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Cheng B, Mohamed AS, Li H, Li Y, Liu J, Liu L, Zou R, Wang F. Evaluation of the influencing factors on facial development for mouth breathing children: Insights from 3D scanning technology. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2025:102384. [PMID: 40306362 DOI: 10.1016/j.jormas.2025.102384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Revised: 03/22/2025] [Accepted: 04/17/2025] [Indexed: 05/02/2025]
Abstract
INTRODUCTION Mouth breathing is considered a predisposing factor for sleep breathing disorders which may affect facial morphology, this study investigated the effect of age, gender, and breathing pattern on children's facial morphological development. MATERIAL AND METHODS 3dMD system (3dMD Inc., Atlanta, GA, USA) was utilized to acquire 3D images of the face. A total of 195 children aged 7-12 years were divided into 12 groups by age (7-8 years group, 9-10 years group,11-12 years group,), gender, and breathing pattern (mouth breathing MB, nasal breathing NB). A total of nineteen linear, angle, and ratio measurements were performed. Independent t-tests, Mann-Whitney U tests, One-way ANOVA tests and Kruskal-Wallis test were used to compare between the groups. Linear regression was used to test the relationship between age, gender, breathing patterns and facial development. RESULTS In males, facial convexity angle (FCA) was significantly greater in the MB group than in the NB group in the 11-12 years age group (MB:17.82 ± 5.86, NB:13.24 ± 3.95, P = 0.023). In females, mandibular width increased with age only in the NB group (P < 0.01); in the 9-10 years group, FCA was greater in the MB group than in the NB group (MB:19.03 ± 5.99, NB:14.3 ± 4.59, P = 0.036). In the 11-12 year old group, the mandibular width was significantly smaller in the MB group (MB:111.11 ± 6.34, NB:117.07 ± 8.53, P = 0.026) than in the NB group. Age (P < 0.01) and gender (P < 0.01) were correlated with mandibular width. Additionally, age (P < 0.01), gender (P < 0.01) and respiratory mode (P < 0.05) were correlated with lower lip height. DISCUSSION The upper mid-part development of the face increased with age, and MB showed a more convex profile in males and a narrower mandible in females. The lower third of the facial development was correlated with age, gender, and breathing pattern. Furthermore, mouth breathing was correlated with limitation of mandibular development and increased lower lip height.
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Affiliation(s)
- Bo Cheng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China; Orthodontist, Clinic 4, Xi'an Jiaotong University, China.
| | - Amin S Mohamed
- PhD candidate, Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hongfei Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China; Postgraduate student, MDS (orthodontics), Xi'an Jiaotong University, China.
| | - Yutong Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China; Postgraduate student, MDS (orthodontics), Xi'an Jiaotong University, China
| | - Jiawen Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China; Postgraduate student, MDS (orthodontics), Xi'an Jiaotong University, China
| | - Lifeng Liu
- Associate Professor, Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, Shaanxi, 710061, China
| | - Rui Zou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China; Professor, Department of orthodontics, Xi'an Jiaotong University, China.
| | - Fei Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China; Associate Professor, Department of orthodontics, Xi'an Jiaotong University, China.
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Zhao M, Mohamed AS, Cheng B, Li H, Wang G, Ji L, Zou R, Wang F. A nomogram for assisting in diagnosing mouth breathing based on maxillofacial surface electromyographic activity. BMC Oral Health 2025; 25:514. [PMID: 40211201 PMCID: PMC11987270 DOI: 10.1186/s12903-025-05765-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 03/06/2025] [Indexed: 04/12/2025] Open
Abstract
OBJECTIVE A nomogram based on maxillofacial surface electromyographic (sEMG) activities was developed to assist in diagnosing mouth breathing (MB). METHODS Differences in maxillofacial sEMG activities between MB and nasal breathing (NB) subjects were compared across a sample of 250 participants to identify MB diagnostic factors, a nomogram was developed to assist in diagnosing MB. RESULTS In the univariate analysis, there were significant differences in sEMG activity of masseter muscle with the lips closed lightly, orbicularis oris superior during rest, orbicularis oris superior with the lips closed lightly (OOS3), orbicularis oris superior during swallowing, mentalis muscle during rest, mentalis muscle during maximal intercuspation (MT2), mentalis muscle with the lips closed lightly (MT3) and mentalis muscle during swallowing between the MB and NB groups. Multivariate analysis revealed that OOS3 and MT3 were independent risk factors for MB, while MT2 might be a protective factor against MB. The nomogram exhibited a good clinical application value with an area under the ROC curve of 0.774 (95% CI 0.713-0.834) and fitted calibration curves. CONCLUSION MB could affect maxillofacial sEMG activities. We developed a nomogram to assist in diagnosing MB in the clinic. CLINICAL SIGNIFICANCE The nomogram can help clinicians diagnose MB quickly and easily, providing a more effective way to diagnose children with MB early so that they can receive timely treatment and block abnormal neuromuscular reflexes early, thereby avoiding the harmful effects of MB.
