Evaluating the Plantar Pressure Loading and Its Correlation to Craniocervical Posture in Subjects With Skeletal Class II Malocclusion Before and After Surgical Mandibular Advancement

Class II malocclusion is one of the most prevalent types of malocclusions following Class I. The most typical postural features observed in Class II patients are extended craniocervical posture, cervical lordosis, and increased forward loading away from the body’s centre of mass for compensating the mandibular deficiency and reduced airway. Its treatment involves orthodontic, functional, and orthognathic surgery. The type of treatment regimen opted for depends upon the age, severity of malocclusion, and need of the patient. Thus, appropriate intervention brings about improvement in dentition along with an overall enhancement of the body posture and plantar loading. These variables undergo a significant change whenever there is a change in the maxillomandibular relationship. The main aim of this paper is to correlate the variation in the craniocervical angulation to the plantar pressure distribution during various phases of orthodontic treatment and bilateral sagittal split osteotomy (BSSO) advancement surgery. The craniocervical angulations were determined from the lateral cephalograms of the patients using cephalometric variables and the plantar pressure was estimated using a digital quanpressurometer device (designed and patented in India by Meenakshi Academy of Higher Education and Research; patent number 390136) at each phase, i.e., during pre-treatment, pre-surgery, post-surgery, post-treatment intervals. The outcome of this study indicated that there was a significant change in the craniocervical angulation and the plantar pressure distribution pattern of the subjects before and after orthognathic surgery and it remained constant for six months after orthognathic surgery. The limitation of the study was the limited sample size. This study reveals that there was an improvement in the craniocervical angulation and plantar pressure distribution during the course of orthodontic decompensation and orthognathic surgical treatment, thus bringing about change in the individual's overall body posture and their plantar loading pattern after orthognathic surgery. Therefore, the change in the stomatognathic system by orthodontic and orthognathic treatment influences the overall muscular and functional balance of an individual thereby improving their attitude and lifestyle.