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Scoliosis and dental occlusion: a review of the literature

Matteo Saccucci1, Lucia Tettamanti2, Stefano Mummolo3, Antonella Polimeni1, Felice Festa4, Vincenzo Salini3 and Simona Tecco4*

Author Affiliations

1 Department of Oral Science, University La Sapienza, Via Caserta 6, 00161, Rome, Italy

2 Department of Surgical Reconstructive Sciences and Advanced Technologie, University of Insubria, Via G. Piatti, 10 - 21100 Velate, Varese, Italy

3 Department of Health Science, University of L'Aquila, Edificio Delta 6 L'Aquila Fraz. Coppito, 67010, L'Aquila, Italy

4 Department of Oral Science, Nano and Biotechnology, University G.D'Annunzio, Via dei Vestini 31, 66013, Chieti, Italy

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Scoliosis 2011, 6:15  doi:10.1186/1748-7161-6-15

Published: 29 July 2011



Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports.


The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis

Search strategy

All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010.

Selection criteria

All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis.

Data collection and analysis

Data were extracted without blinding to the authors, age of patients or type of occlusion.

Main results

Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions.

Authors' conclusions

Based on selected studies, this review concludes that there is plausible evidence for an increased prevalence of unilateral Angle Class II malocclusions associated with scoliosis, and an increased risk of lateral crossbite, midline deviation in children affected by scoliosis. Also, documentation of associations between reduced range of lateral movements and scoliosis seem convincing. Data are also mentioned about the association between plagiocephaly and scoliosis.