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Malocclusion in the primary dentition in children with and without deformational plagiocephaly



Asymmetries of the jaw and orthodontic abnormalities are suspected as long-term consequences of positional cranial deformity. But only few data exist on this issue. As plagiocephaly is a common problem in infancy, potential functional impairments should be investigated to initiate appropriate measures if necessary. The aim of our study was to compare the orthodontic situation in primary dentition of children with positional plagiocephaly and children without cranial deformities.

Material and methods

Fifty children treated by helmet therapy for plagiocephaly and 50 non-affected children (age 1.98–5.69 years) were examined in a cross-sectional study. Orthodontic parameters of all dimensions were assessed and analyzed.


Children of the plagiocephalic group showed more often orthodontic alterations compared to the others. Especially the frequencies of a class II malocclusion (36 vs. 14 %), an edge-to edge bite (28 vs. 12 %), and deviations of the midline (38 vs. 16 %) were conspicuous. However, none of the differences was significant (p > 0.003). Of all observed mandibular asymmetries, 69 % appeared as a shift to the contralateral side of the former flattened occipital region.


Positional head deformity might be associated in some cases with a higher prevalence of occlusal abnormalities in primary dentition.

Clinical relevance

Positional plagiocephaly interfaces medicine and dentistry. As it is a common disorder, this etiology has to be considered in the prevention and therapy of malocclusion.

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Correspondence to Susanne Kluba.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (institutional review board approval: 203/201BO1).

Conflict of interest

The authors declare that they have no competing interests.


The work was supported by the Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Germany.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kluba, S., Roßkopf, F., Kraut, W. et al. Malocclusion in the primary dentition in children with and without deformational plagiocephaly. Clin Oral Invest 20, 2395–2401 (2016).

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  • Positional plagiocephaly
  • Malocclusion
  • Helmet therapy
  • Primary dentition