This systematic review addresses the question whether prematurity re-sults in alteration of palatal morphology, dental occlusion, tooth-crown dimensions, and tooth maturation. A literature survey from the PubMed database covering the period from January 1966 to Novem-ber 2002 used the Medical Subject Headings terms "infant, prema-ture," and "infant, low birth weight" in combination with "jaws," "dental physiology," "dentition," and "tooth abnormalities." Con-trolled studies written in English and with definitions of premature birth according to the World Health Organization were selected. Two reviewers selected and extracted the data independently and also as-sessed the quality of the studies. The search strategy resulted in 113 articles, of which 13 met the inclusion criteria. Scientific evidence was found for altered palatal morphology in the short term among the premature children, and oral intubation was a contributing factor to the alterations. If corrected age was considered for the premature chil-dren, no delay in dental development and eruption was found com-pared with normally born children. Thus, the early birth of premature children must be taken in account when planning for orthodontic treatment. Because of the contradictory results and lack of longitudi-nal studies, the scientific evidence was too weak to answer the ques-tions whether premature birth causes permanent alteration of palatal morphology, alteration of dental occlusion, and altered tooth-crown dimensions. To answer these questions and obtain reliable scientific evidence whether premature children are at risk for malocclusions from possible alterations of palatal morphology such as asymmetry and high arched palates, further well-designed controlled studies as well as longitudinal studies are needed.

OBJECTIVE: To evaluate if prematurely born children have higher prevalence of malocclusion traits and greater orthodontic treatment need than matched full-term born controls. MATERIALS AND METHODS: Seventy-three preterm children were selected from the Medical Birth Register and divided into two subgroups according to their gestational age. One group consisted of 37 very preterm children (VPT), born in gestational week 29-32, and the other of 36 extremely preterm children (EPT), born before the 29th gestational week. The subjects were compared with a control group of 41 full-term children, who were matched for sex, age, and nationality. Data from clinical examinations, study casts, and panoramic radiographs were used to determine malocclusion traits. The dental health component of the index of orthodontic treatment need (IOTN) was used to rank the treatment need. RESULTS: Two or more malocclusion traits occurred significantly more often among EPT (83.3%) and VPT children (73.0%), compared with the full-term children (51.2%). Significantly higher prevalence of deep bites and was found in EPT and VPT groups compared with the full-term control group. Deep bite was the most common malocclusion trait in the EPT and VPT group. Higher orthodontic treatment need was found for the preterm children but no differences in prevalence of malocclusion traits and treatment need were found between VPT and EPT children. CONCLUSION: The clinician should be aware of the potential for a higher number of malocclusion traits and greater orthodontic treatment need in prematurely born children compared with full-term children.

OBJECTIVE: To test the null hypothesis that there is no difference between the craniofacial morphology of prematurely born children and that of matched full-term born controls. MATERIALS AND METHODS: White children 8 to 10 years of age, born at the University Hospitals of Lund and Malmö and living in the same part of Sweden, were included. One group consisted of 36 very preterm children, born during gestational weeks 29 to 32; the other group included 36 extremely preterm children, who were born before the 29th gestational week. Subjects were compared with a control group of 31 full-term children, who were matched for gender, age, nationality, and living area. One lateral head radiograph was taken for each child, and the cephalometric analysis included 15 angular and 11 linear variables. Also, the height, weight, and head circumference of each child were registered. RESULTS: A significantly shorter anterior cranial base and a less convex skeletal profile were found among extremely preterm children, and significantly shorter maxillary length was noted in both extremely preterm and very preterm groups as compared with full-term children. The lower incisors were significantly more retroclined and retruded in the extremely preterm group compared with the very preterm group and the full-term control group. Extremely preterm children were significantly shorter, and both extremely preterm and very preterm children had significantly lower weight and smaller head circumference compared with full-term children. CONCLUSION: The null hypothesis was rejected because several craniofacial parameters differed significantly between preterm and full-term born control children.

OBJECTIVE: To evaluate mandibular function, signs, and symptoms of temporomandibular disorders (TMDs) and headache in prematurely born 8- to 10-year-old children, and to compare the findings with matched full-term born controls. MATERIAL AND METHODS: Seventy-three preterm children were selected from the Medical Birth Register--one group comprising 36 extremely preterm children born before the 29th gestational week, the other group 37 very preterm children born during gestational weeks 29 to 32. The preterm children were compared with a control group of 41 full-term children matched for gender, age, nationality, and living area. The subjective symptoms of TMD and headache were registered using a questionnaire. Mandibular function, signs, and symptoms of TMD and headache were registered. TMD diagnoses were set per Research Diagnostic Criteria for temporomandibular disorders (RDC/TMD). RESULTS: No significant differences between groups or gender were found for TMD diagnoses according to RDC/TMD or for headache. The preterm children had smaller mandibular movement capacity than the full-term control group, but when adjusting for weight, height, and head circumference mostly all group differences disappeared. CONCLUSIONS: Prematurely born children of 8 to 10 years of age did not differ from full-term born children when considering diagnoses according to RDC/TMD, signs, and symptoms of TMD or headache.