OBJECTIVES: Children with obstructive sleep apnea (OSA) may have specific dental arch features, which may provide some guidance for early screening for OSA in children in clinical practice. This study aimed to evaluate the association between OSA and dental arch 3-dimensional features in children and adolescents. METHODS: This systematic review and meta-analysis of clinical trials was conducted according to PRISMA guidelines. PubMed, Embase, Scopus, Cochrane Library and Web of Science databases were searched from inception to April 6, 2024. Clinical studies assessing dental arch features in patients with OSA under the age of 18 years were considered for this review. A Meta-analysis was performed using RevMan5.4 software. RESULTS: Eight studies with a total of 466 subjects were included at the end. Meta-analysis showed that upper arch width and lower arch length were significantly reduced in the OSA group compared to the normal group (MxW1: MD = -1.45, 95% CI [-2.71 to -0.18], P = .02
MxW2: MD = -1.60, 95% CI [-2.24 to -0.96], P <
.00001
MxW3: MD = -1.21, 95% CI [-1.80 to -0.62], P <
.0001
MxW4: MD= -1.35, 95% CI [-2.37 to -0.34], P = .009
lower arch length: MD= -0.84, 95% CI [-1.23 to -0.45], P <
.0001). No significant differences were found in upper arch width, upper arch length and palatal height between the OSA group and the snoring non-OSA group (MxW1: MD= -0.23, 95% CI [0.81 to 0.35], P = .43
MxW4: MD = -0.14, 95% CI [-1.09 to 0.80], P = .7
upper arch length: MD= -0.26, 95% CI [-1.05 to 0.49], P = .50
palatal height: MD= -0.82, 95% CI [-0.45 to 2.09], P = .21). CONCLUSION: this review shows that OSA children tend to exhibit slightly narrower upper arches and shorter lower arches compared to normal children (differences between 1 and 1.5 mm). Snoring non-OSA children had similar dental arch morphology compared to OSA children. However, these findings need to be viewed with caution as they are of very low certainty and only cross-sectional studies were considered, and the corresponding differences may not be clinically significant.