Risk Factors in the Formation of Maxillofacial Anomalies in Children and Adolescents

Abstract

Introduction
Maxillofacial anomalies are among the most widespread structural pathologies in pediatric dentistry, affecting both aesthetics and function of the orofacial complex. Despite advancements in diagnostic technology and orthodontic treatment, the prevalence of these anomalies remains high worldwide. Epidemiological data indicate that up to 95% of adolescents may be affected, depending on age, sex, and regional factors. These anomalies are often multifactorial in origin, involving genetic, epigenetic, and socio-environmental determinants that interact during the stages of craniofacial development. While many risk factors have been proposed, there remains a lack of consensus regarding their relative influence, especially within localized contexts.

Aim
The objective of this study was to identify and stratify socio-biological risk factors associated with the development of maxillofacial anomalies in children and adolescents aged 6 to 16. The study aimed to distinguish between modifiable (controllable) and non-modifiable (uncontrollable) risk factors, with a focus on regional and familial characteristics.

Methods
A cross-sectional case-control study was conducted in Kutaisi, Georgia, involving 239 pediatric patients. Of these, 154 children diagnosed with maxillofacial anomalies constituted the case group, while 85 children without orthodontic pathology served as the control group. Clinical assessments, panoramic radiography, and ICD-10 classification codes were used to confirm diagnoses. Data on prenatal, perinatal, and postnatal conditions, as well as socio-economic indicators and family history, were collected via structured questionnaires. Statistical analyses were performed using SPSS v21, with Pearson’s chi-squared test and logistic regression applied to determine associations. Odds Ratios (OR) and 95% Confidence Intervals (CI) were calculated, with statistical significance set at p < 0.05.

Results
The most common diagnosis was tooth position anomaly (98.7%), followed by arch proportion disorders (67.5%) and temporomandibular dysfunction (18.2%). Statistically significant risk factors included mouth breathing or open-mouth posture (OR = 3.99, p < 0.001), frequent respiratory infections (OR = 4.78, p < 0.001), difficulty breathing (OR = 4.32, p = 0.013), prematurity (OR = 3.85, p = 0.024), and medication allergies (OR = 3.20, p = 0.031). Paternal history of maxillofacial anomalies was also significantly associated (OR = 1.99, p = 0.038). Socioeconomic factors such as unsatisfactory living conditions and single-parent families showed elevated ORs but did not achieve statistical significance.

Conclusion
This study highlights the complex and multifactorial etiology of maxillofacial anomalies in children. A combination of hereditary predisposition, prenatal complications, and postnatal respiratory and behavioral factors significantly increases the risk. Early identification and mitigation of controllable risk factors are critical for effective prevention and public health planning in pediatric populations.