Growth-related considerations for dental implant placement in growing patients with craniofacial deformities: A narrative review

Osseointegrated dental implants behave as ankylosed units and cannot undergo compensatory eruption during craniofacial growth, creating distinct biological challenges when placement is considered in growing patients, particularly those with craniofacial deformities. This narrative review synthesizes and critically appraises current evidence on implant timing and growth-related risks in this population, with emphasis on biological growth patterns, deformity-specific considerations, and skeletal maturity-based timing frameworks. A literature search through December 2024 was conducted using PubMed/MEDLINE, supplemented by citation tracking; approximately 410 records were screened, 78 assessed in full text, and 22 sources formed the principal evidence base. Implant placement before growth completion may result in infraocclusion, occlusal disharmony, soft-tissue discrepancy, and aesthetic compromise, particularly in the anterior maxilla. Risks vary substantially with deformity type, skeletal maturity, implant site, and prior surgical intervention. Evidence remains heterogeneous, especially for craniosynostosis and hemifacial microsomia, where data are largely confined to case reports. Skeletal maturity indicators, with explicit attention to sex-related differences in growth timing, are more reliable than chronological age alone. Definitive implant placement should generally be deferred until skeletal and local site maturity are confirmed, supported by individualized multidisciplinary planning and transitional rehabilitation strategies to minimize long-term complications and revision burden.