Craniocervical posture and skeletal relationship in Peruvian adolescents

Background: Active skeletal growth occurs during adolescence. Elucidating cervical and craniofacial biomechanical connection can help to understand causal relationships and improve orthodontic diagnosis and treatment. This study aimed to evaluate the association between craniocervical posture (CP) versus the sagittal and vertical skeletal relationship (SR) in Peruvian adolescents. Methods: This retrospective study evaluated 153 digital lateral radiographs of adolescents (72 males and 81 females) aged 13 to 17 years (mean age 15.22 ± 1.52 years) distributed into nine groups according to the sagittal SR based on the point A‒nasion line to point B‒nasion line (ANB) angle (class I, II, and III) and vertical SR according to the nasion-sella line and the occlusal plane (NSL-OP’) angle (normodivergent, hypodivergent, and hyperdivergent). CP was analyzed using the Solow and Rocabado parameters. Multiple linear regression models were used to determine the association of CP and SR considering p < 0.05. Results: The sagittal and vertical SR groups showed associations with multiple parameters of CP (p ≤ 0.037). For nine CP parameters, a trend toward cervical flexion was observed in Class III adolescents and toward cervical extension in Class II adolescents across different vertical SR. In model 2, six CP parameters showed significant correlations with the ANB angle (R² = 33.3%, p < 0.001) and the NSL-OP’ angle (R² = 61.8%, p < 0.001). Conclusions: Craniocervical posture parameters were found to be associated with sagittal skeletal relationships. A tendency to the more extended CP was associated with a class II ANB angle, while CP was more flexed in class III regardless of vertical growth. Healthcare professionals should consider cervical posture in the multidisciplinary management of orthodontic treatment for adolescents.