Cephalometric assessment regarding craniocervical posture in orthodontic patients

Abstract

A major factor that contributes to dental malocclusions is represented by the positioning of the mandible. Considering the existing interconnections between the craniocervical and craniomandibular systems it is interesting to assess how changes in one system can influence the other, thus establishing a pattern in terms of certain cephalometric landmarks that orthodontists could consider when diagnosing and evaluating an orthodontic case. Therefore, the aim of this study was to investigate the connections between cervical posture, head position, hyoid bone position in orthodontic patients with different skeletal patterns. 45 lateral cephalometric radiographs were analyzed. Skeletal class and vertical growth were the main elements that were considered when classifying patients. Craniofacial and Cervical landmarks were determined on the cephalograms, from which lines and angles resulted which were considered relevant in our study. Correlations between cephalometric variables of the patients were determined. there were some statistically significant changes identified concerning craniocervical posture and hyoid bone position between the patients in the following parameters: H-Rgn, OPT/HOR, CVT/HOR, OPT/SN, CVT/SN, H-SN. The results obtained allowed us to conclude that there were some differences at the skeletal level of the sample of patients studied. The findings are indicating that there is a close relationship between, mandible position, cervical- and head posture and the hyoid bone. The information obtained in this study could help to better understand the development of malocclusions, and to improve the orthodontic diagnostic and treatment plan.

Differences in the effects of orthodontic treatment on airway-craniocervical functional environment in adult and adolescent patients with skeletal class II high-angle: a retrospective pilot study

“…Recently, the interrelation between malocclusion and craniocervical posture causes concerns in orthodontic field [ 23 , 26 , 32 , 48 ]. Numerous studies have shown significant correlations between craniocervical posture and craniofacial morphology [ 48 – 50 ].…”

“…The teenage group's findings demonstrated that the craniofacial and craniocervical angle was negatively correlated with FMA. In contrast, the majority of recent investigations on the correlation between craniocervical posture and vertical skeletal pattern has suggested that patients with larger FMA typically have larger craniocervical angle [ 23 , 27 , 54 ]. A hypothesis was proposed that high angle adolescent patients with upper airway constriction will extend their entire cervical column instead of merely moving head forward to obtain enough airflow.…”

“…Craniocervical posture refers to a condition that preserves the relative stability of the craniofacial and cervical regions in the external and internal environment, and it frequently reflects the outcome of the coordination of gravity and functional demands [ 23 ]. Craniocervical posture is linked to both sagittal and vertical skeletal facial morphology.…”

“…Craniocervical posture is linked to both sagittal and vertical skeletal facial morphology. Actually, patients in skeletal Class II show a more lordotic curve of the spine and a larger extension of the head than those in Class III, and as a result, exhibit a significantly greater craniocervical angle [ 23 – 25 ]. Additionally, the craniocervical angle is notably increased in high-angle patients compared with low-angle populations [ 23 , 26 , 27 ].…”

“…Actually, patients in skeletal Class II show a more lordotic curve of the spine and a larger extension of the head than those in Class III, and as a result, exhibit a significantly greater craniocervical angle [ 23 – 25 ]. Additionally, the craniocervical angle is notably increased in high-angle patients compared with low-angle populations [ 23 , 26 , 27 ]. To explain this phenomenon, Solow suggests that this stretching of craniocervical posture is a consequence of the patient's effort to obtain a larger airway [ 28 ].…”