Occlusal features in individuals with cerebral palsy: a systematic review and meta-analysis.

BACKGROUND: Cerebral palsy (CP) results from developmental abnormalities or brain lesions that impair movement, posture, and motor function, thereby affecting skeletal development, including craniofacial structures. OBJECTIVES: This study aimed to evaluate occlusal characteristics in individuals with and without CP. SEARCH METHODS: This systematic review followed Meta-Analysis of Observational Studies in Epidemiology guidelines. A comprehensive search was conducted in Embase, PubMed, Web of Science, Ovid, and Scopus, with additional screening of Google Scholar and OpenGrey. SELECTION CRITERIA: Observational studies were included, and the risk of bias was assessed using Newcastle-Ottawa Scale. DATA COLLECTION AND ANALYSIS: Meta-analyses were performed to estimate odds ratios (ORs) with 95% confidence intervals (CIs) and prediction intervals. The GRADE approach was used to evaluate the certainty of the evidence. RESULTS: Of the 584 records identified, 24 cross-sectional studies met the inclusion criteria. Risk-of-bias assessment revealed concerns related to exposure appraisal, nonrespondent characterization, and study comparability. The meta-analysis indicated that individuals with CP had a higher likelihood of Class II malocclusion (OR = 2.56, 95% CI: 1.49-4.38, k = 18) and open bite (OR = 4.27, 95% CI: 1.95-9.37, k = 9). CONCLUSIONS: Individuals with CP are at increased risk of developing Class II malocclusion and open bite, possibly due to neuromuscular dysfunctions and extrinsic factors. Effective management requires a multidisciplinary approach that addresses both biological and behavioral determinants. REGISTRATION: PROSPERO CRD42024551180.