September 27, 2020
In dentistry, a dentist can be faced with a variety of problems that the patients show up with. While some of these issues can be diagnosed simply by looking in the mouth and diagnosing it, a large majority of them need a peek into the more inner structures of the oral cavity. These structures are visualised by the dentist through means of radiographs (x-rays).
The most commonly used radiograph in dentistry is called an IOPA (intraoral periapical). This is a small film that is sufficient to cover two to three teeth in its frame. However, it is used only when the pain or related issue is specific to a particular tooth. There are conditions, diseases and syndromes where the area of concern is not simply a few teeth but te entire oral cavity or a major portion of the face itself. These issues are often concerned with the growth and development of an individual, traumatic incidents, underlying systemic condition, etc. In order to get a better hang of it, dentists can opt for another type of radiograph called the lateral cephalogram (LC).
A lateral cephalogram is an x-ray that covers one side of the entire face. In other words, it is the x-ray of a side profile of a person. A dentist can see most of the the facial bones from this view, including the maxilla (upper jaw) and the mandible (lower jaw). The three types of dentists that can commonly prescribe a LC are orthodontists, oral surgeons and pediatric dentists.
There are a lot of reasons as to why your dentist might ask for a Lateral cephalogram. Firstly, if there is an abnormal bite, chances are that the underlying defect is skeletal. In order to examine the positions of the maxilla and mandible during the bite, a LC can be of great diagnostic value. Secondly, during the stage of development when children bear a combination of both milk and permanent teeth in their oral cavity, they might face issues related to the eruption of the teeth. In order to visualise the developing tooth buds, a LC can help the dentist. There are cases of trauma, where fracture lines need to be located with more precision. Lateral cephalogram can thus help the dentist in studying the extent of the fracture.
One of the advantages of Lateral cephalogram is that it also helps in tracing the soft tissue (lips, nasal tip, chin). A LC is frequently used to understand the growth patterns of an individual. There are certain points on the Lateral cephalogram, (both skeletal and soft tissue points) which a dentist traces in order to create angles that correspond to a normal growth pattern. Any variations in those angles apart from the normal variations can help the dentist (the orthodontist in most cases) to determine the growth stage. This can further help in formulating a treatment plan based on the patient's age. During and after the treatment, multiple LCs can be taken in order to compare the changes in the growth pattern.
LCs are also useful in analyzing the relation between multiple structures. Dentists do this by means of studying various "planes" that they have designated between two points. The angulation between these planes helps them in studying the developmental stages.
LC can also be prescribed to patients having problems like compromised airway, failure to close the lips at rest or having an abnormal jaw closure. LCs also help in examining the frontal and the maxillary sinuses. These are significant hollow spaces in the skull that have multiple functions like voice resonation, pressure distribution, volume distribution, etc. Any problems in these sinuses, especially the filling of infectious fluid in these spaces can be detected on a Lateral cephalogram. Over the years LCs have also helped researchers to understand the facial profiles of people from different races, ethnic groups and countries.
It is important to remove all the jewellery from the head and the neck before going for a Lateral cephalogram scan. The entire procedure takes 15 to 20 minutes to complete where the patient is simply asked to stand still. The patient is advised to clench his or her teeth and lean the forehead slightly downwards based on the angulation of the x-ray beam. Overall, it is a simple procedure that asks only two things from the patient - to stay still and be patient.