Variation in natural head position and establishing corrected head position

Corrected head position (CHP) has been simulated by using the Frankfurt horizontal (FH) for over 100 years but FH varies between individuals. Because CHP is biologically relevant for orthodontic diagnosis and treatment planning, orthognathic surgical planning, and art, this study examined relationships between head position and selected cephalometric planes. Natural head position cephalograms of Aboriginal Australians and two contemporary samples from private orthodontic practices were analysed. Each sample comprised 40 individuals (20 males and 20 females). The Aboriginal Australian sample comprised longitudinal data (T1 early adolescent, T2 late adolescent, and T3 adult), enabling examination of natural head position (NHP) reproducibility over a period of approximately 8 years. Results of reproducibility differences revealed an absolute mean=2.9°, range=-7.9° to 8.2°, and standard deviation=3.6°. Stable basicranial line (SBL), neutral horizontal axis (NHA), FH, palatal plane (P plane), and Krogman-Walker plane (KW plane) demonstrated near parallelism and their mean angulations from the true horizontal (HOR) ranged between -4.6° and 2.4°. While NHP is not consistently reproducible at the individual level, the combined use of multiple planes such as SBL, P plane, and KW plane enables a more consistent CHP to be achieved.