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Maximal bite force (MBF) and its associations with craniofacial morphology and spinal posture were studied in a group of young adults (46 M and 38 F) aged 21 to 23 years. MBF was recorded in molar and incisal regions. Sagittal spinal posture was measured by spinal pantography and trunk asymmetry at thoracic and lumbar levels by a forward-bending test. Craniofacial variables and posture of the cervical spine were examined from lateral cephalograms taken in a natural head position. No statistically significant correlations existed between MBF and spinal posture, but significant correlations did exist between MBF and craniofacial variables, especially in women.

The aim of the present study was to investigate associations between thoracic hyper- and hypokyphosis, head posture, and craniofacial morphology in young adults. Using forward bending test and spinal pantographic measurements, 31 subjects, 16 with thoracic hyper- and 15 with hypokyphosis, were selected from a population-based cohort of 430 young adults. Lateral roentgen-cephalograms were taken in natural head posture and craniofacial and postural angular measurements were calculated. Any statistically significant differences between the groups thoracic hyperkyphosis and thoracic hypokyphosis--were analysed using Student's t test. Subjects with thoracic hyperkyphosis had a larger atlantocervical angle (At/ CVT, P < 0.01) than subjects with thoracic hypokyphosis. However, head position (NSL/VER) was similar in both groups, probably owing to the visual perception control of craniovertical relation. There was no statistically significant difference in craniofacial morphologyy between the groups.

The nasolabial appearance with acceptable symmetry after cleft lip and reconstructive surgery of the nose was achieved. Symmetry of the nasolabial appearance in patients with UCLP differed from those in the control group. The 3D photographs with a proposed set of anthropometric landmarks for evaluation of nasolabial appearance seems to be a convenient, accurate, and noninvasive way to follow and evaluate patients after surgery.

Background There has been a lack of a standardized protocol for collection of patient reported outcomes (PRO) and detection of and indication for psychological treatment in cleft care. The objectives of this paper was to translate Cleft Hearing Appearance and Speech Questionnaire (CHASQ) into eight European languages, to investigate whether levels of PRO in patients with cleft lip and/or cleft palate (CL/P) were comparable across countries and to investigate clinician experience of the instrument. Methods The PRO measure-CHASQ-was translated into Bulgarian, Estonian, Greek, Latvian, Macedonian, Romanian, Serbian and Swedish and implemented with patients in the respective countries. A focus group discussion was conducted to investigate health care professional experience on the use of CHASQ in their clinics. Data was analysed in accordance with the principles of thematic analysis. Results Analysis showed statistically significant differences between countries and groups of diagnosis in CHASQ scores. CHASQ helped clinicians gain patient information and informed on treatment decisions, broadened the clinicians' role as caregivers and was perceived as short and easy to use. Limited time and resources in clinics were limitations in implementing the instrument. Conclusions Translation and utilization of CHASQ facilitated international comparison and cooperation. Linguistically, valid replicas of CHASQ are now available in many European languages. Results from this study show that CHASQ may be used for collection of PRO on patient satisfaction and to spark conversation between clinicians, patients and families. Level of evidence: Not rateable.

The aim of the present study was to detect possible associations between trunk and cervical asymmetry and facial symmetry. Frontal cephalograms prepared in the natural head position, representing 79 subjects (40 males, 39 females) with mild to moderate trunk asymmetry, were analyzed separately for thoracic humps, lumbar prominences, and cervical inclination by discriminating two groups: right-sided-dominant and left-sided-dominant. The differences between the groups were analyzed using an unpaired 2-group t test. The results showed that location of the thoracic humps and inclination of the cervical spine was predominantly right-sided, while the location of lumbar prominence was predominantly left-sided. Craniofacial morphological variables of the head and face were nearly equal for right-sided and left-sided thoracic humps and lumbar prominences, showing that moderate trunk asymmetry does not affect facial symmetry. Further, it was found that frontal head position in relation to the true vertical (VER/ORB) is stable in that the angle between the supraorbital and vertical lines is constantly maintained close to 90 degrees regardless of moderate trunk asymmetry, indicating that visual perception control is most important in orienting the head in frontal plane. Maintenance of the head position takes place by cervical spine adaptation.

The aim of the study was to test (a) the validity of the supra-orbital line as a substitute for the interpupillary line, and (b) the reproducibility of two different approaches of assessing cranio- and cervico-vertical relationships on frontal cephalograms. The material consisted of natural head position frontal cephalograms of 21 healthy Finnish students and 11 Danish young adults prepared according to a method described previously, modified in the Danish sample by addition of spectacles with a wire to indicate the interpupillary line. The cephalograms were analysed manually twice by two investigators with an interval of one week. The following reference lines were selected: (1) orbital line (ORB): a tangent to the extreme cranial point on the supra-orbital margins; (2) cranial line (CR): the line drawn through crista galli and anterior nasal spine; (3) cervical line (CER): a line drawn through the midpoints of atlas (half the distance between the most median points on the tubercle of the transverse ligament), and C4 (half the distance between the most concave points of the lateral masses); (4) the main course of the upper cervical spine (SPINE): a subjective impression of the spinal inclination; (5) the interpupillary line (IP); and (6) the true vertical and horizontal lines (VER, HOR). The angles were measured to the nearest 0.5 degrees. Intra- and inter-examiner reproducibility was calculated. The supra-orbital line almost coincided with the interpupillary line as the mean inclination between the lines was only 0.5 degrees. Both intra- and inter-examiner errors were less for ORB and CER than for CR and the line indicating the main course of the upper cervical spine (SPINE). The intra-examiner reproducibility s(i) for ORB/HOR and CR/VER was 0.4 and 0.8 degrees respectively, and for CER/VER and SPINE/VER 0.8 degrees and 1.0 degrees. Based on these results, the supra-orbital line and the cervical line (defined as the mid-transversal line between the atlas and the fourth cervical vertebra) are recommended as reference lines for assessing frontal head posture.

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