A New Horizontal Plane of the Head


  • Ehab El Kattan Faculty of Oral and Dental Medicine, Cairo University, Cairo
  • Mohamed El Kattan Faculty of Oral and Dental Medicine, Cairo University, Cairo
  • Omnia A. Elhiny National Research Centre, Cairo http://orcid.org/0000-0002-8435-1021




, Cephalometrics, Frankfurt Horizontal, True vertical, Natural head position


AIM: This study aimed to attempt to introduce a new extracranial horizontal plane of the head (K plane that extends from SN to SAE bilaterally) that could act as a substitute to the Frankfurt horizontal intracranial reference plane; both clinically and radiographically.

MATERIAL AND METHODS: The new K plane depended on three points of the head. The first was the soft tissue nasion (NS) on the interpupillary line when the subject looked forward at a distant point at eye level. The other two points were the superior attachments of the ears (SAE).

RESULTS: The student “t†test comparing mean values of K/V and FH/V was not significant; -0.21.  The coefficient of correlation between different variables was highly positively significant (r = 0.98 with probability = 0.001).

CONCLUSION: Within the limitations of this prospective study, the new K plane was found to be both reliable and reproducible. It can be used as a reliable reference plane instead of Frankfort horizontal plane both clinically and radiographically; as it is an accurate tool for head orientation in the natural head position.


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Broadbent BH. A new x-ray technique and its application to orthodontia. The Angle Orthodontist. 1931; 1(2):45-66.

Bjerin BA. A comparison between the Frankfort horizontal and the sella turicica-nasion as references planes in cephalometric analysis, Acta Odont Secand. 1957; 15:1-12. https://doi.org/10.3109/00016355709041090

De Beer GR. How animals hold their heads. Proc Linnean Soc London. 1947; 159:125-139. https://doi.org/10.1111/j.1095-8312.1947.tb00491.x

Downs WB. Variation in facial relationship: Their significance in treatment and prognosis. Am J Orthod. 1948; 34:812-840. https://doi.org/10.1016/0002-9416(48)90015-3

Downs WB. The role of cephalometrics in orthodontic case analysis and diagnosis. Am J Orthod. 1952; 38:162-182. https://doi.org/10.1016/0002-9416(52)90106-1

Downs WB. Analysis of the dentofacial profile. Angle Orthod. 1956; 26:191-211.

Moorres CF, Kean MR. Natural head position, a basic consideration in the interpretation of cephalometric radiograph. Am J Phys Antropol 1958; 16: 213-234. https://doi.org/10.1002/ajpa.1330160206

Krogman WM, Sassouni V. A Syllabus in roentgenographic cephalometry. Philadelphia 1957, Philadelphia Growth Center for Research in Child Growth, 1957.

Koski K, Virolarinen K. On the relationships between roentgenographic-cephalometric lines of reference. Acta Odont Scand. 1956; 14:23-32. https://doi.org/10.3109/00016355609007501

Sassouni V. A roentogenographic cephalometric analysis of cephalofacial-dental relationship. Am J Orthod. 1955; 41:735-764. https://doi.org/10.1016/0002-9416(55)90171-8

Fenart R, Lie Fooghe J. Relation entre la posture et la form. J Sci Med Lille. 1956; 83:279-288.

Kronman WM. Craniometry and cephalometric as research tools in growth of head and face. Am J Orthod. 1951; 37:406-414. https://doi.org/10.1016/0002-9416(51)90190-X

Mohl ND. Craniofacial relationships and adaptation in bats. Ph.D. dissertation stale University of New York at Buffalo, Buffalo. N.Y., 1971.

Broca P. Sur L'angle orbito-occipital Bull. Soc Anthropal Paris. 1877; 12:325-333.

Delattre A, Fenart R. La method vestibulaire. Morphal Anthropal. 1958; 49:90-114.

Lundstrorn A, lundstrom F, Lebret LL, Moorrees CF. Natural head position and natural head orientation: basic considerations in cephalometric analysis and research. Europ J Orthod. 1995; 17: 111-117. https://doi.org/10.1093/ejo/17.2.111

Solow B, Tallgren A. Natural head position in standing subjects. Acta Odont scand. 1971; 29: 591-607. https://doi.org/10.3109/00016357109026337 PMid:5290983

Vig P.S., Rink J.F., Show Fety K.J.: Adaptation of head posture in response to relocating the center of mass. A pilot study. Am J Orthod 1983; 83:138-142. https://doi.org/10.1016/S0002-9416(83)90299-3

Slow B, Tallgren A. Head posture and craniofacial morphology. Am J Phys Anthropol. 1976; 44: 417-435. https://doi.org/10.1002/ajpa.1330440306 PMid:937521

Marcotte MR. Head posture and dentofacial proportions. Angle Orthod. 1981; 51: 208-213. PMid:6943949

Peterson CB, Evans WG, Todress J. The relation between orthohead posture and head posture measured during walking. Am J Orthod Dent Ortho. 1997; 111:283-287. https://doi.org/10.1016/S0889-5406(97)70186-0

Virgilio F, Chiarello S, Domenica G, Luca D, Alessandro M. An integrated Head Posture and cephalometric analyses photographic radiographic technique. Am J Orthod Dent ortho. 1994; 106: 257-263. https://doi.org/10.1016/S0889-5406(94)70045-1

Davidson T. Photography in facial plastic and reconstructive surgery. J Biol Photogr. 1979; 47: 59-67.

Madsen DP, Sampson WJ, Townsend GC. Craniofacial reference plane variation and natural head position. Europ J of Orthod Oct. 2008; 30(5):532-540. https://doi.org/10.1093/ejo/cjn031 PMid:18632837

Shetty D, Bagga DK, Goyal S, Sharma P. A cephalometric study of various horizontal planes in natural head position. J Ind Orthod Soc. 2013; 47(3):143-147. https://doi.org/10.5005/jp-journals-10021-1146



How to Cite

El Kattan E, El Kattan M, Elhiny OA. A New Horizontal Plane of the Head. Open Access Maced J Med Sci [Internet]. 2018 May 19 [cited 2021 Jul. 31];6(5):767-71. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.172



A - Basic Science