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Craniofacial Changes Among Children and Adolescents Submitted to Growth Hormone Therapy: A Systematic Review

Raul Borges Nascimento1, Suelly Maria Mendes Ribeiro2, Nathalia Carolina Fernandes Fagundes2

  • 1Faculty of Dentistry, Federal University of Pará, Belém, Brazil.

Orthodontics & Craniofacial Research
|April 23, 2025
PubMed

Insights

Growth hormone (GH) therapy in children with GH deficiency or idiopathic short stature (ISS) showed a small, clinically insignificant increase in mandibular dimensions. More long-term studies are needed to confirm effects on craniofacial growth.

Area of Science:

  • Pediatric Endocrinology
  • Craniofacial Biology
  • Systematic Review Methodology

Background:

  • Growth hormone (GH) therapy is used for children with GH deficiency or idiopathic short stature (ISS).
  • Understanding the impact of GH therapy on craniofacial development is crucial for monitoring treatment outcomes.
  • Previous research has yielded varied results regarding craniofacial changes during GH therapy.

Purpose of the Study:

  • To systematically review the association between craniofacial changes and GH therapy in pediatric populations with GH deficiency or ISS.
  • To synthesize evidence on the effects of GH therapy on cephalometric measurements and dental age.
  • To assess the risk of bias and certainty of evidence for included studies.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Electronic search across seven databases without year or language restrictions.
  • Inclusion of studies on craniofacial changes in children/adolescents receiving GH therapy; risk of bias and evidence certainty assessed using JBI, RoB 2.0, and GRADE tools.

Main Results:

  • Seven studies met eligibility criteria from 4494 identified citations.
  • GH therapy showed a small, clinically insignificant increase in mandibular dimensions.
  • No significant differences were found in maxillary and mandibular dimensions between immediate and delayed treatments.
  • Low risk of bias and low certainty of evidence were observed across all outcomes.

Conclusions:

  • GH therapy may lead to a slight increase in mandibular and maxillary dimensions without significant adverse health effects.
  • Current evidence suggests minimal clinical impact on craniofacial growth.
  • Further controlled intervention studies with long-term follow-up are necessary to establish precise recommendations.

Keywords:
facegrowth and developmentgrowth hormoneorthodontics

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