Craniofacial Morphology and Dental Age Assessment in Pediatric Craniosynostosis: A Comparative Cross‐Sectional Study

OBJECTIVES: To delineate the craniofacial morphometric characteristics of Thai children with syndromic (SC) and non-syndromic craniosynostosis (NSC) and to assess dental maturation relative to Chronological Age (CA). METHODS: This comparative cross-sectional study evaluated 19 patients (SC: n = 13; NSC: n = 6; mean age 9.32 ± 2.67 years). Seventeen skeletal and dental cephalometric variables were analyzed against age-matched ethnic norms. Dental age (DA) was quantified using the modified Demirjian's four-tooth method, calibrated via the Thai-specific Duangto model. One-sample and Welch's t-tests compared DA with CA and skeletal parameters with normative data. RESULTS: SC patients demonstrated significant maxillary retrusion and midface hypoplasia, characterized by reduced SNA (73.63 ± 9.52°), ANB (-7.1 ± 10.51°), and maxillary depth (79.36 ± 11.2°) compared to normative data (p < 0.05). Additionally, the SC group exhibited a hyperdivergent growth pattern (increased FMA: 32.61 ± 6.87°), a shortened anterior cranial base (41.47 ± 4.56 mm), and compensatory mandibular incisor retroclination (IMPA: 88.38 ± 8.57°) (p < 0.05). In contrast, the NSC phenotype was primarily localized to a shortened anterior cranial base (48.17 ± 5.66 mm, p < 0.05), with other skeletal parameters remaining within normative ranges. When evaluating dental maturation relative to chronological age, no statistically significant differences were detected in either cohort (mean difference: SC = 0.09 ± 1.50 years, p > 0.05; NSC = 1.23 ± 1.61 years, p > 0.05). CONCLUSIONS: Children with SC present with severe multi-planar skeletal discrepancies and secondary dental compensations, whereas NSC-related dysmorphology is primarily confined to the cranial base. No statistically significant differences were detected between DA and CA in either group. Because dental development does not necessarily reflect the extent of craniofacial skeletal discrepancies, treatment timing must instead rely on comprehensive, patient-specific structures and skeletal malocclusion.