Childhood Obesity and Craniofacial Growth: An Orthodontic Cephalometric Study

Background: Childhood obesity has become a major global health concern and is increasingly recognized as a factor influencing skeletal development. Emerging evidence suggests that excess adiposity may alter craniofacial growth patterns, potentially affecting orthodontic diagnosis, treatment planning, and airway function. However, the extent to which obesity influences craniofacial morphology in growing individuals remains incompletely understood. Objective: To evaluate the relationship between body mass index (BMI) and craniofacial morphology in children and adolescents using selected sagittal and linear craniofacial parameters, and to determine the independent effects of age and sex on these associations. Methods: This cross-sectional orthodontic study included 130 healthy subjects aged 19 or younger. Anthropometric measurements were recorded, and BMI was calculated to classify participants into normal weight, overweight, and obese groups. Standardized lateral cephalometric radiographs were obtained, and twenty-one skeletal and soft-tissue parameters were analyzed. Statistical evaluation included tests of normality, one-way ANOVA, and post-hoc comparisons to assess differences according to BMI, sex, and age groups. Results: Obesity was significantly associated with increased sagittal skeletal dimensions. Mandibular body length, mandibular unit length, SNB angle, and maxillary unit length demonstrated progressive increases across BMI categories (p < 0.05). In contrast, vertical growth parameters showed no significant differences. Soft-tissue analysis revealed reduced facial convexity and lower facial height ratios in obese subjects. Age was strongly associated with increases in linear jaw dimensions, whereas sex differences were limited primarily to skeletal size rather than morphological relationships. Conclusions: Childhood obesity is associated with enhanced sagittal craniofacial growth, particularly involving mandibular structures, while vertical skeletal patterns remain largely unaffected. These findings highlight the importance of incorporating BMI assessment into orthodontic evaluation and suggest that obesity may influence growth timing, facial morphology, and airway-related risk factors.