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Affiliation(s)
- Minyue Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China
- MDS (Orthodontics), Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Amin S Mohamed
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China
- Melbourne Dental School, University of Melbourne, Victoria, Australia
| | - Bo Cheng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China
- MDS (Orthodontics), Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Hongfei Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China
- MDS (Orthodontics), Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Gaoli Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China
- MDS (Orthodontics), Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Lingling Ji
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China
- MDS (Orthodontics), Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Rui Zou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China
- Department of Orthodontics, Jiaotong University, Xi'an, People's Republic of China
| | - Fei Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, People's Republic of China.
- Department of Orthodontics, Jiaotong University, Xi'an, People's Republic of China.
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Wu Z, Zhuo R, Yang Y, Liu X, Wu B, Wang J. Optimized deep learning model for diagnosing tonsil and adenoid hypertrophy through X-rays. Front Oncol 2025; 15:1508525. [PMID: 40134602 PMCID: PMC11932914 DOI: 10.3389/fonc.2025.1508525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 02/20/2025] [Indexed: 03/27/2025] Open
Abstract
Objective To explore the application of a deep learning model based on lateral nasopharyngeal X-rays in diagnosing tonsillar and adenoid hypertrophy. Methods A retrospective study was conducted using DICOM images of lateral nasopharyngeal X-rays from pediatric outpatients aged 2-12 at our hospital from July 2014 to July 2024. The study included patients exhibiting varying degrees of respiratory obstruction symptoms (disease group). Initially, 1006 images were collected, but after excluding low-quality images and standardizing the imaging phase, 819 images remained. These images were divided into training and validation sets in an 8:2 ratio. The independent test set is consisted of 484 images. We delineated the target areas for tonsils and adenoids and used a YOLOv8n-based model for object detection and use various convolutional neural network models to classify the cropped images, assessing the severity of tonsillar and adenoid hypertrophy. We compared the performance of these models on the training and validation sets using metrics such as ROC-AUC, accuracy, precision, recall, and F1 score. Results The combined model, incorporating YOLOv8 for object detection and secondary classification, demonstrated excellent performance in diagnosing tonsillar and adenoid hypertrophy, significantly improving diagnostic accuracy and consistency. The ResNet18 model, due to its lightweight nature and minimal computational resource requirements, performed exceptionally well in the YOLOv8-ResNet fusion model for detecting and classifying tonsils and adenoids, making it our preferred model. Conclusion The deep learning model combining YOLOv8n and ResNet18 based on lateral nasopharyngeal X-rays demonstrates significant advantages in diagnosing pediatric tonsillar and adenoid hypertrophy.
