Craniofacial soft tissue surface landmarks (continued)
- Where accurate landmarks are needed
- Measuring between two landmarks
- The instruments
- Spreading and sliding callipers
- Take-home messages: the records
- Take-home messages: position and measurement
- References
- References (continued)
- References (continued)
- Facial Aesthetics: Concepts and Clinical Diagnosis, 2nd Edition