Relationship of natural head position to craniofacial morphology

This investigation aimed at discussing the utility of natural head position-based cephalometric variables and to evaluate the relationship between natural head position and craniofacial morphology. Lateral facial photographs and cephalograms of 284 young adult males taken in a natural head position were analyzed. The average inclination of the intracranial reference planes, Frankfurt horizontal, and palatal plane, in relation to the true horizontal were nearly similar and smaller than 1 degrees. Variables based on the true vertical to describe mandibular sagittal position like B-N(vert) and Pg-N(vert) had very high variances. To study the topographic error, flexors and extenders were identified on basis of four positional variables: NSL/VER; FH/VER; PP/VER; and PMvert/VER. Only 15 measurements were different, according to at least 2 of the 4 positional variables. The 3 that were different in all categories were: facial axis (NBa/PmGn), lower face height (ANS-Me), and the facial ratio (N-ANS/ANS-Me). The "extenders" had higher values for the facial axis and lower face height, and smaller for the face height ratio. Besides these 3 measurements, there was a tendency for the extenders to have increased anterior vertical height, distal sagittal relations, and smaller and retrognathic mandibles. Correlation coefficients between postural and morphologic variables tended to confirm these observations.