Analysis Guide

Björk-Jarabak Cephalometric Analysis: Growth Rotation & the Posterior/Anterior Ratio

The Björk-Jarabak analysis is orthodontics' primary tool for classifying mandibular growth rotation. Through a chain of three posterior angles and the ratio of posterior to anterior facial height, it distinguishes anterior rotators from posterior rotators — a distinction that fundamentally shapes treatment strategy in growing patients.

By Bayan Healthcare Analytics · Updated · 9 min read

What Is the Björk-Jarabak Analysis?

The Björk-Jarabak analysis synthesises the independent work of Arne Björk (a Danish-Swedish orthodontist who studied mandibular implant markers to observe actual growth rotation) and Jaroslav Jarabak (who formalised the angular and linear measurements into a clinically applicable cephalometric system). The analysis focuses primarily on the vertical dimension and growth pattern — the features that most influence the stability of orthodontic treatment and the long-term prognosis for malocclusion correction.

Its central contribution is the concept of mandibular growth rotation. Björk's implant studies demonstrated that the mandible does not simply grow downward and forward as a unit — it rotates about a condylar centre of rotation, and the direction of that rotation varies dramatically between individuals. A patient growing with strong anterior rotation will tend to close their bite over time; a patient growing with posterior rotation will tend to open it. These tendencies have profound implications for deep bite management, open bite prognosis, and the stability of any achieved occlusal result.

For context on how growth rotation fits into the broader diagnostic picture alongside angular and linear analyses, see the cephalometric analysis guide. For the complementary linear measurement of lower facial height, see McNamara analysis.

Björk-Jarabak Measurements — Norms and Interpretation

Measurement Mean Norm SD Clinical Range High Value Low Value
Saddle Angle (N-S-Ar) 123° ± 5° 118° – 128° Post. condylar position Ant. condylar position
Articular Angle (S-Ar-Go) 143° ± 6° 137° – 149° Posterior ramus inclination Anterior ramus inclination
Gonial Angle (Ar-Go-Me) 130° ± 7° 123° – 137° Open / hyperdivergent Closed / hypodivergent
Upper Gonial Angle (Ar-Go-N) 52° – 55° 47° – 60° Ramus flared forward Ramus inclined posteriorly
Lower Gonial Angle (N-Go-Me) 70° – 75° 65° – 80° Steep mandibular body Flat mandibular body
Sum of Posterior Angles 396° ± 6° 390° – 402° >402° = Posterior rotation <390° = Anterior rotation
Post. Facial Height (S-Go) ~80 mm ± 5 mm Sex/age dependent Long posterior face Short posterior face
Ant. Facial Height (N-Me) ~122 mm ± 6 mm Sex/age dependent Long anterior face Short anterior face
PFH/AFH Ratio (S-Go/N-Me) 62% – 65% 59% – 68% >65% = Anterior rotation <62% = Posterior rotation

Norms from Jarabak & Fizzell (1972) and Björk's original growth studies. PFH/AFH ratio norms reflect white Western European and North American samples.

The sum of posterior angles is the single most reliable predictor of growth rotation type. A sum below 390° indicates anterior rotation (deep bite tendency, favourable for Class II correction in growing patients). A sum above 402° indicates posterior rotation (open bite tendency, less favourable prognosis for Class II or open bite correction). A sum between 390° and 402° is neutral.

Landmarks Required for Björk-Jarabak Analysis

N
Nasion
Most anterior point of the frontonasal suture. Superior point of the anterior facial height measurement (N-Me) and the upper reference for the upper gonial angle subdivision (Ar-Go-N).
S
Sella
Centre of the sella turcica. Vertex of the saddle angle (N-S-Ar) and superior reference point for posterior facial height (S-Go).
Ar
Articulare
The intersection of the posterior border of the mandibular ramus with the lower border of the cranial base. Used as a practical substitute for the condyle in the saddle angle and articular angle. Not to be confused with Condylion (Co) used in McNamara analysis.
Go
Gonion
Most posteroinferior point at the mandibular angle, constructed at the intersection of the ramus tangent and mandibular plane tangent. Central vertex for both the articular angle (S-Ar-Go) and the full gonial angle (Ar-Go-Me), and the reference point for upper/lower gonial angle subdivision.
Me
Menton
Most inferior point of the mandibular symphysis. Inferior endpoint for both the anterior facial height (N-Me) and the gonial angle (Ar-Go-Me). One of the most reliably identified landmarks in cephalometrics.

