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

Abstract

Changes in craniocervical posture are a critical issue in modern society. Alterations of the mandible position in the anterior-posterior direction in association with head and neck posture are reported. The objective of the present review was to evaluate the relationship between craniocervical posture and sagittal position of the mandible and to evaluate the risk of bias inthe included studies. Electronic databases used to perform the search were PubMed, Wiley Online Library, and Cochrane. Only clinical trials that assessed sagittal craniocervical posture and mandible position in lateral cephalograms were included. Selected inclusion criteria were used to assess the finally selected studies. The upper and lower cervical spine was evaluated by seven and six studies, respectively. The risk of bias in the included studies varied from low to moderate. Literature research identified 438 records from 3 databases. Eventually, seven eligible clinical trials were included in this review. Evaluating the relationship between craniocervical posture and mandible position in the sagittal plane, it can be concluded that increased cervical inclination and head upright position are associated with the posterior position of the mandible. Attention to patients’ craniocervical posture should be paid as a part of clinical evaluation since it might be the reason for the changed mandible position.

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

“…These results suggest that maxilla components may have a less significant impact on determining craniocervical posture compared to the mandibular. As opposed to the maxilla, the results indicate a strong relationship to mandibular-related indicators at the peak growth periods, significant differences were observed in the majority of parameters related to the mandible and craniocervical posture, suggesting that the size and position of the mandible are two primary factors strongly associated with head and cervical posture, which is in line with previous studies 56 – 59 . A significantly higher extension of the head upon the spine was observed.…”

Relationship Between Craniocervical Posture and Vertical Face Pattern in Class II Division 1 Malocclusion

“…The next most prevalent type of head posture was Extended (posterior head rotation) i.e., 28.6-47.1%; whereas Flexed type of head posture (anterior head rotation) was seen in only 1. 4 positive correlation with the vertical pattern of the face but did not show any significant correlation with sagittal skeletal variables. This suggested an increase in craniocervical angle along with the increase in vertical height of the face.…”

Behavior of the mandibular length in class II non-growing patients treated with jaw functional orthopedics

“…Regarding some aspects that justify Class II treatment such as increase attractiveness [4,5] and consequently self-esteem, helping prevention or assist in the treatment of spinal column problems [6][7][8]10], TMD treatment [26], they are not analyzed in the present study.…”

“…Almasan et al [6] reported a relationship between class II malocclusion, temporomandibular disorders and cervical posture in studies that show MRI bone and soft tissues change, although literature still shows contradictory opinions. Sandoval et al [7] described the relation between retrognathia and cervical lordosis and Zokaite et al [8] reported an increase of cervical inclination and head upright position. Watanabe et al [9] reported the relationship of the height of the atlas dorsal arch of cervical vertebrae with anteroposterior position of the mandible.…”