Assessment of relationship between craniocervical morphology, posture and sagittal skeletal discrepancies among Indian population – A cephalometric study

• Joseph Joy,*  
• Tanvi Malkarnekar,  
• Gopinath Kallampilly,  
• Suryakant Narsing Powar,  
• Sumeet Wasudeorao Ghonmode

Abstract

OBJECTIVE: The objective of this study was to investigate the relationship between sagittal skeletal discrepancies and craniocervical posture in Indian population METHODS: Lateral cephalograms of 98 subjects of Indian origin were taken in Natural Head Position (NHP). Cephalometric analysis was performed to determine the growth pattern, sagittal position of maxilla and mandible with respect to cranial base, maxillomandibular relationship and craniocervical angles. The craniocervical angles used in this study were Angle between Nasion Sella line and Odontoid process tangent (NSL/OPT), Angle between Nasion Sella line and Cervical vertebra tangent (NSL/CVT), Angle between Nasion line and Odontoid process tangent (NL/OPT) and Angle between Nasion line and Cervical vertebra tangent. These variables were then correlated. RESULTS: A negative association was seen between cranio-cervical parameter NSL/OPT and sagittal skeletal parameters (SNA, SNB, NA linear and NB linear) values whereas there was a positive association between NSL/OPT with ANB and Wits appraisal. It was observed that this relationship was statistically significant between NSL/OPT and ANB. A positive association was observed between the NSL/OPT- Y-Axis, NSL/OPT-FMPA and there was a negative association between NSL/OPT- Gonial angle and NSL/OPT- Jarabak’s Ratio. However, this relationship was not statistically significant (p>0.05). A positive association was observed between NSL/CVT- Y-Axis, NSL/CVT-FMPA and there was a negative association between NSL/CVT- Gonial angle and NSL/CVT- Jarabak’s Ratio which was statistically significant (p>0.05). CONCLUSIONS: The postural variables (craniocervical angulations) were slightly higher than those previously reported in European population. More upright craniocervical posture was associated with Class II maxillomandibular relation. As the craniocervical angles reduced, the maxillary and mandibular prognathism increased. Cervical spine flexion was seen to be associated with horizontal growers and more erect spine was seen in vertical growers

Keywords

Cervical vertebrae, craniocervical posture, cervical spine morphology, Indian population