Prevalence and Associated Factors of Specific Dentofacial Characteristics in Saudi Populations: A Systematic Review and Meta-Analysis

Dentofacial characteristics, including malocclusion and dental anomalies, are a public health concern in Saudi Arabia. Numerous primary studies have been conducted across the Kingdom, but data remains fragmented. This systematic review and meta-analysis aimed to synthesize the prevalence of specific dentofacial characteristics, including malocclusion traits and dental anomalies, and evaluate their associated factors within the Saudi population. A search of electronic databases was conducted to identify cross-sectional studies published up to 2025. Studies reporting the prevalence of malocclusion (Angle's classification, overjet, overbite, crowding) and dental anomalies (hypodontia, hyperdontia, impaction, dilaceration) in Saudi participants were included. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. A random-effects meta-analysis was performed using the Freeman-Tukey double arcsine transformation. Heterogeneity was assessed using the I² statistic, and sources of variation were explored through subgroup analyses (region, gender, setting) and meta-regression. Fifty-three studies involving 17,917 participants were included. The pooled prevalence of Angle's Class I malocclusion was 71.1% (95% CI: 54.6%-68.2%), followed by Class II (16.3%) and Class III (9.8%). Dental crowding was the most frequent trait (39.7%), followed by increased overjet (28.4%). Among dental anomalies, root dilaceration (30.2%) and hypodontia (4.6%-25.7%) were the most prevalent. Significant regional variations were observed (p < 0.001), with the Northern region reporting the highest prevalence of malocclusion. Meta-regression indicated no significant temporal trend in prevalence over the past 34 years (p = 0.69). Gender did not significantly influence the overall prevalence of malocclusion (OR = 1.05; p = 0.68). Malocclusion and dental anomalies are highly prevalent in the Saudi population, with Class I malocclusion, crowding, and hypodontia being the most common findings. The stability of these rates over time highlights the need for national preventive oral health programs. Future research should focus on longitudinal studies to elucidate etiological factors and the impact of early interventions.