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Affiliation(s)
- Zhiqing Wu
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ran Zhuo
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yali Yang
- Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiaobo Liu
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Bin Wu
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jian Wang
- Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China
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Su Y, Wang Z, Chang H, Zhu S, Zhou Y, Cao Z, Ma L, Yuan Y, Xie Y, Niu X, Lu C, Zhang Y, Liu H, Shao N, Yin L, Si C, Ren X, Shi Y. Craniofacial Development Characteristics in Children with Obstructive Sleep Apnea for Establishment and External Validation of the Prediction Model. Nat Sci Sleep 2024; 16:2151-2170. [PMID: 39723200 PMCID: PMC11669283 DOI: 10.2147/nss.s492714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Accepted: 12/03/2024] [Indexed: 12/28/2024] Open
Abstract
Purpose Aimed to analyze the developmental characteristics of craniofacial structures and soft tissues in children with obstructive sleep apnea (OSA) and to establish and evaluate prediction model. Methods It's a retrospective study comprising 747 children aged 2-12 years (337 patients and 410 controls) visited the Department of Otolaryngology-Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University (July 2017 to March 2024). Lateral head radiographs were obtained to compare the cephalometric measurements. The clinical prediction model was constructed using LASSO regression analysis. We analyzed 300 children from the Xi'an Children's Hospital for external validation. Results Children with OSA had a higher body mass, a higher tonsil grade, larger AN ratio (ratio of the adenoids to the skeletal upper airway width), larger radius of the tonsils, a smaller angle between the skull base and maxilla (SNA) and smaller angle between the skull base and mandible (SNB), a larger distance from the hyoid to the mandibular plane (H-MP) and smaller distance between the third cervical vertebra and hyoid (H-C), a larger thickness of the soft palate (SPT) and smaller inclination angle of the soft palate than those of the controls (all p < 0.05). A prediction model was constructed for 2-12 years group (AUC of 0.812 [95% CI: 0.781-0.842]). Age-specific prediction models were developed for preschool children (AUC of 0.769 [95% CI: 0.725-0.814]), for school-aged children (AUC of 0.854 [95% CI: 0.812-0.895]). Conclusion Our study findings support the important role of craniofacial structures such as the hyoid, maxilla, mandible, and soft palate in pediatric OSA. Age-stratified predictive models for pediatric OSA indicated varying parameters across different age groups which underscore the necessity for stratifying by age in future research. The prediction model designed will greatly assist health care practitioners with rapidly identifying.
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Affiliation(s)
- Yonglong Su
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Zitong Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Huanhuan Chang
- Department of Otorhinolaryngology Head and Neck Surgery, Xi’an Children’s Hospital, Xi’an, People’s Republic of China
| | - Simin Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yanuo Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Zine Cao
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Lina Ma
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yuqi Yuan
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yushan Xie
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Xiaoxin Niu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Chendi Lu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yitong Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Haiqin Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Na Shao
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Libo Yin
- Department of Otorhinolaryngology Head and Neck Surgery, Xi’an Central Hospital, Xi’an, People’s Republic of China
| | - Chao Si
- Department of Otorhinolaryngology Head and Neck Surgery, Xi’an Children’s Hospital, Xi’an, People’s Republic of China
| | - Xiaoyong Ren
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yewen Shi
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
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Li Y, Yi S, Zhang J, Hua F, Zhao T, He H. The hyoid bone position and upper airway morphology among children with and without adenotonsillar hypertrophy: a cross-sectional study. BMC Oral Health 2024; 24:1365. [PMID: 39523320 PMCID: PMC11550519 DOI: 10.1186/s12903-024-05139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 10/30/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Adenotonsillar hypertrophy (ATH) is a major cause of pediatric obstructive sleep apnea (OSA), potentially impacting craniofacial growth and development. Currently, whether children with ATH exhibit distinctive hyoid bone position and upper airway morphology remains uncertain. This research aimed to compare the hyoid bone position and upper airway morphology of children with and without ATH. METHODS A total of 199 children aged 6-8 years were recruited for the study, and their pre-treatment lateral cephalograms were obtained. The size of the adenoids and tonsils on the lateral cephalogram was assessed based on Fujioka's and Baroni's methods for classification into groups: adenoid hypertrophy only (AHO) group, tonsillar hypertrophy only (THO) group, adenoid and tonsillar hypertrophy (AH + TH) group, and control group (CG). The position of the hyoid bone and upper airway morphology was analyzed using Dolphin Image Software. RESULTS The distance between the hyoid bone and mentum was greater in the THO group compared to the AHO group (P = 0.005). Children in the AHO group exhibited a longer soft palate (SPL) compared to the THO group (P = 0.014), whereas the THO group displayed a reduced SPL in comparison to healthy controls (P = 0.008). The THO group showed a more inferior tongue position compared to children in the AHO group (P = 0.004). Subjects in the THO group exhibited significantly wider inferior airway space compared to healthy children (P < 0.001). CONCLUSIONS Adenotonsillar hypertrophy may be associated with hyoid bone position and upper airway morphology in children seeking for orthodontic treatment. In children with enlarged tonsils, the hyoid bone was positioned farther from the mentum than in those with enlarged adenoids. Conversely, children with enlarged adenoids had a longer soft palate compared to those with enlarged tonsils.
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Affiliation(s)
- Yaqi Li
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Susu Yi
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Jun Zhang
- Department of Oral Radiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Zhao
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China.
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
- Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Hong He
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China.