Articulare vs Condylion: The Björk-Jarabak analysis uses Articulare (Ar) — a constructed landmark at the intersection of the ramus posterior border and cranial base — rather than the anatomical Condylion (Co) used in McNamara analysis. Articulare is more consistently identifiable on standard lateral cephalograms where the condylar outline may be obscured by superimposition.

Clinical Interpretation of Björk-Jarabak Analysis

Anterior vs Posterior Growth Rotation

An anterior rotator (sum < 390°, PFH/AFH > 65%) grows with the mandibular symphysis rotating forward and upward relative to the anterior cranial base. This rotation tends to close the bite, increase the overbite, and may convert a Class II malocclusion into a more favourable skeletal relationship over time. Anterior rotators are generally good candidates for functional appliances and have better long-term stability for deep bite correction.

A posterior rotator (sum > 402°, PFH/AFH < 62%) grows with the symphysis rotating downward and backward. The bite tends to open over time, the mandibular plane angle steepens, and Class II malocclusions become more severe with growth. Posterior rotators are significantly more challenging to treat, particularly for open bite correction, and relapse rates are higher. Treatment decisions in posterior rotators must account for the ongoing negative growth vector.

The Gonial Angle Subdivision

The full gonial angle (Ar-Go-Me, norm 130°) can be subdivided by a line from Go to Nasion. The upper gonial angle (Ar-Go-N, norm 52–55°) reflects the relationship between the ramus and the anterior cranial base. The lower gonial angle (N-Go-Me, norm 70–75°) reflects the angle of the mandibular body. In anterior rotators, the upper gonial angle tends to be larger (the ramus is relatively more anteriorly inclined); in posterior rotators, the lower gonial angle tends to be larger (the mandibular body is more steeply inclined).

Using Björk-Jarabak Alongside Other Analyses

The Björk-Jarabak analysis complements the vertical measurements in McNamara analysis (which provides the lower facial height in absolute millimetres), the vertical component of Downs analysis (mandibular plane angle and Y-axis), and the vertical growth indicators in Ricketts analysis (facial axis and mandibular plane angle). When multiple analyses consistently classify a patient as hyperdivergent, the growth rotation classification from Björk-Jarabak adds the prognostic dimension: not just how much vertical excess exists now, but which direction it is heading.

Run Björk-Jarabak Analysis Free in BCeph

BCeph includes a complete Björk-Jarabak module computing all three posterior angles, their sum, the upper and lower gonial angle subdivisions, S-Go, N-Me, and the PFH/AFH ratio. Results are displayed with norm ranges and growth rotation classification (anterior, neutral, or posterior).

The Articulare landmark used in Björk-Jarabak overlaps with the Ricketts analysis in BCeph, and the Nasion, Sella, Gonion, and Menton landmarks are shared across most analysis modules. Running a full diagnostic session across all BCeph modules requires a single unified landmark placement workflow.

Frequently Asked Questions

What is the Björk-Jarabak cephalometric analysis?
The Björk-Jarabak analysis uses a chain of three posterior angles (saddle, articular, gonial) and the posterior-anterior facial height ratio to classify mandibular growth rotation. It distinguishes anterior rotators (hypodivergent, deep bite tendency) from posterior rotators (hyperdivergent, open bite tendency) — a clinically critical distinction for treatment planning in growing patients.
What is the normal posterior/anterior facial height ratio?
The normal PFH/AFH ratio (S-Go divided by N-Me) is 62–65%. Above 65% indicates anterior growth rotation (hypodivergent pattern); below 62% indicates posterior growth rotation (hyperdivergent). The ratio is one of the most informative single values for vertical skeletal classification.
What is the normal sum of posterior angles?
The sum of the saddle angle (N-S-Ar), articular angle (S-Ar-Go), and gonial angle (Ar-Go-Me) has a norm of 396° ± 6°. Below 390° = anterior rotation. Above 402° = posterior rotation. The sum is considered the most reliable predictor of growth rotation direction in the analysis.
What does the saddle angle measure?
The saddle angle (N-S-Ar) measures the angular relationship at Sella between Nasion, Sella, and Articulare. Norm is 123° ± 5°. A smaller saddle angle positions Articulare anteriorly, generally contributing to a more Class I or anterior rotation tendency. A larger saddle angle places Articulare more posteriorly, contributing to mandibular retrusion.
Can I run Björk-Jarabak analysis for free?
Yes. BCeph includes a complete Björk-Jarabak module at no cost. All three angles, the PFH/AFH ratio, the sum of posterior angles, and the growth rotation classification are calculated automatically. Runs entirely in your browser — no installation, no cloud storage.

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