Mandibular Arch Width in Stunted and Non-Stunted Children From High-Stunting Areas in Bandung, Indonesia: A Panoramic Radiographic Study

<title>Abstract</title> <p>Background Stunting is a chronic nutritional condition that may affect skeletal growth, including craniofacial development. However, evidence regarding its association with mandibular arch dimensions in early childhood remains limited. This study aimed to compare mandibular arch width between stunted and non-stunted children aged 3–7 years using panoramic radiographs. Methods This cross-sectional study used secondary panoramic radiographic data from 61 children aged 3–7 years, consisting of 30 stunted and 31 non-stunted children. Stunting status was determined based on height-for-age z-scores according to the WHO growth standards. Mandibular intercanine and intermolar widths were measured on digital panoramic radiographs using WebCeph software and expressed in pixel units. Intra-observer reliability was assessed using intraclass correlation coefficients. Normality was evaluated using the Shapiro–Wilk test, and between-group comparisons were performed using independent-samples t-tests or Welch’s t-tests, as appropriate. Effect sizes were calculated using Cohen’s d. Results Children in the stunted group showed smaller mandibular arch widths than non-stunted children. The mean intercanine width was 130.47 ± 14.47 pixels in the stunted group and 145.42 ± 18.81 pixels in the non-stunted group, with a mean difference of 14.95 pixels (95% CI: 6.36–23.54; p = 0.001; Cohen’s d = 0.89). The mean intermolar width was 255.97 ± 25.14 pixels in the stunted group and 288.97 ± 43.63 pixels in the non-stunted group, with a mean difference of 33.00 pixels (95% CI: 14.74–51.26; p &lt; 0.001; Cohen’s d = 0.92). Intra-observer reliability was excellent for both intercanine and intermolar measurements. Conclusion Stunted children showed significantly smaller mandibular intercanine and intermolar widths than non-stunted children. These findings suggest that chronic growth impairment may be associated with reduced transverse mandibular arch development in early childhood.</p>