Leptin levels and skeletal response: exploring functional treatment efficacy in overweight vs. normal-weight Class II...

This prospective cohort study aimed to evaluate whether salivary leptin hormone levels correlate with skeletal and dental responses to functional therapy in normal-weight versus overweight skeletal class II malocclusion patients.

Thirty-two patients with skeletal Class II division 1 malocclusion were divided into two groups: overweight and normal weight. All patients were treated with twin block appliances; their growth stage being about MP3cap. Lateral cephalometric x‑rays and body mass index (BMI) percentiles were assessed before (T0) and at the end of the functional treatment (T1). Unstimulated saliva samples were collected from all patients at four time points (before, in the first month, in the third month and at the end of the functional treatment) using a noninvasive passive pouring method. Leptin levels were measured photometrically using an enzyme-linked immunosorbent assay (ELISA) kit.

Overweight patients exhibited higher salivary leptin levels and earlier skeletal maturation. Overjet correction was achieved in these patients with more incisor movement and they showed greater mandibular length increase. Correlation analysis revealed positive associations between leptin and the change of maxillary parameters as well as of soft tissue convexity. Negative correlations were observed between salivary leptin levels and changes in posterior facial height (PFH), PFH/AFH ratio (AFH: anterior facial height), and lower incisor inclination.

Body weight significantly affected treatment timing and outcomes in Class II correction and should be considered in adolescent treatment planning.