Problem
The Frankfurt plane is tilted downward.
Effects
The roots of the mandibular anterior teeth are positioned
outside the focal trough so it is out-of-focus and blurred.
The shadow of the hyoid bone is typically superimposed on
the anterior mandible.
Condyles may be cut off at the top of the radiograph.
Pre-molars are severely overlapped.
Severe curvature of the occlusal plane.