Frontal Cephalometrics: Practical Applications, Part I

Aims: Many clinicians have not employed the frontal perspective. Therefore, the purposes of this paper are to: (1) update the findings in morphology and growth in the transverse dimension; (2) simplify evaluation of facial asymmetry using the Ricketts and Grummons frontal analyses; and (3) describe practical clinical applications of anteroposterior images and analysis. Methods: Maxillary width variations, frontal (anteroposterior) anatomic land- mark locations, and frontal tracing methods are specified. Asymmetry conditions are differentially treated. Results: Utilizing frontal facial information, therapeutic approaches are more specific and effective, while directed toward particular etiology. Occlusal plane, mid- line, chin location, and smile esthetics are primarily addressed. Beautiful facial proportions and smile harmony are demonstrated. Asymmetry of the facial parts is the rule, rather than the exception. Conclusion: Patients view themselves from the frontal perspective, so this carries priority in assessing problems and treatment outcomes. Facial harmony and smile beauty are optimal when facial and dental midlines are aligned. The occlusal plane should be level, or nearly so. The maxillary width should be sufficiently wide to be in harmony with the individual patient facial type and morphology. The chin should be centered, or nearly so. Best facial development and proportionality exist when the transverse skeletal and dental components are optimized and symmetric. World J Orthod 2003;4:297–316.