Cephalometric analysis plays an important role in orthodontic diagnosis and treatment; over the past half-century, increasingly comprehensive and accurate cephalometric systems have been developed. Overreliance on cephalometric data, however, can be problematic if different systems yield different diagnostic results. The present study compared the Steiner, Ricketts, and Cervera anal- yses, which are based on different reference planes, in the skeletal diagnosis of 35 patients with Class II malocclusions.
The Steiner system, introduced in 1950, can be considered the first modern cephalometric analysis, because it takes into account not only the measurements themselves, but also their relation- ships to one another. Steiner’s reference plane is the anterior cranial base (sella-nasion plane), inthe upper third of the face. In 1960, Ricketts
introduced a system that allowed morphological evaluation and individual growth forecasting of the craniofacial complex by means of a Visualized Treatment Objective (VTO). His reference plane is Frankfort horizontal (porion-orbitale plane), in the middle third of the face.4-7 In 1970, Cervera, echoing Tweed’s emphasis on function, moved
