Page 71 - Welcome to Posture Pro
P. 71
418 Craniocervical posture: cephalometric and biophotogrammetric analysis
Fig. 1 – Craniocervical biophotogrammetric variables A) Angle FE – head flexion/extension of B) Angle A1 – Forward head posture; C) Angle A2 –
Forward head posture
Fig. 2 – Craniocervical cephalometric variables. A) craniovertebral angle (CVT); B) CVT/EVT Angle – Cervical lordosis; C) CPL/HOR angle–
Forward head posture.
The cephalometric radiography to assess the point of the body of C2) . The smaller the CPL-Hor angle,
craniocervical posture was performed with the Orthophos Plus the greater the hyperextension of the head on the upper
equipment (Siemens, Erlangen, Germany) with the chassis cervical spine.
positioned parallel to the face and immediately adjacent to
the shoulder of the individual to ensure the visualization of The forward head posture was measured by the angle
C7. It was used chassis with T MAT G Kodak film of de formed by the intersection of the CPL line (craniocervical
18x24 cm, with a fixed focus distance of 1.52 m and in postural line) in relation to the horizontal8. The CPL line
accordance with the protocol of radiation protection in reaches the central points that are demarked in the body of
accordance with Ordinance 453 of 06/01/1998 (Ministry of the first six cervical vertebrae. The smaller the CPL-Hor angle,
Health, Department of Health Surveillance). the more forward the head.
All angles were traced manually by a single, previously For the analysis of the cervical curve the CVT/EVT ratio
trained examiner. The cephalograms were drawn on acetate was used15-16. The CVT line intersects the apex of the tooth
paper with the aid of a mechanical pencil (graphite 0.3 mm) of the second cervical vertebra with the most posterior-inferior
using a light box in order to enable a better visualization of point of the body of the fourth cervical vertebra, while the
the structures. A protractor to perform the angular EVT line intersects the most posterior-inferior points of the
measurements and a millimeter ruler for the linear body of the fourth and sixth cervical vertebrae. The smaller
measurements were used. the CVT/EVT angle, the more rectified the cervical curvature.
In the lateral radiographic record, three variables related The variables were measured by a single examiner
to the posture of the head and of the cervical spine (Figure through manual cephalometric tracing. With a one week
2) were evaluated. The position of flexion/extension of the interval, 20 radiographs were randomly assigned to a second
head was measured using the cranio-vertebral angle of analysis of the variables to verify the reliability of the
Rocabado13 (1983), recently described in the literature3,14-15. performed tracing.
This angle is formed by the McGregor Plane (a plane that
touches the base of the occipital bone to reach the posterior Statistical analysis
nasal spine) and by the odontoid process (from the apex of
the odontoid process of C2 to the most anterior and inferior The Intraclass correlation coefficient (ICC) verifies the
reliability of the cephalometric measurements. The ICC values
Braz J Oral Sci. 11(3):416-421 should be greater than 0.75 to indicate good reliability and
