Head posture refers to the upright position of the head of a standing or sitting subject. The literature reports that head posture is affected by many factors. Objective: To evaluate differences in head posture according to craniofacial growth pattern. Methods: A total of 163 individuals (83 females and 80 males) were included in this study. Patients were divided into three groups according to ANB angle as Class I, Class II, and Class III, and each group was divided further into three subgroups according to SN/GoGn angle as hyperdivergent, normodivergent, and hypodivergent. The patients were compared in terms of head posture measurements. Two-way ANOVA was used to evaluate the main and interactive effects of vertical growth pattern and malocclusion type on the head posture of the patients. Results were considered statistically significant at p < 0.05. Results: No statistically significant difference between malocclusion and face-type groups was observed in all head posture measurements (p > 0.05). Conclusion: Head posture is similar among subgroups of different malocclusion types separated by vertical growth pattern.


  1. Mariya Q, Mushtaq M. Cephalometric evaluation of cervical column curvature with respect to sagittal jaw position. Int J Appl Dent Sci. 2017;3(4):238-42.
  2. Gomes Lde C, Horta KO, Gonçalves JR, Santos- Pinto AD. Systematic review: craniocervical posture and craniofacial morphology. Eur J Orthod. 2014 Feb;36(1):55-66.
  3. Cerruto C, Di Vece L, Doldo T, Giovannetti A, Polimeni A, Goracci C. A computerized photographic method to evaluate changes in head posture and scapular position following rapid palatal expansion: a pilot study. J Clin Pediatr Dent. 2012;37(2):213-8.
  4. Clavel L, Rémy-Neris S, Skalli W, Rouch P, Lespert Y, Similowski T, Sandoz B, Attali V. Cervical spine hyperextension and altered posturo-respiratory coupling in patients with obstructive sleep apnea syndrome. Front Med. 2020;(7):30.
  5. Bass NM. Measurement of the profile angle and the aesthetic analysis of the facial profile. J Orthod. 2003 Mar;30(1):3-9.
  6. Yagci A, Uysal T, Usumez S, Orhan M. Rapid maxillary expansion effects on dynamic measurement of natural head position. Angle Orthod. 2011 Sep;81(5):850-5.
  7. Linder-Aronson S, Woodside D. Factors affecting the facial and dental structures in excess face height: malocclusion, etiology, diagnosis, and treatment. Chicago: Quintessence Pub Co. 2000:1- 33.
  8. Schwarz A. Positions of the head and malrelations of the jaws. Int J Orthod, Oral Surg, Radiograph. 1928;14(1):56-68.
  9. Rocabado M, Ben E. Johnston Jr, Mitchell G Blakney. Physical therapy and dentistry: an overview. J Craniomand Pract. 1982,1:1,46-9.
  10. Woodside D, Linder-Aronson S, Stubbs DO: relationship between mandibular incisor crowding and nasal mucosal swelling. Proc Finn Dent Soc. 1991;87:127-38.
  11. Liu Y, Sun X, Chen Y, Hu M, Hou X, Liu C. Relationships of sagittal skeletal discrepancy, natural head position, and craniocervical posture in young Chinese children. Cranio. 2016;34(3):155-62.
  12. Basheer B, Hegde KS, Bhat SS, Umar D, Baroudi K. Influence of mouth breathing on the dentofacial growth of children: a cephalometric study. J Int Oral Health. 2014;6(6):50-5.
  13. Afrand M, Ling CP, Khosrotehrani S, Flores-Mir C, Lagravère-Vich MO. Anterior cranial-base time-related changes: a systematic review. Am J Orthod Dentofacial Orthop. 2014;146(1):21-32.e6.
  14. Meiyappan N, Tamizharasi S, Senthilkumar KP, Janardhanan K. Natural head position: an overview. J Pharm Bioallied Sci. 2015;7(Suppl 2):S424-7.
  15. Shenoy U, Banerjee S, Wajekar P, Vasvani V. Assessment and comparison of the head posture and craniofacial growth in vertical dimension—a cephalometric study. J Evol Med Dent Sci. 2020;9(15):1276-81.
  16. Solow B, Tallgren A. Head posture and craniofacial morphology. Am J Phys Anthropol. 1976;44(3):417- 35.
  17. Tekale PD, Vakil KK, Nagmode SL. Hyoid bone position and head posture comparison in skeletal Class I and Class II subjects: a retrospective cephalometric study. APOS Trend Orthod. 2014;4(3):53.
  18. Jose NP, Shetty S, Mogra S, Shetty VS, Rangarajan S, Mary L. Evaluation of hyoid bone position and its correlation with pharyngeal airway space in different types of skeletal malocclusion. Contemp Clin Dent. 2014;5(2):187-9.
  19. Soheilifar S, Momeni MA. Cephalometric comparison of position of the hyoid bone in class I and class II patients. Iran J Ortho. 2017;12(1).
  20. Torre C, Guilleminault C. Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children. J Pediatr (Rio J). 2018;94(2):101-3.
  21. Cassi D, De Biase C, Tonni I, Gandolfini M, Di Blasio A, Piancino MG. Natural position of the head: review of two-dimensional and three-dimensional methods of recording. Br J Oral Maxillofac Surg. 2016;54(3):233-40.
  22. Graber LW, Vanarsdall RL, Vig KW, Huang GJ. Orthodontics: current principles and techniques. Elsevier Health Sciences. 2016.
  23. Ertürk N, Dogan S, Aras A. The investigation of the relationships between the natural head position, posture and sagittal jaw relations. Turk J Orthod. 1990;3:1-6.
  24. Cole S. Natural head position, posture, and prognathism: the Chapman Prize Essay. Br J Orthod. 1988;15(4):227-39.
  25. Soytarhan A, Aras A. Evaluation of the head posture in orthodontic malocclusions. Turk J Orthod. 1990;3:102-6.
  26. Hedayati Z, Paknahad M, Zorriasatine F. Comparison of natural head position in different anteroposterior malocclusions. J Dent (Tehran, Iran). 2013;10(3):210.

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