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
- Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Liu F, Qin L, Zhang K, Yuan F, Zeng X, Zhao Y. Differential impact of chronic intermittent hypoxia and stress changes on condylar development. Arch Oral Biol 2024; 167:106051. [PMID: 39094424 DOI: 10.1016/j.archoralbio.2024.106051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/22/2024] [Accepted: 07/13/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVES This study aimed to determine the effects of chronic intermittent hypoxia (CIH) and stress change (SC) on the development of the condyle in mouth breathing rats. DESIGN A total of 120 4-week-old rats were randomly assigned to one of five groups. The control (Ctrl) group was the blank control and the intermittent nasal obstruction (INO) group was the positive control. Mild CIH (mCIH) and severe CIH (sCIH) groups were developed by adjusting environmental oxygen concentration and monitoring real-time blood oxygen saturation (SpO2). The SC group was developed using INO, increased environmental oxygen concentration, and real-time SpO2 monitoring. Six rats from each group were sacrificed for analysis at 0, 1, 2, or 4 weeks. RESULTS Similar to the INO group, condyle and mandibular body development in the sCIH group, but not in the mCIH group, was significantly inhibited compared with the Ctrl group. The SC group had inhibited development of the condyle, especially of the posterior zone, but had minimal impact on the growth of the mandible. CONCLUSION The inhibitory effects of CIH on the development of the condyle and mandibular body were SpO2-dose-dependent. When SC occurred, inhibited development was observed in the posterior zone of condyle but not the whole mandible. These findings provide important insights for targeted interventions that address the consequences of mouth breathing in children.
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Affiliation(s)
- Fei Liu
- Department of Dentistry, Xuanwu Hospital Capital Medical University, Changchun Street, No.45, Xicheng District, Beijing 100053, People's Republic of China
| | - Lu Qin
- Department of Dentistry, Xuanwu Hospital Capital Medical University, Changchun Street, No.45, Xicheng District, Beijing 100053, People's Republic of China
| | - Ke Zhang
- Department of Dentistry, Xuanwu Hospital Capital Medical University, Changchun Street, No.45, Xicheng District, Beijing 100053, People's Republic of China
| | - Fengning Yuan
- Department of Dentistry, Xuanwu Hospital Capital Medical University, Changchun Street, No.45, Xicheng District, Beijing 100053, People's Republic of China
| | - Xiangjun Zeng
- Department of Physiology and Pathophysiology, Capital Medical University, No.10 You An Men Wai Xi Tou Tiao, Fengtai District, Beijing 100069, People's Republic of China.
| | - Ying Zhao
- Department of Dentistry, Xuanwu Hospital Capital Medical University, Changchun Street, No.45, Xicheng District, Beijing 100053, People's Republic of China.
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Huang L, Zheng L, Chen X, Bai Y. Age-group-specific associations between adenoid/tonsillar hypertrophy and craniofacial features. BMC Oral Health 2024; 24:1212. [PMID: 39402487 PMCID: PMC11472513 DOI: 10.1186/s12903-024-04932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 09/19/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Age plays an important role in the association between adenotonsillar hypertrophy and craniofacial morphology. This study aimed to analyse the association of adenoid and tonsillar hypertrophy with craniofacial features in different age groups. METHODS Lateral cephalograms were obtained from 942 patients aged 6-15 years (433 boys, 509 girls). They were divided into three age groups: 6-9 years (n = 189), 9-12 years (n = 383), and 12-15 years (n = 370). According to the different sites of pharyngeal obstruction, they were classified as control group (CG), adenoid hypertrophy group (AG), tonsillar hypertrophy group (TG) and adenotonsillar hypertrophy group (ATG). Cephalometric measurements were performed on each enrolled participant. Comparisons between groups and correlations between these cephalometric variables and obstruction sites were evaluated. RESULTS At 6-9 years of age, ATG and TG correlated with increased mandibular height (B = 2.2, p = 0.029; B = 2.6, p = 0.042, respectively). At the age of 9-12 years, AG showed a steep growth direction (B = 1.5, p = 0.002), TG showed a higher probability of Class III skeletal pattern (smaller SNB, ANB and SGn/FH, larger Go-Me) and ATG manifested a higher proportion of Class III skeletal pattern. At 12-15 years of age, there was no significant association between cephalometric measurements and pharyngeal lymphoid tissue enlargement. CONCLUSIONS Children with isolated adenoid hypertrophy have a vertical growth direction at 9-12 years of age. Isolated adenoid hypertrophy correlated with longer mandibular body, more anterior mandible and horizontal skeletal Class III pattern at 6-12 years. Combination of obstructive adenoids and tonsils manifested similarly to children with isolated tonsil hypertrophy.
