281 - Prevalence of Malocclusions between Individuals with and without Down Syndrome

Purpose: To conduct a systematic review and meta-analysis to assess whether individuals with Down syndrome (DS) display a higher frequency of malocclusion compared to individuals without DS.

Methods: A literature search of indexed databases (PubMed, Web of Science, Cochrane) was conducted without language restriction up to and including January 1, 2025. Cross-referencing was used to further identify articles. The eligibility criteria were observational studies with original data that statistically compared the prevalence of malocclusion between individuals with and without DS. Random effects meta-analysis through the Mantel-Haenszel estimator was used to evaluate the association between DS and malocclusion based on odds ratios (ORs) with 95% confidence intervals (CIs).

Results: The literature search generated 154 records, and 21 full-text articles were reviewed. Sixteen studies comprising 12,639 individuals from 12 countries (Argentina, Brazil, Denmark, Italy, Jordan, Malaysia, Nigeria, Saudi Arabia, Sweden, the United Arab Emirates, and the USA) fulfilled our selection criteria and were included in the meta-analysis. The meta-analysis revealed statistically significant associations between DS and Class 3 malocclusion (OR, 11.8; 95% CI, 7.8 to 17.7), anterior open bite (OR, 6.8; 95% CI, 3.4 to 13.5), anterior crossbite (OR, 13.8; 95% CI, 3.4 to 56.9), and posterior crossbite (OR, 7.8; 95% CI, 5.7 to 10.8). The OR estimates of the reviewed studies exhibited significant heterogeneity (P  < 0.0001). 

Conclusion: Our findings suggest a higher prevalence of malocclusion in individuals born with DS compared to control.

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