{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:45:06Z","timestamp":1791179106721,"version":"4.1.0"},"reference-count":72,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior \u2013 Brasil","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Obesity and overweight represent significant public health concerns affecting children and adolescents. Besides their association with accelerated pubertal growth, the high body mass index (BMI) has been implicated in craniofacial dimension alterations and malocclusion development within this age group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to evaluate the impact of high BMI on sagittal and vertical craniofacial dimensions and malocclusions in children and adolescents. Search methods: We conducted unrestricted electronic searches across nine databases until November 2024. Selection criteria: Inclusion criteria were cross-sectional, case-control, and cohort studies involving participants aged 5 to 19 years that established a relationship between BMI, dimensional changes in craniofacial structures, and the presence of malocclusion. The research question applied the PECO framework. Data collection and analysis: After removing duplicates, extracting the data, and assessing the risk of bias with the JBI Critical Appraisal Tools for observational studies, we performed random-effects meta-analyzes of mean differences (MD) with 95% confidence intervals (CI). Subsequently, we assessed the quality of evidence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study included 21 articles (19 cross-sectional, one cohort, one case-control) with low-to-moderate risk of bias. Eight studies focused on craniofacial dimensions, and 13 on malocclusion. The meta-analysis revealed significantly larger sagittal dimensions in patients with obesity or overweight, including extended cranial base length (S-N, MD\u2005=\u20050.8452 [0.5531\u20131.1373]), mandibular length (Cd-Gn, MD\u2005=\u20050.5770 [0.0639\u20131.0902]), maxillary length (Cd-A, MD\u2005=\u20050.8021 [0.4251\u20131.1790]), and bimaxillary protrusion (SNA, MD\u2005=\u20050.6008 [0.1099\u20131.0916]; SNB, MD\u2005=\u20050.6712 [0.1328\u20131.2096]; SNPg, MD\u2005=\u20050.5921 [0.0666\u20131.1175]). Concurrent gains in posterior facial height (S-Go, MD\u2005=\u20050.6619 [0.2385; 1.0853]) in the vertical dimension usually did not alter the overall facial plane, tending towards more horizontal growth. These gains were higher for girls with high BMI. Regarding malocclusions, only two of the 13 studies identified statistically significant associations between dental crowding and high BMI. While seven studies exhibited a low risk of bias, the included articles commonly demonstrated limited control over potential confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Based on limited evidence, children and adolescents with high BMI presented enhanced bimaxillary prognathism and enlarged sagittal and vertical craniofacial dimensions. The BMI did not consistently impact malocclusions, although a few studies linked dental crowding to overweight. Orthodontic planning for this population should consider the patient\u2019s BMI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Registration<\/jats:title>\n                  <jats:p>PROSPERO (CRD 42024511194).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjaf044","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T06:19:20Z","timestamp":1750832360000},"source":"Crossref","is-referenced-by-count":5,"title":["Craniofacial dimensions and malocclusions in children and adolescents with a high body mass index: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2089-0162","authenticated-orcid":false,"given":"Douglas","family":"Teixeira da Silva","sequence":"first","affiliation":[{"name":"Graduation Program in Dentistry, Universidade Federal de Uberl\u00e2ndia - UFU, Campus Umuarama, R. Rep\u00fablica do Piratini, 1229, Umuarama, 38405-266 , Uberl\u00e2ndia, MG ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7599-0120","authenticated-orcid":false,"given":"Luiz Renato","family":"Paranhos","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Dentistry, Universidade Federal de Uberl\u00e2ndia - UFU, Campus Umuarama, Av. Par\u00e1, 1720, Bloco 2G, 38405-320, Uberl\u00e2ndia, Minas Gerais ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3895-7871","authenticated-orcid":false,"given":"Helena Benatt do Nascimento","family":"Alves","sequence":"additional","affiliation":[{"name":"School of Dentistry, Universidade Federal de Uberl\u00e2ndia - UFU, Campus Umuarama, R. Rep\u00fablica do Piratini, 1229, Umuarama, 38405-266, Uberl\u00e2ndia, MG ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5268-0595","authenticated-orcid":false,"given":"Heitor Bernardes Pereira","family":"Delfino","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, Universidade Federal de Uberl\u00e2ndia - UFU, Campus Umuarama, Av. Par\u00e1, 1720, Bloco 2U, sala 1, 38405-320, Uberl\u00e2ndia, MG ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6892-3659","authenticated-orcid":false,"given":"Caio Melo","family":"Mesquita","sequence":"additional","affiliation":[{"name":"Graduation Program in Dentistry, Universidade Federal de Uberl\u00e2ndia - UFU, Campus Umuarama, R. Rep\u00fablica do Piratini, 1229, Umuarama, 38405-266 , Uberl\u00e2ndia, MG ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8872-2865","authenticated-orcid":false,"given":"Walbert de Andrade","family":"Vieira","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Centro Universit\u00e1rio das Faculdades Associadas de Ensino - UNIFAE, 13870-377, S\u00e3o Jo\u00e3o da Boa Vista, SP ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0887-9385","authenticated-orcid":false,"given":"Carlos","family":"Flores-Mir","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, College of Health Sciences University of Alberta, 5-528 Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB T6G 1C9 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7375-0361","authenticated-orcid":false,"given":"Guilherme de Ara\u00fajo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Dentistry, Universidade Federal de Uberl\u00e2ndia - UFU, Campus Umuarama, Av. 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