Aim: This systematic review aimed to determine the risk factors for malocclusions. Methods: A comprehensive search for publications in electronic databases such as PubMed, Medline, Embase, Cochrane, Google scholar, Scopus and Web of science was conducted in order to identify and choose the literature for this paper. 13 articles were selected, and their level of methodological quality was appraised using the STROBE quality assessment tool. Results: The analysis of these articles allowed us to identify the major risk factors in the development of malocclusions. We have classified these factors into general and local factors. General factors were age, gender and genetic background. Local factors were preterm birth, breastfeeding habits, oral health, quality of life and socio-economic status, dysfunctions such as mouth ventilation, and parafunctions such as finger sucking. Conclusion: The risk factors for the development of malocclusion have been identified. Understanding these local and general risk factors will help orthodontists adopt a preventive and interceptive approach when managing these malocclusions.
Cite this paper
Kenza, K. , Ghina, N. and Farid, B. (2025). Malocclusion’s Risk Factors: A Systematic Review. Open Access Library Journal, 12, e3036. doi: http://dx.doi.org/10.4236/oalib.1113036.
Alhammadi, M.S., Halboub, E., Fayed, M.S., Labib, A. and El-Saaidi, C. (2018) Global Distribution of Malocclusion Traits: A Systematic Review. Dental Press Journal of Orthodontics, 23, 40.e1-40.e10. https://doi.org/10.1590/2177-6709.23.6.40.e1-10.onl
Cenzato, N., No-bili, A. and Maspero, C. (2021) Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review. Dentistry Journal, 9, Article 117. https://doi.org/10.3390/dj9100117
Lombardo, G., Vena, F., Negri, P., Pagano, S., Barilotti, C., Paglia, L., et al. (2020) Worldwide Prevalence of Maloc-clusion in the Different Stages of Dentition: A Systematic Review and Me-ta-Analysis. European Journal of Paediatric Dentistry, 21, 115-122.
Varrela, J. (2006) Masticatory Function and Malocclusion: A Clinical Perspective. Seminars in Orthodontics, 12, 102-109. https://doi.org/10.1053/j.sodo.2006.01.003
World Dental Federation, F. (2020) Malocclusion in Orthodontics and Oral Health. International Dental Journal, 70, 11-12. https://doi.org/10.1111/idj.12554
Lione, R., Huanca Ghislanzoni, L.T., Defraia, E., Franchi, L. and Cozza, P. (2015) Bonded versus Banded Rapid Palatal Expander Followed by Facial Mask Therapy: Analysis on Digital Dental Casts. The European Journal of Orthodontics, 38, 217-222. https://doi.org/10.1093/ejo/cjv038
Moimaz, S.A.S., Garbin, A.J.í., Li-ma, A.M.C., Lolli, L.F., Saliba, O. and Garbin, C.A.A.S. (2014) Longitudinal Study of Habits Leading to Malocclusion Development in Childhood. BMC Oral Health, 14, Article No. 96. https://doi.org/10.1186/1472-6831-14-96
Marmaite, U. (2014) The Prevalence of Malocclusion and Oral Habits among 5-7-Year-Old Children. Medical Science Monitor, 20, 2036-2042. https://doi.org/10.12659/msm.890885
Vedovello, S.A.S., Ambrosano, G.M.B., Pereira, A.C., Valdrighi, H.C., Filho, M.V. and Meneghim, M.D.C. (2016) Association between Malocclusion and the Contextu-al Factors of Quality of Life and Socioeconomic Status. American Journal of Or-thodontics and Dentofacial Orthopedics, 150, 58-63. https://doi.org/10.1016/j.ajodo.2015.12.022
Chen, X., Xia, B. and Ge, L. (2015) Effects of Breast-Feeding Duration, Bottle-Feeding Duration and Non-Nutritive Sucking Habits on the Occlusal Characteristics of Primary Denti-tion. BMC Pediatrics, 15, Article No. 46. https://doi.org/10.1186/s12887-015-0364-1
Germa, A., Clément, C., Weissenbach, M., Heude, B., Forhan, A., Martin-Marchand, L., et al. (2016) Early Risk Factors for Posterior Crossbite and Anterior Open Bite in the Primary Dentition. The Angle Orthodontist, 86, 832-838. https://doi.org/10.2319/102715-723.1
Sultana, S. and Hossain, Z. (2019) Prevalence and Factors Related to Malocclusion, Normative and Per-ceived Orthodontic Treatment Need among Children and Adolescents in Bang-ladesh. Dental Press Journal of Orthodontics, 24, 44.e1-44.e9. https://doi.org/10.1590/2177-6709.24.3.44.e1-9.onl
Objois, C. and Ge-beile-Chauty, S. (2019) Is Premature Birth an Orthodontic Risk Factor? A Con-trolled Epidemiological Clinical Study. International Orthodontics, 17, 544-553. https://doi.org/10.1016/j.ortho.2019.06.015
Paolantonio, E.G., Ludovici, N., Saccomanno, S., La Torre, G. and Grippaudo, C. (2019) Association between Oral Habits, Mouth Breathing and Malocclusion in Italian Preschoolers. Euro-pean Journal of Paediatric Dentistry, 20, 204-208.
