Craniofacial form differences between obese and nonobese children.

Introduction: Current evidence suggests that obesity is correlated with differences in craniofacial form in children and adolescents. Here, we sought to test this hypothesis by evaluating the craniofacial form of obese and nonobese preorthodontic patients, using 2D cephalometric data combined with cephalometric and geometric morphometric approaches.

Methods: Height, weight, age, and lateral cephalometric radiographs were gathered from patients aged 7-16 years before beginning orthodontic treatment at the University of British Columbia. Based on their body mass index, 24 obese patients were age, sex, and Angle classification of malocclusion matched with nonobese controls. Cephalometric radiographs were annotated, and coordinates of landmarks were used to obtain linear and angular cephalometric measurements. Geometric morphometric analyses were performed to determine overall craniofacial form differences between cohorts. Dental maturation index scores and cervical vertebral maturation scores were recorded as an indicator of skeletal maturation.

Results: Cephalometric analysis revealed that the maxillary length and gonial angle are the only marginally larger metrics in obese subjects than in control subjects. However, principal component and discriminant analyses (geometric morphometrics) confirmed that the overall craniofacial form of obese patients differs statistically from that of control patients. Obese patients tend to be slightly mandibular prognathic and brachycephalic. Dental maturation index scores were statistically higher in the obese group than in the control group, with no statistical difference in cervical vertebral maturation scores.

Conclusions: Our data reveals a subtle but significant difference in cranial skeletal morphology between obese and nonobese children and adolescents, suggesting a correlation between craniofacial form and physiological/metabolic phenotypes of subjects. It is likely that with continued growth, these differences may increase. Recording body mass index as part of the orthodontic records for patients may help in supporting the assessment of craniofacial form.