Cephalometry in 2025: history and outlook

Cephalometry has its roots in the cultural tradition of representing the human body. During the Renaissance, the search for ideal proportions was a major focus of scholarly thought. In the 18th and 19th centuries, anthropology took over, and with the advent of the X-ray, cephalometry began to be applied to orthodontics. The aim of this article is to describe the evolution of cephalometry and assess its role in 2025.

The article is based on a literature review.

Cephalometric analyses based on profile teleradiography did not emerge until the 1930s, becoming an essential diagnostic tool that soon revealed both its value and limitations. Analytical approaches -whether typological, dimensional, or architectural- varied according to their proponents and were often grounded in their personal conceptual frameworks, leading to ongoing debates.

Since the 2000s, the introduction of lower radiation 3D imaging (CBCT) has revolutionized the field, where access to volumetric data has transformed routine practices thanks to the richness of the images. Moreover, 3D imaging can be combined with other digital examinations, enabling, for example, the visualization of treatment objectives within an anatomical, individualized, three-dimensional context. However, 2D cephalometric analysis remains a fundamental measurement and control tool, particularly for assessing incisor axis orientation.

We are at a turning point: The information provided by profile teleradiography is now limited compared to what can be drawn from 3D analyses. This calls for a tiered approach to prescribing examinations, tailored to each patient's specific needs.