Influence of BMI percentile on craniofacial morphology and development in children and adolescents

Abstract

Summary Background The prevalence of childhood and adolescent obesity is increasing worldwide. Reports suggest that elevated body mass index (BMI) is associated with larger craniofacial dimensions and advanced dental and skeletal development. Such an association is important for timing orthodontic treatment relative to pubertal growth and dental eruption. Materials and Methods To evaluate associations between BMI, craniofacial morphology, dental age, and cervical vertebrae maturation staging (CVMS), 400 participants were consecutively selected (8–15 years, n = 200 overweight and obese BMI >85%, 200 normal weight) from the University of North Carolina database. Records were analysed for cephalometric measures, Demirjian index values, and CVMS. Bivariate statistics and linear regression analysis evaluated whether CVMS, dental age, and cephalometric dimensions varied with BMI. Results Overweight/obese children and adolescents had a proportionally larger bimaxillary prognathic skeletal pattern compared to those of normal weight. These cephalometric measurements [articulare–gnathion (Ar–Gn), condylion–anterior nasal spine (Co–ANS), sella–gonion (S–Go), nasion–menton (N–Me), anterior nasal spine–menton (ANS–Me), sella-nasion-A point (SNA), sella-nasion-B point (SNB), and sella-nasion-pogonion (SNPg)] were significantly different [statistically (P < 0.05) and clinically (>2 mm or >2 degrees)] between the two study groups, with a linear relationship between BMI percentile and craniofacial dimension. The overweight/obese BMI group had a mean dental age 1.4 years advanced relative to the normal weight group (P < 0.05), with an advancement of nearly one CVM stage between the ages of 12 and 14 (P < 0.05). Limitations The study is retrospective. Conclusions Obese/overweight children and adolescents have proportionally larger antero-posterior and vertical dimensions and are more likely to experience advanced dental and skeletal maturation. Obese/overweight subjects may enter their growth spurt at a younger age and have earlier eruption of teeth, affecting treatment timing. BMI percentile should be a consideration for orthodontic treatment in growing patients.

Novel Genetic Determinants of Dental Maturation in Children

“…Genetic correlation was evaluated between the summary statistics of the NT-GWAS and anthropometric traits, blood lipids, hormones, and glycemic traits using the linkage disequilibrium (LD) score regression as implemented in the LD Hub database, making use of the already reported epidemiological association of these traits with dental maturation/eruption (Lal et al 2008; Partyka et al 2018; Danze et al 2021). We used only the NT GWAS summary statistics to avoid combining 2 proxies of dental maturation - NT and radiographic DD - in the LD Hub database (Zheng et al 2016).…”

Effects of endocrine disorders on maxillary and mandibular growth in Colombian children and adolescents: a cross-sectional study

“…Overweight and obesity can alter bone metabolism, stimulate bone growth, inhibit bone remodeling, and increase the risk of musculoskeletal injuries (Dimitri 2019 ). Craniofacially, they can induce prognathism (Danze et al 2021 ), increased facial height (Cuccia et al 2007 ), early tooth eruption (Saloom et al 2017 ), and periodontitis (Zhu et al 2017 ). Growth hormone deficiency decreases growth velocity, leading to an immature facial appearance, short stature, hair deficiency, and delayed puberty (Ogilvy-Stuart and Shalet 1992 ).…”

Influence of the nutritional status on facial morphology in young Japanese women

“…A study using geometric morphometric modeling of facial landmark data in 2D photographs 16 successfully predicted the BMI (32% of variance explained) and percentage body fat (21%). In addition to effects on soft tissue, recent studies have further clarified the influence of obesity or a high BMI on the hard-tissue craniofacial morphology using roentgen cephalograms 17 . These studies showed that obesity results in a greater facial size and bimaxillary protrusion with advanced maturation with or without vertical differences.…”

“…These studies showed that obesity results in a greater facial size and bimaxillary protrusion with advanced maturation with or without vertical differences. This is assumed to be related to the fact that obesity can cause precocious puberty (earlier sexually development) and advanced bone maturity 17 , indicating the sexhormonal association of obesity.…”

“…However, little is known at present regarding the influences of holistic nutritional status, including the dietary intake, eating behaviors, and body composition, on the facial form 24 . Furthermore, most of these previous findings were primarily based on 2D photos 17,25 , which leads to difficulties in discussion from a biological aspect. In addition, indices to express 'maleness' in previous studies 18,19 were only based on observers' perception; however, one study 26 showed that the shape features perceived as masculine only partly resembled the biological facial sexual dimorphism characteristics.…”