Since the end of the 20th century, the problems of the temporomandibular disorders (TMDs) have aroused interest to the orthodontists. The aim of this literature review is to present the contemporary evidence concerning the association between the presence of malocclusions and the occurrence of signs and symptoms of the TMJ. In addition, additional variables, which may affect the TMJs of a patient during the orthodontic treatment are pointed out. It is evident that there is an increased number of patients who are seeking for orthodontic treatment, not only in order to enhance their facial aesthetics and the function of mastication system, but also to relieve the symptoms of the temporomandibular joint (TMJ). There are multiple etiological factors that have been associated with the TMDs and they may be manifested by pain and/or sounds of TMJ. In addition, during the clinical examination it can be detected a deviation from the normal function of the mandible.

Osteoporosis is the most common metabolic bone disorder, characterized by reduced bone mass and abnormal bone microarchitecture, resulting in increased bone fragility and a heightened risk of low-energy fractures. Pediatric osteoporosis may be either primary, due to genetic factors, or secondary, arising from chronic diseases and/or their treatment. Oral health and proper occlusion are integral components of overall health, influencing functionality, nutrition, facial aesthetics, and psychosocial development during childhood. Severe malocclusion can adversely affect speech, mastication, appearance, psychological well-being, and social interactions. The aim of this narrative review is to examine the existing literature on orthodontic anomalies and management strategies in pediatric patients with osteoporosis while highlighting clinical challenges, treatment limitations, and areas necessitating further research. A comprehensive literature search was conducted in the PubMed database, focusing on studies involving human subjects aged 3 to 18 years, published in English between 2002 and 2024. The findings indicate that children with osteoporosis present with more severe dental and occlusal complications compared to their healthy peers, often facing increased orthodontic complexity due to skeletal fragility and systemic comorbidities. These challenges necessitate careful, individualized treatment planning and close multidisciplinary collaboration. Although research in this field remains limited due to the rarity of pediatric osteoporosis, recognizing and addressing the specific needs of this population is critical to improving clinical outcomes and guiding future therapeutic approaches.

Background: Craniofacial growth is regulated by a complex interaction of genetic, functional, and systemic metabolic factors. Mechanical loading generated during mastication plays a fundamental role in mandibular development through bone modeling and remodeling mechanisms. In contrast, Type I diabetes mellitus is associated with impaired bone metabolism, which may compromise skeletal growth. Although the independent effects of functional loading and metabolic disorders on bone tissue have been widely investigated, their combined influence on mandibular development remains insufficiently understood. Objective: This study primarily aimed to evaluate the effect of Type I diabetes mellitus on mandibular growth in growing rats and, secondarily, to assess the impact of dietary consistency (hard versus soft food) on mandibular development under diabetic and non-diabetic conditions, as well as determine whether diabetes modifies the mandibular adaptive response to increased masticatory loading. Materials and Methods: An experimental animal study was conducted using twenty-four male Wistar rats aged one month. The animals were randomly allocated into four groups according to metabolic status (control or diabetic) and dietary consistency (hard or soft diet). Type I diabetes mellitus was experimentally induced in the relevant groups using streptozotocin. All animals underwent cone beam computed tomography (CBCT) scanning at baseline (Day 1) and at the end of the experimental period (Day 28). Linear measurements were obtained using specialized software following euthanasia. Two-way ANOVA was used to evaluate the effects of diabetes, diet, and their interaction, using appropriate post hoc tests for multiple comparisons. Categorical variables were analyzed using the chi-square test. A p-value < 0.05 was considered statistically significant. Results: Longitudinal morphometric analysis demonstrated that Type I diabetes mellitus significantly impaired mandibular growth. Diabetic animals exhibited reduced growth rates and smaller final mandibular dimensions compared with controls. Hard diet intake significantly enhanced mandibular development in control animals, reflecting a strong adaptive response to increased functional loading. However, this osteogenic response was markedly attenuated in diabetic rats. Under soft-diet conditions, differences between control and diabetic groups were diminished, indicating that reduced mechanical stimulation limits adaptive growth responses. Significant interaction effects between diabetes and dietary consistency were observed in several morphometric parameters, particularly those related to mandibular body length, ramus height, and condylar position. Conclusions: Type I diabetes mellitus exerts a detrimental effect on mandibular growth in growing rats and compromises the adaptive response of craniofacial structures to mechanical loading. Although a hard diet functions as a potent osteogenic stimulus, its growth-promoting effect is substantially reduced in the presence of metabolic dysfunction.