Grippaudo, M.M., Quinzi, V., Manai, A., Paolantonio, E.G., Valente, F., La Torre, G. and Marzo, G. (2020) Orthodontic Treatment Need and Timing: Assessment of Evolutive Mal-occlusion Conditions and Associated Risk Factors. European Journal of Paediat-ric Dentistry, 21, 203-208.
Nota, A., Darvizeh, A., Primožič, J., Onida, F., Bosco, F., Gherlone, E.F., et al. (2020) Prevalence of Caries and Associated Risk Factors in a Representative Group of Preschool Children from an Urban Area with High Income in Milan Province, Italy. International Journal of Environ-mental Research and Public Health, 17, Article 3372. https://doi.org/10.3390/ijerph17103372
da Silva Filho, O.G., Ferrari Júnior, F.M. and Okada Ozawa, T. (2008) Dental Arch Di-mensions in Class II Division 1 Malocclusions with Mandibular Deficiency. The Angle Orthodontist, 78, 466-474. https://doi.org/10.2319/022307-89.1
Bourzgui, F., Sebbar, M., Hamza, M., Lazrak, L., Abidine, Z. and El Quars, F. (2012) Prevalence of Malocclusions and Orthodontic Treatment Need in 8- to 12-Year-Old Schoolchildren in Casa-blanca, Morocco. Progress in Orthodontics, 13, 164-172. https://doi.org/10.1016/j.pio.2011.09.005
Onyeaso, C.O. and Aderinokun, G.A. (2002) The Pattern of Malocclusion among Orthodontic Pa-tients Seen in Dental Centre, University College Hospital, Ibadan, Nigeria. Afri-can Journal of Medicine and Medical Sciences, 31, 207-211.
Siddegowda, R. and Satish, R. (2014) The Prevalence of Malocclusion and Its Gender Distri-bution among Indian School Children: An Epidemiological Survey. SRM Journal of Research in Dental Sciences, 5, 224-229. https://doi.org/10.4103/0976-433x.145118
Arabiun, H., Mirzaye, M., Dehghani-Nazhvani, A., Ajami, S., Faridi, S. and Bah-rpeima, F. (2014) The Prevalence of Malocclusion among 14-18 Years Old Students in Shiraz. Journal of Oral Health and Oral Epidemiology, 3, 8-11.
