Frontal cephalometrics: practical applications, part 2.

AIMS: To (1) demonstrate the needs and benefits of three-dimensional diagnostic and treatment applications; (2) illustrate practical clinical applications of anteroposterior images and frontal analysis; and (3) enhance utilization of the Ricketts and Grummons frontal analyses.

METHODS: Frontal analysis methods and applications are specified and integrated into facial, smile, jaw, and occlusal therapies. Asymmetry conditions must be differentially diagnosed and effectively treated. Frontal and related image analysis and tracing steps are detailed.

RESULTS: Asymmetry of facial parts is the rule, rather than the exception. Dental and facial midlines, occlusal plane, chin location, and smile esthetics are primarily emphasized. Beautiful facial proportions and smile harmony can be developed despite initial facial dysmorphosis and disproportions.

CONCLUSIONS: Patients view themselves from the frontal perspective, so this carries priority when assessing problems. It is important to know the etiology of asymmetry to assist others with genetic counseling. Facial harmony and smile beauty are optimal when facial and maxillary dental midlines are aligned. The maxillary dentition width should be sufficiently wide to be in harmony with the individual patient facial morphology. The occlusal plane should be level and the chin centered as much as possible. Best facial development and proportionality exist when the skeletal and dental components are optimized transversely and are symmetric.