Does head and cervical posture correlate to malocclusion? A systematic review and meta-analysis

BackgroundThe association of head and cervical posture with malocclusion has been studied for many years. Despite extensively encouraging researches, no conclusive evidence has been reached for clinical application. ObjectiveTo identify the question "Does head and cervical posture correlate to malocclusion?", a systematic review and meta-analysis based on the available studies were carried out (PROSPERO registration number: CRD42022319742). MethodsA search of PubMed, Embase, Cochrane Library, and the grey literature was performed without language restrictions. The study screening, data extraction, risk-of-bias evaluation and methodological quality assessment were performed by two independent investigators. When a disagreement arose, a third author was consulted. Results6 original cross-sectional studies involving 505 participants were included, which were of moderate methodological quality. NL/VER in Class II group and NL/CVT in Class III group showed significant differences compared to Class I group, but no significant differences were observed in most of the variables like NSL/VER, OPT/CVT, OPT/HOR, CVT/HOR, NSL/OPT, NSL/CVT, NL/OPT in Class II and III groups. ConclusionsThe results suggested that the current research evidence is not sound enough to prove the association of head and cervical posture with sagittal malocclusion. Better controlled design and a larger sample size are required for clarifying this question in future study.