Sagittal occlusal relationships and asymmetry in prematurely born children

The aim of this investigation was to examine the effect of pre-term birth on sagittal occlusal relationships. The subjects were 328 prematurely born white and black children and 1804 control children who participated in the cross-sectional study of the Collaborative Perinatal Project (USA) in the early 1960s and 1970s. Dental examinations, including dental casts and photographs, were performed at the age of 6-12 years. The sagittal occlusion of the permanent molars and the canine relationship was recorded by examining and measuring the hard stone casts. The pre-term and comparison groups were divided by sex and race. A significantly greater prevalence of pre-normal canine relationships was found in the pre-term group than in the controls (P < 0.001). The incidence of a bilateral symmetrical canine relationship was 60.3 per cent in both the pre-term and control groups, but in the pre-term group the girls had better symmetry than the boys. Asymmetry occurred significantly more often on the left side (P < 0.001), especially in the control boys, but this was not so clear in the pre-term group. The prevalence of mesial molar occlusion was greater in the pre-term group. These results suggest that premature birth and the consequent exceptional adaptation from intra- to extra-uterine nutrition may influence dental occlusal development. This emphasizes the importance of early functional activity and differences in masticatory muscle activity and the largely unknown phenomenon of early catch-up growth. Individual differences in neonatal factors, in the need for intubation and other medical care are also of importance. Pre-term birth may also interfere with the development of symmetry and lateralization.