A protocol for cranial base reference in cephalometric studies

Establishment of the cranial base references and the coordinate system is important for measurement of events occurring on the face. The literature suggests that the horizontal axis is obtained by tracing a line in clockwise direction at seven degrees from the Sella-Nasion line, and the vertical axis is perpendicular to this former axis passing through the Sella point. However, could this standardization better represent the angle between the Sella-Nasion line and Frankfort Horizontal Plane in a Brazilian population and be employed in cephalometric studies? Thus, the present study had two purposes: to identify the cranial base inclination in adult patients presenting with intermaxillary anteroposterior skeletal disharmony and to evaluate the reliability of a protocol to reproduce the cranial base reference. Lateral cephalograms of three different times were traced: T0) onset of orthodontic treatment and immediately before the orthognathic surgery, T1) six months after surgery, and T2) one year after surgery. The results displayed a mean cranial base inclination of 7.91 degrees. Variation of the intraindividual data allowed the conclusion that the protocol proposed by utilization of an individual template of the cranial base reference was effective for the exactness of measurements in cephalometric studies.