Craniofacial development in children with cystic fibrosis

Cystic fibrosis (CF) is a genetic disorder affecting multiple systems and is often associated with nasal congestion, rhinorrhea, and mouth breathing because of upper respiratory tract involvement. These factors may influence craniofacial growth. This study aimed to evaluate craniofacial morphology in children with CF.

Fifty-six Turkish participants were included: 28 children with CF (14 boys and 14 girls; mean age = 12.10 ± 2.74 years) and 28 age- and sex-matched healthy controls (14 boys and 14 girls; mean age = 12.14 ± 2.74 years). Craniofacial features were assessed using cephalometric radiographs and maxillary digital models. Descriptive characteristics were compared using the chi-square test, and group differences were analyzed using the independent-samples t test.

The sagittal skeletal classification revealed that patients with CF were 32.1% Class I, 35.7% Class II, and 32.1% Class III skeletal bases. Class I malocclusion was the most common (85.7%). In the control group, Class I skeletal relationships and malocclusion patterns were most prevalent (89.3%). Children with CF showed a statistically significant decrease in Ricketts maxillary width, and smaller SNA and SNB values (58.93 ± 3.55 mm, 79.51° ± 3.26°, and 76.43° ± 2.89°, respectively) than controls (64.03 ± 4.05 mm, 81.73° ± 2.60°, and 79.26° ± 2.47°, respectively). Conversely, the CF group had a higher Frankfort mandibular plane angle, a lower anterior facial height (LAFH), and LAFH% values (29.66° ± 2.90°, 66.0 ± 4.03 mm, and 57.09% ± 1.01%) than controls (25.91° ± 1.59°, 60.52 ± 2.67 mm, and 53.33% ± 1.16%). Digital model analysis showed a significantly reduced palatal width and palatal curvature angle (the mean difference was -2.36, -2.57, -3.06, and -3.77 mm for palatal width and -9.46°, -10.91°, -10.67°, and -11.67° for palatal curvature angle at the canine, first premolar, second premolar, and first molar teeth, respectively) and increased palatal depth (the mean difference was 0.41, 1.20, 1.64, 1.69 mm at the canine, first premolar, second premolar, and first molar regions, respectively), in the CF group (P <0.05).

Children with CF exhibit altered craniofacial development, including bimaxillary retrusion and a constricted maxilla with a narrowed dental arch. Although the Frankfort mandibular plane angle and LAFH were statistically greater in patients with CF, these measurements were within normative limits, suggesting a tendency toward a vertically directed growth pattern. Future studies with a larger sample size can investigate this tendency.