Role of Growth Hormone Therapy in Craniofacial Development of Children with or without Growth Hormone Deficiency—A Systematic Review

Abstract

To evaluate effect of growth hormone (GH) therapy in craniofacial development in children with or without growth hormone deficiency. The systematic review was conducted by searching the electronic databases—PubMed, Cochrane clinical trials register, Google scholar, and EBSCO host. Randomized controlled trials and observational studies published till January 2022 were included. The risk of bias was assessed by Risk-Of-Bias VISualization (ROBVIS) tool. The risk of bias of the included studies was presented as a “traffic light” plot of individual studies and a summary diagram. Data was studied by two authors and any dispute was resolved by another reviewer. A total of 964 articles were obtained through electronic database search. After eliminating the duplicates, 13 articles met inclusion criteria. Of the 13 studies, 8 studies had moderate risk of bias, 2 had serious risk of bias, and 1 had critical risk of bias as per the ROBINS-I assessment. According to the RoB 2, two studies were having high risk of bias. The maxillary length, the mandibular length, and the cranial base length increased post-GH therapy, causing an overall increase in the facial height. The limitation of GH therapy was in the transverse direction as maxillary and mandibular arch dimensions remained almost equal to those in the untreated subjects. Dentition had minimal influence of GH therapy. The systematic review was registered in the International Prospective Register of Systematic Reviews database under CRD42021257044.