Assessment and Comparison of the Head Posture and Craniofacial Growth in Vertical Dimension- A Cephalometric Study.

ABSTRACT

The aim of the present study was to examine as to whether any association can be found between the head posture and the craniofacial growth in the vertical direction.METHODSThe sample comprised of 150 subjects in the age group of 18 - 25 years and were further divided into three groups. These groups were classified into hypodivergent, normodivergent, and hyperdivergent according to the sella-nasion (SN) mandibular plane angle. The head posture was measured by calculating craniocervical and cervicohorizontal postural variables, recorded from the lateral cephalograms taken with the subjects standing with the head in the natural head position.RESULTSA clear pattern of association was found between the head posture and the vertical growth pattern. An extended head posture was seen in hyperdivergent group and flexion of the head was seen in hypodivergent group when compared to normodivergent cases (P<0.05, P<0.01). The findings were in agreement with the soft tissue stretching hypothesis according to which stronger forces are exerted on the facial skeleton whenever there is an increase in the tension in the soft tissue layer. When these forces are active for a long time during growth, they might restrict the growth of the maxilla and the mandible in forward direction and redirect it in a more caudal direction. Such a mechanism could explain the association between the extension of the head and the development of facial skeleton and in particular, the mandible.CONCLUSIONSThe cervical vertebral column area should be evaluated in routine cephalometric analysis and any deviation in the cervical column morphology and head posture should be registered. These registrations may prove useful when considering the diagnosis and evaluating the etiology, especially in patients with severe skeletal malocclusion and obstructive sleep apnea.