A Systematic Review of the Consequences of Premature Birth on Palatal Morphology, Dental Occlusion, Tooth-crown Dimensions, and Tooth Maturity and Eruption

This systematic review addresses the question whether prematurity re-sults in alteration of palatal morphology, dental occlusion, tooth-crown dimensions, and tooth maturation. A literature survey from the PubMed database covering the period from January 1966 to Novem-ber 2002 used the Medical Subject Headings terms "infant, prema-ture," and "infant, low birth weight" in combination with "jaws," "dental physiology," "dentition," and "tooth abnormalities." Con-trolled studies written in English and with definitions of premature birth according to the World Health Organization were selected. Two reviewers selected and extracted the data independently and also as-sessed the quality of the studies. The search strategy resulted in 113 articles, of which 13 met the inclusion criteria. Scientific evidence was found for altered palatal morphology in the short term among the premature children, and oral intubation was a contributing factor to the alterations. If corrected age was considered for the premature chil-dren, no delay in dental development and eruption was found com-pared with normally born children. Thus, the early birth of premature children must be taken in account when planning for orthodontic treatment. Because of the contradictory results and lack of longitudi-nal studies, the scientific evidence was too weak to answer the ques-tions whether premature birth causes permanent alteration of palatal morphology, alteration of dental occlusion, and altered tooth-crown dimensions. To answer these questions and obtain reliable scientific evidence whether premature children are at risk for malocclusions from possible alterations of palatal morphology such as asymmetry and high arched palates, further well-designed controlled studies as well as longitudinal studies are needed