Linking Malocclusion, Diet, and Body Mass via Genetic Variants within the Hippo Signaling Pathway

Background and Objective: Body Mass Index (BMI) has a profound effect on the body’s growth and development. A growing number of orthodontic patients are obese, and it is important to understand the role BMI can play in orthodontic treatment. The Hippo Signaling Pathway is a central regulator of both tissue homeostasis and organ size development. The purpose of this study is to evaluate how BMI and variations along the Hippo Signaling Pathway relate to craniofacial morphology as observed in lateral cephalograms. Findings: Higher BMI females show an increase in vertical dimensions of the mandible, increased FMA and increased gonial angles when compared to normal weight female subjects. Higher BMI females show a retrusive maxilla when compared to normal weight female subjects. Variations in FOXO6, TEAD3, TEAD4, MST1, LATS2 and RUNX2 show significant phenotypic differences in obese and normal weight female subjects. Significance for Practice: Obese patients may reach pubertal growth earlier in life leading to the need to render orthodontic treatment earlier in these patients. Understanding that growth may be completed earlier in obese patients may lead to earlier surgical interventions when needed. It is possible that overweight patients have constricted airways during growth and development which causes growth in a more vertical dimension. The variations in the Hippo signaling pathway indicate that there may be a genetic component to these phenotypes. It is important to understand the link between obesity, sleep apnea, and facial form to better diagnose, manage and treat these orthodontic patients.