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Affiliation(s)
- Liping Huang
- Department of Orthodontics, Xiamen Key Laboratory of Stomotalogical Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, 361006, P.R. China
| | - Liyuan Zheng
- Department of Prosthodontics, Xiamen Key Laboratory of Stomotalogical Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, 361006, P.R. China
| | - Xiaobo Chen
- Department of Orthodontics, Xiamen Key Laboratory of Stomotalogical Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, 361006, P.R. China
| | - Yuming Bai
- Department of Orthodontics, Xiamen Key Laboratory of Stomotalogical Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, 361006, P.R. China.
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Zhao T, Yang Z, Ngan P, Luo P, Zhang J, Hua F, He H. Association between adenotonsillar hypertrophy and dentofacial characteristics of children seeking for orthodontic treatment: A cross-sectional study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101751. [PMID: 38145836 DOI: 10.1016/j.jormas.2023.101751] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To compare the dentofacial characteristics of children with and without adenoid and/or tonsillar hypertrophy. METHODS A consecutive sample of orthodontic patients aged 6-12 that took pre-treatment lateral cephalograms were included in this study. Those with history of previous orthodontic treatment, adenoidectomy or tonsillectomy, or craniofacial anomalies were excluded. The diagnosis of adenoid and tonsillar hypertrophy was based on Fujioka's and Baroni's methods, according to which the subjects were divided into four groups: the adenoid hypertrophy only (AHO) group; tonsillar hypertrophy only (THO) group; combined adenoid and tonsillar hypertrophy (AH+TH) group; and no adenoid or tonsillar hypertrophy (NH) group. Cephalograms were used for skeletal and dental measurement. Data were analyzed using one-way ANOVA, LSD post-hoc tests and Chi-square test. RESULTS A total of 598 patients were included. Compared with the NH group, the THO group had significantly larger SNB angle (P < 0.001), as well as significantly smaller ANB angle (P<0.001) and Wits value (P = 0.001). The U1-L1 angle of AHO group was significantly smaller than that in the NH group (P = 0.035). The proportion of adenoid hypertrophy in Class II patients was significantly higher than that in Class III patients (P = 0.001). The proportion of tonsillar hypertrophy in Class III patients was significantly higher than that in Class I patients (P < 0.001) and Class II patients (P < 0.001). CONCLUSION Over 80 % of children seeking orthodontic treatment had either adenoid or tonsillar hypertrophy. Children with adenoid hypertrophy tend to have skeletal Class II malocclusion, while those with tonsillar hypertrophy tend to have skeletal Class III malocclusion.
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Affiliation(s)
- Tingting Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zheng Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, School of Dentistry, West Virginia University, Morgantown, WV, United States of America
| | - Ping Luo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jun Zhang
- Department of Oral Radiology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Guo F, Li Q, Ngan P, Guan G, Chen X, Yang X, Lv C, Hua F, Zhao T, He H. Impact of tonsillectomy on the efficacy of Alt-RAMEC/PFM treatment protocols in children with class III malocclusion and tonsillar hypertrophy: protocol for a cluster randomised controlled trial. BMJ Open 2024; 14:e084703. [PMID: 38950988 PMCID: PMC11328653 DOI: 10.1136/bmjopen-2024-084703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/22/2024] [Indexed: 07/03/2024] Open
Abstract
INTRODUCTION Orthodontic treatment using face mask protraction combined with an alternate rapid maxillary expansion and constriction/protraction face mask (Alt-RAMEC/PFM) protocol is effective in the early treatment of patients with class III malocclusion, but the stability of treatment outcomes represents a major concern. Previous studies have suggested that tonsillar hypertrophy can be a risk factor for class III malocclusion and tonsillectomy may prompt the normalisation of dentofacial growth. However, these studies had a low-to-moderate level of evidence. This study was designed to identify the impact of tonsillectomy before orthodontic treatment on the efficacy and stability of Alt-RAMEC/PFM protocols and the sleep quality and oral health in children with anterior crossbite and tonsillar hypertrophy. METHODS AND ANALYSIS This is a two-arm, parallel-group, superiority cluster randomised controlled trial, with four clinics randomly assigned to the surgery-first arm and the orthodontic-first arm in a 1:1 ratio. The Alt-RAMEC protocol involves alternate activation and deactivation of the expander's jet screw over 6 weeks to stimulate maxillary suture distraction. Patients will be instructed to wear the PFM for a minimum of 14 hours per day. The primary outcomes are changes in Wits appraisal and the degree of maxillary advancement from baseline to the end of orthodontic treatment. Lateral cephalometric radiographs, polysomnography, Obstructive Sleep Apnoea-18 questionnaire and Oral Health Impact Profile-14 questionnaire will be traced, collected and measured. We will recruit 96 patients intofor the study. To assess differences, repeated multilevel linear mixed modelling analyses will be used. ETHICS AND DISSEMINATION This study has been granted ethical approval by the Ethics Committee of the School & Hospital of Stomatology, Wuhan University (approval No. 2023-D10). Written informed consent will be obtained from the participants and their guardians. The results of the trial will be disseminated through academic conferences and journal publications. TRIAL REGISTRATION NUMBER ChiCTR2300078833.
