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.