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Craniofacial differences between obese and non-obese orthodontic patients Tam, Samuel P.


Introduction: Although childhood obesity has recently seen a plateau in the USA and Canada, it still effects 10-20% of children and adolescents. Increasing evidence points to obesity contributing to changes in growth and development, puberty, bone metabolism and tooth movement. For this study, we compared craniofacial differences in obese and non-obese orthodontic patients between the ages of 7-16 years old, focusing on a younger age cohort than studied previously. Objectives: To evaluate the craniofacial form of obese and non-obese adolescent patients using 2D cephalometric data and geometric morphometric approaches. Methods: Height, weight, age, and lateral cephalometric radiographs were gathered from patients aged 7-16, before beginning orthodontic treatment at the University of British Columbia (UBC). A group of 24 obese patients were age, sex and Angle-classification of malocclusion matched, with non-obese controls. Cephalometric radiographs were annotated, and coordinates of landmarks used to obtain traditional linear and angular measurements. Additionally, geometric morphometric (GM) analyses was performed to determine overall craniofacial form. Dental maturation index scores were assessed from panoramic films using the Demerijian method and cervical vertebral maturation (CVM) scores were recorded from the cephalograms, as an indicator for skeletal maturation. Results: Our conventional cephalometric analysis revealed that the maxillary length and gonial angle are larger in obese individuals (p=0.041 and p=0.028 respectively). GM analyses confirmed that the overall craniofacial form of obese patients differs statistically from the form of control patients and also reveal that obese patients present with a more dolichocephalic facial type. Dental maturation index scores were statistically higher in the obese group compared to the control group with no statistical difference in CVM scores. Conclusions: Our data reveals a subtle but significant difference in cranial skeletal morphology between obese and non-obese adolescent patients, suggesting a correlation between dental maturation, craniofacial form and physiologic/metabolic phenotypes of individuals. Body Mass Index should be included as part of the orthodontic assessment to aid in appropriate diagnosis of the underlying craniofacial form.

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