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Updated: Jul 14, 2026

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Validity and reliability of ear landmarks as reference points for cephalometric analysis.

Wanjira Chutimanutskul1, Joseph P Geenty, Gang Shen

  • 1Faculty of Dentistry, Sydney Dental Hospital, The University of Sydney, Sydney, Australia.

World Journal of Orthodontics
|June 22, 2007
PubMed
Summary

The external ear and its landmarks are reliable for cephalometric analysis. This study found ear structures stable for superimposition in orthodontic patients.

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Area of Science:

  • Orthodontics
  • Cephalometric Analysis
  • Craniofacial Complex

Background:

  • Cephalometric analysis is crucial in orthodontics for diagnosing and planning treatment.
  • Accurate superimposition techniques are vital for assessing treatment changes and growth.
  • Identifying stable reference structures is essential for reliable cephalometric analysis.

Purpose of the Study:

  • To evaluate the external ear as a suitable reference structure for cephalometric analysis.
  • To determine the stability of ear landmarks and planes relative to the craniofacial complex.

Main Methods:

  • Cephalometric analysis of 21 orthodontic patients (mean age 16.5 years).
  • Superimposition of pre- and posttreatment cephalograms on the cranial base.
  • Defined ear landmarks (UE, PE, Ea) and planes (UE-PE, EaP) to assess ear position stability.

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  • Paired t tests used to evaluate landmark and plane displacement significance.
  • Main Results:

    • The angulation between the ear point plane (EaP) and SN showed no significant difference.
    • The angulation between the E-line and SN changed minimally.
    • A significant change was observed in the linear distance between S and N (1.19 mm).

    Conclusions:

    • The external ear and its associated landmarks are reliable and feasible reference structures for cephalometric analysis.
    • Ear structures demonstrate stability relative to the craniofacial complex during orthodontic treatment.
    • The findings support the use of the ear as a reference in cephalometric superimposition.