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TWEED’S ANALYSIS

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
Background
• In 1930, with the death of Dr. Angle
• the introduction of the cephalometric
headplate by Dr. Broadbent,

www.indiandentalacademy.com
Charles H Tweed (1895~1970)
• Dr. Tweed
established the
diagnostic facial
triangle
• Based primarily on
deflection of
mandible as
measured by FMA
and position of the
lower incisors
www.indiandentalacademy.com
Planes Used for Tweeds Facial Triangle

Frankfort Horizontal Plane

Long Axis of
Lower Incisor

Mandibular plane

www.indiandentalacademy.com
Frankfort Horizontal Plane
• Adopted at 13th German Congress of
Anthropologists – the Frankfort Agreement
at Frankfort am Main , 1882
• Finally accepted by the International
Agreement for the Unification of
Craniometric and cephalometric
Measurements in Monaco, 1906
www.indiandentalacademy.com
Frankfort Horizontal Plane
• A horizontal plane represented in the
profile by a line between the lowest point
on the margin of the orbit to the highest
point on the margin of the auditory meatus
• Tweed took the Porion as a point 4.5 mm
above the geometric center of the
mechanical ear rods
www.indiandentalacademy.com
Mandibular plane
• Tangent to the lower border of the
mandible

www.indiandentalacademy.com
Angles of Tweeds Facial Triangle

www.indiandentalacademy.com
Angles of Tweeds Facial Triangle
Variable

Mean
Value

Range

Frankfort Mandibular
plane Angle (FMA)

250

160-350

Incisor Mandibular Plane
Angle (IMPA)

900

850-950

Frankfort Mandibular
Incisor Angle (FMIA)

650

600-750

www.indiandentalacademy.com
Objectives
• Determines the position the lower incisor
should occupy at the end of treatment
– Useful information for treatment planning
– Planning of Extraction

• Prognosis of treatment result

www.indiandentalacademy.com
• People agreed that extraction was often
necessary.
• Tweed’s reasons for extraction seem to
have prevailed

www.indiandentalacademy.com
When extraction is done, one is
inevitably reminded of Newton’s
third law
Newton’s third law
“For every action,
there is an equal
and opposite
reaction.”

www.indiandentalacademy.com
Newton’s Law in Orthodontics
• In orthodontics this means that when
retracting front teeth, one will be faced
with the problem of having to minimize the
tendency of the posterior teeth to move
forward

www.indiandentalacademy.com
Anchorage & Anchorage
Preparation
• The minimization of such force is called
“Anchorage”
• Dr. Tweed introduced en-masse
anchorage preparation

www.indiandentalacademy.com
Determining Growth Pattern
• When FMA<25
– Horizontal Growth Pattern

• When FMA>25
– Vertical Growth Pattern

www.indiandentalacademy.com
Prognosis???
 If FMA 160 to 280

PROGNOSIS IS GOOD
at 160 IMPA should BE 900+50 = 950
0
0
at 25 IMPA should be 90
at 280 IMPA should be 900-50 =850
www.indiandentalacademy.com
 Approximately 60% of malocclusion have
0

0
Prognosis???
• If FMA 280 to 350

PROGNOSIS IS FAIR
at 28 0 IMPA should be 90 0-95 0
at 35 0 Extraction necessary in majority of
cases
IMPA should be 80 0 -85 0

www.indiandentalacademy.com
Prognosis???
• If FMA above 350

PROGNOSIS IS BAD
• Extraction usually complicates the
problem
• Tweed stressed the importance of the
FMIA angle recommending that it be
maintained at 65° to 70°
www.indiandentalacademy.com
Thank You
Qu
Any
•

ns??
estio

www.indiandentalacademy.com

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Tweed’s analysis /certified fixed orthodontic courses by Indian dental academy

  • 1. TWEED’S ANALYSIS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. Background • In 1930, with the death of Dr. Angle • the introduction of the cephalometric headplate by Dr. Broadbent, www.indiandentalacademy.com
  • 3. Charles H Tweed (1895~1970) • Dr. Tweed established the diagnostic facial triangle • Based primarily on deflection of mandible as measured by FMA and position of the lower incisors www.indiandentalacademy.com
  • 4. Planes Used for Tweeds Facial Triangle Frankfort Horizontal Plane Long Axis of Lower Incisor Mandibular plane www.indiandentalacademy.com
  • 5. Frankfort Horizontal Plane • Adopted at 13th German Congress of Anthropologists – the Frankfort Agreement at Frankfort am Main , 1882 • Finally accepted by the International Agreement for the Unification of Craniometric and cephalometric Measurements in Monaco, 1906 www.indiandentalacademy.com
  • 6. Frankfort Horizontal Plane • A horizontal plane represented in the profile by a line between the lowest point on the margin of the orbit to the highest point on the margin of the auditory meatus • Tweed took the Porion as a point 4.5 mm above the geometric center of the mechanical ear rods www.indiandentalacademy.com
  • 7. Mandibular plane • Tangent to the lower border of the mandible www.indiandentalacademy.com
  • 8. Angles of Tweeds Facial Triangle www.indiandentalacademy.com
  • 9. Angles of Tweeds Facial Triangle Variable Mean Value Range Frankfort Mandibular plane Angle (FMA) 250 160-350 Incisor Mandibular Plane Angle (IMPA) 900 850-950 Frankfort Mandibular Incisor Angle (FMIA) 650 600-750 www.indiandentalacademy.com
  • 10. Objectives • Determines the position the lower incisor should occupy at the end of treatment – Useful information for treatment planning – Planning of Extraction • Prognosis of treatment result www.indiandentalacademy.com
  • 11. • People agreed that extraction was often necessary. • Tweed’s reasons for extraction seem to have prevailed www.indiandentalacademy.com
  • 12. When extraction is done, one is inevitably reminded of Newton’s third law Newton’s third law “For every action, there is an equal and opposite reaction.” www.indiandentalacademy.com
  • 13. Newton’s Law in Orthodontics • In orthodontics this means that when retracting front teeth, one will be faced with the problem of having to minimize the tendency of the posterior teeth to move forward www.indiandentalacademy.com
  • 14. Anchorage & Anchorage Preparation • The minimization of such force is called “Anchorage” • Dr. Tweed introduced en-masse anchorage preparation www.indiandentalacademy.com
  • 15. Determining Growth Pattern • When FMA<25 – Horizontal Growth Pattern • When FMA>25 – Vertical Growth Pattern www.indiandentalacademy.com
  • 16. Prognosis???  If FMA 160 to 280 PROGNOSIS IS GOOD at 160 IMPA should BE 900+50 = 950 0 0 at 25 IMPA should be 90 at 280 IMPA should be 900-50 =850 www.indiandentalacademy.com  Approximately 60% of malocclusion have 0 0
  • 17. Prognosis??? • If FMA 280 to 350 PROGNOSIS IS FAIR at 28 0 IMPA should be 90 0-95 0 at 35 0 Extraction necessary in majority of cases IMPA should be 80 0 -85 0 www.indiandentalacademy.com
  • 18. Prognosis??? • If FMA above 350 PROGNOSIS IS BAD • Extraction usually complicates the problem • Tweed stressed the importance of the FMIA angle recommending that it be maintained at 65° to 70° www.indiandentalacademy.com