Philip J. Kroth, MD, MS pkroth@salud.unm.edu Shamsi Daneshvari shamsi@unm.edu

Philip J. Kroth, MD, MSpkroth@salud.unm.edu

Shamsi Daneshvarishamsi@unm.edu

Clinical LOINC Committee Meeting

July 16, 2010

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

Overview

• What are cephalometrics?• What we are trying to accomplish• Two questions for the committee

What are Cephalometrics

• Head X-rays taken in a standardized manner

• Cephalometrics are measurements on the X-ray itself

• Mostly consist of lengths and angles• Hundreds of cephalometrics have

been defined• Used by some orthodontists to help

with treatment planning• Used for research• Defined in several cephalometric

atlases

What are Cephalometrics?

APO_PTII

What we are trying to accomplish

• Use LOINC term definitions to unify the cephalometric definitions of several cephalometric atlases and analyses.

Atlas/Analyses References

Downs AnalysisDowns WB (1948). Variations in Facial Relationships: Their Significance in

Treatment and Prognosis. American Journal of Orthodontics, 34:812-840.Frontal Analysis

Grummons DC, Kappeneye van de Coppelo MA (1987). A Frontal Asymmetrical Analysis. The Journal of Clinical Grummons DC, Ricketts RM (2004).

Frontal Cephalometrics: Practical Application. World Journal of Orthodontics, 5: 99-119.

Epker BN, Fish LC(1986). Dentofacial Deformities: Integrated Orthodontic and Surgical Corrections Volume I. Saint Louis: C. V. Mosby Co.

Jarabak-Bjork AnalysisJarabak JR, Fizzell JA (1972). Technique and treatment with light-wire edgewise appliances. Saint Louis: C. V. Mosby Co.

London AtlasBhatia SN, Leighton BC (1993). A Manual of Facial Growth: A Computer Analysis of Longitudinal Cephalometric Growth Data. Oxford: Oxford university Press.

McNamara AnalysisMcNamara JA Jr, Brundon WL (2001). Orthodontic and Dentofacial Orthopedics. Ann Arbor: Needham Press.

Atlas/Analyses References (Continued)

Ricketts AnalysisRicketts RM, Roth RH, Chaconas SJ, Schnlhof RJ, Engel A (1982). Orthodontic Diagnosis and Planning, Volumes I and II. Denver: Rocky Mountain Orthodontics.

Michigan / Riolo AtlasRiolo ML, Moyers RE, McNamara JA, Hunter WS (1974). An Atlas of Craniofacial Growth: Cephalometric Standards from the University School Growth Study, The University of Michigan. Ann Arbor: The University of Michigan.

Holdaway Soft Tissue AnalysisHoldaway RA (1983). A Soft Tissue Cephalometric Analysis and its Use in Orthodontic Planning, Part I. American Journal of Orthodontics, 84: 1-28.

Holdaway RA (1984). A Soft Tissue Cephalometric Analysis and its Use in Orthodontic Planning, Part II. American Journal of Orthodontics, 85: 279-293.

Steiner AnalysisSteiner CC (1953). Cephalometrics for You and Me. American Journal of Orthodontics, 39: 729-755.

Tweed AnalysisTweed CH (1954). The Frankfort Mandibular Incisal Angle (FMIA) in Orthodontic Diagnosis, Treatment Planning,

and Prognosis. The Angle Orthodontics, 24: 121-169.

Downs Analysis

LondonAtlas

Holdaway Soft Tissue

Analysis

LOINC

Frontal Analysis

Steiner Analysis

Ricketts AnalysisMichigan

/ Riolo Atlas

Jarabak-Bjork

Analysis

Tweed Analysis

McNamara

Analysis

Benefits of LOINC terminology definitions of cephalometrics

• Unify terms in 10 existing standards for cephalometric definitions (See Ceph Manual)

• Allow data in this area to be exchanged more easily

• Benefits our current project by creating a rigorous and legitimate standard form for future case donations:http://hsc.unm.edu/programs/ocfs/

Question One

• Should we define LOINC terms for landmarks (point) definitions and then embed these in angle and plane measurements’ terms? (I don’t know if there is a “point” measurement type currently defined in LOINC.)

• See page 2 of our Cephalometric Manual for “standard” point definitions

Question Two

• Can we or should we incorporate the cephalometric parameter diagrams into the LOINC database?

• Current text fields in RELMA are limited in length and it is difficult (but still possible) to reference up to five sources for a given cephalometric term

Philip J. Kroth, MD, MSpkroth@salud.unm.edu

Shamsi Daneshvarishamsi@unm.edu

Clinical LOINC Committee Meeting

July 16, 2010

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.