Relationship between Craniocervical Posture and Sagittal Position of the Mandible: A Systematic Review

Craniocervical posture in patients with skeletal malocclusion and its correlation with craniofacial morphology during different growth periods

The association between craniocervical posture and craniofacial structures in the various sagittal skeletal malocclusion during different growth stages has been the focus of intense interest in fields of orthodontics, but it has not been conclusively demonstrated. Thus, this study aimed to investigate the association between craniofacial morphology and craniocervical posture in patients with sagittal skeletal malocclusion during different growth periods. A total of 150 from a large pool of cephalograms qualified for the inclusion and exclusion were evaluated and classified into three groups according to the Cervical Vertebral Maturation (CVM) by examining the morphological modifications of the second through fourth cervical vertebrae, each group consisted of 50 cephalograms. In each growth period, for the comparison of head and cervical posture differences among various skeletal classes, the radiographs were further subdivided into skeletal Class I (0° < ANB < 5°, n = 16), skeletal Class II (ANB ≥ 5°, n = 18), and skeletal Class III (0° ≤ ANB, n = 16) on the basis of their ANB angle. There was no significant difference in gender (P > 0.05). Some variables were found to be significant during pubertal growth and later in patients with sagittal skeletal malocclusion (P < 0.05). Most indicators describing craniocervical posture were largest in skeletal Class II and smallest in skeletal Class III during the peak growth periods and later. Cervical inclination variables were greater in skeletal Class III than in skeletal Class II. Variables of craniofacial morphology and craniocervical posture are more correlated during the pubertal growth period and later in patients with sagittal skeletal malocclusion. A tendency is an indication of the close interrelationship that a more extended head was in skeletal Class II while a flexed head was in skeletal Class III. Nevertheless, with the considerations of some limitations involved in this study, further longitudinal studies with large samples are required to elucidate the relationship clearly.

Photometric analysis of the relationship between craniovertebral angle and facial profile in children aged 10-12 years

Background

Head posture deviation is seen in 52.5 % of children aged 6-15 years. Studies have shown that poor posture habits can impair muscle function during craniofacial growth and development. A muscle imbalance causes abnormal positioning of dental and skeletal structures, a condition that exerts negative impacts, such as changes in facial morphology.

Objective

To determine through photometric analysis the relationship between craniovertebral angle as a function of head posture and glabella-subnasale-pogonion (G-Sn-Pg) angle as a function of facial profile in 10-12-year-old children, and the results will help to avoid facial development issues.

Methods

Thirty-three subjects met the inclusion criteria. Their craniovertebral angles and facial profiles were measured using lateral photometry and ImageJ. The craniovertebral angle was determined by connecting the tragus and C7 with a horizontal line, whereas the facial profile angle was determined by connecting the glabella, subnasale, and pogonion. The relationship between the craniovertebral and G-Sn-Pg angle values was analyzed using the Pearson correlation test.

Results

A significant relationship was observed between the craniovertebral angle and the G-Sn- Pg angle (p < 0.05), although such a relationship was weak (r = 0.373).

Conclusion

A more forward head posture is associated with a more convex facial profile, and this relationship is useful for the early prevention and treatment.