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Affiliation(s)
- Feiyang Guo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qiujing Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA
| | - Guoqiang Guan
- Department of Orthodontics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Xiong Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiuping Yang
- Department of Otorhinolaryngology, Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chenxing Lv
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tingting Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Chowdhary K, Yadav G, Rai A, Saha S, Dhinsa K, Sharma A. Mouth Breathing Habit and Their Effects on Dentofacial Growth in Children in the Age Range of 6-14 Years: A Cephalometric Study. Int J Clin Pediatr Dent 2024; 17:545-551. [PMID: 39355183 PMCID: PMC11440658 DOI: 10.5005/jp-journals-10005-2864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2024] Open
Abstract
Nasal breathing protects the upper airway and is responsible for adequate craniofacial development. It is believed that long-standing obstruction causes mouth breathing, which has a negative impact on the craniofacial complex. Aim The study aimed to verify the effects of mouth breathing on the dentofacial structure by employing cephalometric analysis. Materials and methods The present study was conducted on 68 patients (34 mouth-breathing group or study group and 34 nasal-breathing group or control group) aged 6-14 years. Study subjects were screened based on the inclusion and exclusion criteria. Clinical assessment of nasal function was done to select the mouth breathing patients and referred for ear, nose, and throat (ENT) clearance. Lateral cephalograms were taken for the study subjects, including both nasal and mouth breathers, over which selected landmarks were marked to evaluate linear, skeletal, and dental angular variables for comparison with cephalometric variables of a normal child. Results The mean values of facial height (N-Me, ANS-Me) and mandibular plane angle (SN-GoGn) were significantly higher for mouth breathers. The gonial angle (Ar-GoMe) for ages 6-14 years was significantly lower in the nasal breathing group. Conclusion The study led to the conclusion that all subjects with a history of mouth breathing showed an increase in facial height, gonial angle, and mandibular plane angle. Clinical significance Evaluating dentoskeletal changes in a patient with a mouth-breathing habit helps discern the importance of early identification and interception at an early age, thereby ensuring a functional environment adequate for physiological growth and dentofacial esthetics. How to cite this article Chowdhary K, Yadav G, Rai A, et al. Mouth Breathing Habit and Their Effects on Dentofacial Growth in Children in the Age Range of 6-14 Years: A Cephalometric Study. Int J Clin Pediatr Dent 2024;17(5):545-551.
