Relationship between Cervical Column Morphology and Skeletal Deep Bite: a Pilot Study

Purpose: Previous studies have shown that cervical column morphology is related to head posture, which is associated with craniofacial morphology such as mandibular rotation pattern. Furthermore, cervical column deviations and fusions have been linked with vertical and sagittal facial morphology. In addition, skeletal deep bite may lead to respiratory and swallowing difficulties, aesthetic and functional problems, as well as TMJ and facial pains. The aim of this study was to examine the cervical column morphology in adult patients with skeletal deep bite and to compare it with that of the control group with neutral occlusion and normal craniofacial morphology. Methods: In a case–control study, 25 deep bite patients (17 female, 8 male), aged 17–30 years were compared with 25 controls (16 female, 9 male) of the same age range. For each individual, angular measurements of craniofacial and cervical column dimensions were made on profile radiographs. Anomalies of cervical column such as fusion and arch deficiency were assessed. Jarabak index, ANB, SN-MP, and FMA angles were also evaluated. Results: In the deep bite group, 72% of patients had cervical column fusion compared to 32% of control sample. In the control group, the fusions were always occurred between C2 and C3. However, fusion in the deep bite individuals occurred in the C2-C3, C3-C4 and C4-C5 sites. Fusion occurred significantly more often in the overbite group compared with the control group. (p < 0.001). Conclusion: Associations between skeletal deep bite and cervical column deviations are evident. Most significant deviation in cervical vertebrae was observed at C2-C3 intervertebral space.