Head angulation and variations in the maxillomandibular relationship. Part II: The effects on facial contour and lip support.

Twelve edentulous patients were evaluated for changes in facial contour and lip support when the head was progressively tilted backward. The mandibular facial contour changes did not occur in a progressive cause and effect type of relationship. A trend pattern could not be discerned. The maxillary facial contour did have a significant progressive cause and effect relationship in two of the 12 patients and was a positive relationship. As the angles were increased, the displacement of the maxillary facial contour increased anteriorly. The question as to why the maxillary facial contour had a significant progressive cause-and-effect relationship in two of the 12 patients and the mandibular facial contour did not remain unresolved. In a practical sense, it seems reasonable to establish the maxillomandibular relationship with the patient in a comfortable position. This and the ease of recording by the dentist are the primary considerations.