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Affiliation(s)
- Kritika Chowdhary
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gunjan Yadav
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Rai
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sonali Saha
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kavita Dhinsa
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Anshul Sharma
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Lv C, Yang L, Ngan P, Xiao W, Zhao T, Tang B, Chen X, He H. Role of the tonsil-oropharynx ratio on lateral cephalograms in assessing tonsillar hypertrophy in children seeking orthodontic treatment. BMC Oral Health 2023; 23:836. [PMID: 37936131 PMCID: PMC10629199 DOI: 10.1186/s12903-023-03573-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVES To analyze the diagnostic value of the tonsil-oropharynx (T/O) ratio on lateral cephalograms for evaluating tonsillar hypertrophy (TH). METHODS A cross-sectional study was performed on 185 consecutive children (101 males, 84 females; mean age 7.3 ± 1.4 years) seeking orthodontic treatment. The T/O ratios on lateral cephalograms were calculated following Baroni et al.'s method. Tonsil sizes were clinically determined according to the Brodsky grading scale. Spearman correlation coefficients between the T/O ratio and clinical tonsil size were calculated with the total sample and subgroups and then compared between subgroups. Diagnostic value was analyzed using the receiver operating characteristic (ROC) curve, sensitivity, specificity, positive and negative predictive values, and accuracy. RESULTS There was a strong correlation between the T/O ratio and clinical tonsil size in children (ρ = 0.73; P < 0.001). A significantly higher correlation coefficient was found in the Class III children. The ROC curve revealed an area under the curve of 0.90 (95% CI, 0.86-0.94; P < 0.001). The optimal cutoff value of the T/O ratio for predicting TH was 0.58, with a sensitivity of 98.7% and specificity of 64.2%. Employing the cutoff value of 0.5, the sensitivity was 100% and the specificity was 45.9%. CONCLUSIONS Measurement of the T/O ratio on lateral cephalograms may be helpful to initial screening in children for TH. Practitioners may combine the clinical examination of tonsil size with the cephalometric findings for a more comprehensive evaluation.
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Affiliation(s)
- Chenxing Lv
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liu Yang
- Department of Stomatology, Hangzhou Traditional Chinese Medicine Hospital, Hangzhou, China
| | - Peter Ngan
- Department of Orthodontics, School of Dentistry, West Virginia University, Morgantown, USA
| | - Wenjie Xiao
- Department of Otorhinolaryngology-Head and Neck Surgery, Guangdong Clifford Hospital, Guangzhou, China
| | - Tingting Zhao
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bojun Tang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xiong Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong He
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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12
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Manrikyan GE, Vardanyan IF, Markaryan MM, Manrikyan ME, Badeyan EH, Manukyan AH, Gevorgyan MA, Khachatryan SG. Association between the Obstructive Sleep Apnea and Cephalometric Parameters in Teenagers. J Clin Med 2023; 12:6851. [PMID: 37959316 PMCID: PMC10650301 DOI: 10.3390/jcm12216851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND OSA is a common problem in children and adolescents. Angle class II malocclusion, a tendency toward the vertical type of growth, causes a decrease in the volume of the oral air space, increasing the risk of OSAS. The aim of this study was to evaluate the relationship between cephalometric and OSA parameters, to develop collaborative approaches between orthodontists and somnologists in the treatment of adolescents with OSA. METHODS We analyzed data from 41 adolescents with OSA. Their mean age was 15.8 ± 1.08 years. Orthodontic and polysomnographic examinations of patients were conducted. Statistical analysis was performed in SPSS 19.0.0. RESULTS Most often in patients with distal occlusion, a violation of the harmony in the development of the dental system was observed. The sagittal incisive fissure, characteristic of a distal occlusion, was absent due to the palatal inclination of the upper incisors in 25 (60.98%) patients. The SNB was 79.4 ± 3.1°, indicating a distal position of the mandible relative to the anterior cranial base. The SNA exceeded the normal value, which is one of the prerequisites for mandibular retrognathia. The ANB angle was 4.3 ± 1.9°. Tonsillar hypertrophy affected 6 patients, 21 had adenoid hypertrophy, and 3 had both of them. Movements of the masticatory muscles during sleep were recorded in 22.0% of patients. CONCLUSION To improve the quality of diagnosis and treatment of OSA, a multidisciplinary approach is needed that will correct the processes of child growth and development.
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Affiliation(s)
- Gayane E. Manrikyan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia; (M.M.M.)
| | - Izabella F. Vardanyan
- Department of Pediatric Dentistry and Orthodontics, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia; (I.F.V.); (M.E.M.)
| | - Marina M. Markaryan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia; (M.M.M.)
| | - Mikayel E. Manrikyan
- Department of Pediatric Dentistry and Orthodontics, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia; (I.F.V.); (M.E.M.)
| | - Elen H. Badeyan
- Department of Pediatric Dentistry and Orthodontics, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia; (I.F.V.); (M.E.M.)
| | - Anna H. Manukyan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia; (M.M.M.)
| | - Mariana A. Gevorgyan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia; (M.M.M.)
| | - Samson G. Khachatryan
- “Somnus” