Influence of head and linear growth on the development of malocclusion at six years of age: a cohort study

CAMPOS, Manuelly Pereira de Morais Santos; VALENÇA, Paula Andréa de Melo; SILVA, Genivaldo Moura da; LIMA, Marília de Carvalho; JAMELLI, Silvia Regina; GÓES, Paulo Sávio Angeiras de

doi:10.1590/1807-3107bor-2018.vol32.0098

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Original Research, Pediatric Dentistry • Braz. oral. res. 32 • 2018 • https://doi.org/10.1590/1807-3107bor-2018.vol32.0098 linkcopy

Influence of head and linear growth on the development of malocclusion at six years of age: a cohort study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of this article was to evaluate the influence of biological and sociobehavioral factors on the development of malocclusions in children. This is a cross-sectional study nested in a cohort of 350 children who participated in a community intervention study. After six years, an active search identified 290 children with occlusal abnormalities. Socioeconomic status, linear growth, and nutritional status of the child at birth and at the time of measurement, as well as dietary and sucking habits, were investigated. Malocclusions were evaluated across three spatial planes - anteroposterior, vertical, and transverse. The prevalence of these anomalies was 64.5%, primarily in the anteroposterior plane. The logistic regression analysis revealed that pacifier use for 60 months or more, stunting as measured at age six, and reduced gain in head circumference from birth to six years of age, were significantly associated with the development of malocclusion in childhood. Head circumference and linear growth are associated with occlusal anomalies in infants, independent of pacifier sucking.

Growth and Development; Child, Preschool; Malocclusion; Oral Health

Variable	n	%	Malocclusions

			Yes (%)	n (%)	OR (95%IC)	p-value*
Per capita family income (MW)
≤ 0.25	130	44.8	88 (67.7)	42 (32.3)	1.21 (0.64–2.30)	0.56
0.26-0.50	100	34.5	61 (61.0)	39 (39.0)	0.91 (0.47–5)
> 0.51	60	20.7	38 (63.3)	22 (36.7)	1.00
Mother’s education (years)
0 a 3	58	20.0	40 (69.0)	18 (31.0)	1.35 (0.68–2.66)	0.68
4 a 8	121	41.7	78 (64.5)	43 (35.5)	1.10 (0.65–1.88)
≥ 9	111	38.3	69 (62.2)	42 (37.8)	1.00
Ceiling features
Concrete	59	20.3	39 (66.1)	20 (33.9)	2.05 (0.91–4.63)	0.07
Clay	190	65.5	128 (67.4)	62 (32.6)	2.17 (1.09–4.30)
Asbestos cement	41	14.2	20 (48.8)	21 (51.2)	1.00
Household – refrigerator
No	61	21.1	45 (73.8)	16 (26.2)	1.72 (0.92–3.23)	0.09
Yes	229	78.9	142 (62.0)	87 (38.0)	1.00

Variable	n	%	Malocclusions

			Yes (%)	No (%)	OR (95%IC)	p-value*
Breastfeeding (6 months)
None	147	50.7	105 (71.4)	42 (28.6)	2.15 (1.20–3.83)	0.03
Partial	68	23.4	44 (64.7)	24 (35.3)	1.56 (0.79–3.09)
Exclusive/Predominant	75	25.9	40 (53.3)	35 (46.7)	1.00
Bottle use (6 months)
Yes	226	77.9	155 (68.8)	71 (31.4)	2.18 (12.4–3.84)	0.01
No	64	22.1	32 (50.0)	32 (500)	1.00
Pacifier use (6 years)
Yes	171	58.9	121 (70.8)	50 (29.2)	1.94 (1.19–3.17)	0.01
No	119	41.1	66 (55.5)	53 (44.5)	1.00
Pacifier use duration
No	119	41.0	66 (55.5)	53 (44.5)	1.00	0.00
< 60 months	111	38.3	69 (62.2)	42 (37.8)	1.32 (0.78–2.23)
≥ 60 months	60	20.7	52 (86.6)	8 (13.4)	5.20 (2.28–11.94)
Finger sucking (6 years)
Yes	33	11.4	20 (60.6)	13 (39.4)	0.83 (0.39–1.74)	0.62
No	257	88.6	167 (65.0)	90 (35.0)	1.00

Variable	n	%	Malocclusions

			Yes (%)	No (%)	OR (95%CI)	p-value*
Gender
Male	166	57.3	107 (64.5)	59 (35.5)	0.99 (061–1.62)	0.99
Female	124	42.7	80 (64.5)	44 (35.5)	1.00
Birth weight (g)
≤ 2500	24	8.3	17 (70.8)	7 (29.2)	1.37 (0.55–3.42)	0.50
> 2500	266	91.7	170 (63.9)	96 (36.1)	1.00
CP at birth (cm)
< 33	42	14.5	29 (69.0)	13 (31.0)	1.27 (0.63–2.57)	0.50
≥ 33	248	54.5	158 (63.7)	90 (36.3)	1.00
CP at 6 years (cm)
< 50	44	15.2	34 (77.3)	10 (22.7)	2.07 (0.98–4.38)	0.05
≥ 50	246	84.8	153 (62.2)	93 (37.8)	1.00
Gain in CP (0 to 6 years)
Lesser gain	39	13.4	32 (81.6)	7 (18.4)	2.71 (1.15–6.41)
Higher gain	251	86.6	156 (62.0)	95 (38.0)	1.00	0.02
Height/age (at birth)
Height deficit	18	6.2	15 (83.3)	3 (16.7)	2.91 (0.82–10.3)	0.08
Normal height	272	93.8	172 (63.2)	100(36.8)	1.00
Height/age (6 years)
Height deficit	85	29.3	64(75.0)	21 (25.0)	1.93 (1.09–3.41)	0.02
Normal height	205	70.7	125(60.8)	80 (39.2)	1.00

Variable	Total	Malocclusions

	n = 290	Gross			Adjusted

		n = 187	OR	p-value*	OR	95%IC	p-value*
Model 1
Ceiling features
Concrete	59	39	2.05	0.07	2.83	1.15–6.97	0.08
Clay	190	128	2.17		2.48	1.17–5.29
Asbestos cement	41	20	1.00		1.00
Households - Refrigerator
No	61	45	1.72		1.62	0.81–3.26	0.17
Yes	229	142	1.00	0.09	1.00
Model 2
Breastfeeding (6 months)
None	147	105	2.15	0.03	2.19	1.21–3.95	0.32
Partial	68	44	1.56		1.49	0.74–2.97
Exclusive/Predominant	75	40	1.00		1.00
Model 3
Gain in CP (0 a 6 years)
Lesser growth	39	32	2.71	0.02	2.93	1.16–7.39	0.02
Greater growth	251	156	1.00		1.00
Height/age (6 years)
Height deficit	85	64	1.93	0.02	2.00	1.02–3.89	0.04
Normal height	205	125	1.00		1.00
Model 4
Bottle use (6 months)
Yes	226	155	2.18	0.01	1.61	0.77–3.37	0.20
No	64	32	1.00		1.00
Pacifier use duration
< 60 months	111	69	1.32	0.01	1.07	0.54–2.12	0.01
≥ 60 months	60	52	5.20		4.45	1.80–10.9
None	119	66	1.00		1.00

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[TFN1] *Pearson Chi-square test; MW: Minimum wage.