Grewe, J.M., Cervenka, J., Shapiro, B.L. and Witkop, C.J. (1968) Prevalence of Malocclusion in Chippewa Indian Children. Journal of Dental Research, 47, 302-305. https://doi.org/10.1177/00220345680470021701
šidlauskas, M., šalomskienė, L., Andriuškevičiūtė, I., šidlauskienė, M., Labanauskas, ž., Vasili-auskas, A., et al. (2015) Heritability of Mandibular Cephalometric Variables in Twins with Completed Craniofacial Growth. The European Journal of Orthodon-tics, 38, 493-502. https://doi.org/10.1093/ejo/cjv062
Santana, L.G., Flores-Mir, C., Iglesias-Linares, A., Pithon, M.M. and Marques, L.S. (2020) In-fluence of Heritability on Occlusal Traits: A Systematic Review of Studies in Twins. Progress in Orthodontics, 21, Article No. 29. https://doi.org/10.1186/s40510-020-00330-8
Watanabe, M., Suda, N. and Ohyama, K. (2005) Mandibular Prognathism in Japanese Families Ascer-tained through Orthognathically Treated Patients. American Journal of Ortho-dontics and Dentofacial Orthopedics, 128, 466-470. https://doi.org/10.1016/j.ajodo.2004.09.018
Sharma, K. and Corruccini, R. (1986) Genetic Basis of Dental Occlusal Variations in Northwest Indian Twins. The European Journal of Orthodontics, 8, 91-97. https://doi.org/10.1093/ejo/8.2.91
Melo, P.E.D. and Pontes, J.R.d.S. (2014) Hábitos orais deletérios em um grupo de crianças de uma escola da rede pública na cidade de São Paulo. Revista CEFAC, 16, 1945-1952. https://doi.org/10.1590/1982-0216201418213
Emmerich, A., Fonseca, L., Elias, A.M. and Medeiros, U.V.d. (2004) Relação entre hábitos bucais, Alteraçães oronasofaringianas e mal-oclusões em pré-escolares de Vitória, Espírito Santo, Brasil. Cadernos de Saúde Pública, 20, 689-697. https://doi.org/10.1590/s0102-311x2004000300005
Aloufi, S.A., Jan, H.E., Abuhamda, I.S., Assiri, A.T., Samanodi, H.S., Alsulami, A.A., et al. (2017) Meta-Analysis of Prevalence of Bad Oral Habits and Relationship with Preva-lence of Malocclusion. EC Dental Science, 11, 111-117.
Sousa, J.B.R., An-selmo-Lima, W.T., Valera, F.C.P., Gallego, A.J. and Matsumoto, M.A.N. (2005) Cephalometric Assessment of the Mandibular Growth Pattern in Mouth-Breathing Children. International Journal of Pediatric Otorhinolaryngol-ogy, 69, 311-317. https://doi.org/10.1016/j.ijporl.2004.10.010
Thomaz, E.B.A.F., Cangussu, M.C.T., Silva, A.A.M.D. and Assis, A.M.O. (2010) Is Malnu-trition Associated with Crowding in Permanent Dentition? International Journal of Environmental Research and Public Health, 7, 3531-3544. https://doi.org/10.3390/ijerph7093531
Kaushal, J., Vivek, A. and Ruchi, A. (2017) A Study between Malnutrition Associated with Malocclusion, Dental Caries, Enamel Hypoplasia and Salivary Gland Flow in Mixed Dentition Stage—An in Vivo Study. Journal of Dental and Medical Sciences, 16, 68-71
Barao, K. and Forones, N.M. (2012) Body Mass Index: Different Nutritional Status According to WHO, OPAS and Lipschitz Classifications in Gas-trointestinal Cancer Patients. Arquivos de Gastroenterologia, 49, 169-171. https://doi.org/10.1590/s0004-28032012000200013
Saghiri, M.A. and Saghiri, A.M. (2017) In Memoriam: Dr. Hajar Afsar Lajevardi MD, MSc, MS (1955-2015). Iranian Journal of Pediatrics, 27, e8093. https://doi.org/10.5812/ijp.8093
Paulsson, L. and Bondemark, L. (2009) Craniofacial Morphology in Prematurely Born Children. The Angle Orthodontist, 79, 276-283. https://doi.org/10.2319/030108-124.1
Neiva, F.C.B. and Leone, C.R. (2007) Evolução do ritmo de sucção e influência da estimulação em prematuros. Pró-Fono Revista de Atualização Científica, 19, 241-248. https://doi.org/10.1590/s0104-56872007000300002