International Journal of Health Sciences & Research (www.ijhsr.org) 110 Vol.7; Issue: 7; July 2017 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Comparison of Cranio-Cervical Posture and Upper Cervical Range of Motion in Class I and Class II Skeletal Malocclusion Badal Sonawane 1 , Shreevidya Karthik 2 , Karthik Balasubramanian 3 , Loveleen Waghule 1 1 Physiotherapy Intern, School Of Physiotherapy, D.Y Patil University, Nerul, Navi Mumbai, Maharashtra, India 2 Assistant Professor, School Of Physiotherapy, D.Y Patil University, Nerul, Navi Mumbai, Maharashtra, India 3 Lecturer, YMT Dental College and Hospital, Dr. G.D. Pol Foundation, Kharghar, Navi Mumbai, Maharashtra. Corresponding Author: Shreevidya Karthik ABSTRACT Jaws form important component of skull, which is connected with rest of the spine through cervical vertebrae. Evidence on relationship between incongruent arrangement of upper and lower jaws i.e. skeletal malocclusion and cranio-cervical posture in Indians is limited. Restriction in upper cervical mobility due to cervical postural abnormalities is also not known. This study aimed to identify cranio- cervical postural abnormalities and restriction of upper cervical mobility in skeletal malocclusion. Methods: 24 participants (13 in Class I and 11 in Class II) were included in this study. Lateral cephalograms were utilised to measure the cranio-cervical angle.(CCA) Upper cervical mobility was measured using Cervical Range of Motion (CROM) device during Flexion Rotation Test (FRT). Comparison between mean values of CCA and FRT of Class I and Class II skeletal malocclusion values were was done using student’s t-test. Correlation between CCA and FRT ranges were analysed using Pearson’s correlation co-efficient. Results: Mean of the CCA and FRT ranges were found to be affected in Class II. Mean CCA of Class II subjects was 94.36± 4.08. Mean of FRT ranges on right and left sides were 39.66±2.08 and 39.81±2.33 respectively. A high and significant correlation was found between CCA and FRT ranges on both right (r = 0.78; p < 0.001) and left side (r = 0.69; p <0.001). Conclusion: CCA and FRT ranges were significantly reduced in people with skeletal Class II malocclusion as compared to skeletal Class I. Strong positive correlation was found between CCA and upper cervical range of motion. Keywords: Atlanto-occipital joint, skeletal malocclusion, cranio-cervical angle, lateral cephalogram, flexion rotation test. INTRODUCTION Malocclusion is a result of an interaction between jaw position and the position assumed by the teeth, as they erupt, which is again affected by jaw relationships. Angle's system of classification provides an orderly way to classify malocclusions. Although Angle's system involves assessment of first molar to classify, a broader basis for assessment is skeletal or radiographic assessment of malocclusions using angle’s principles. According to this there are three main types of skeletal malocclusions viz. Class I, Class II and Class III. In Class I malocclusion, there is simultaneous protraction of the upper and lower jaw. In Class II malocclusion, there is protraction of the upper jaw or maxilla in comparison to the lower jaw and in Class III, there is protraction of the lower jaw or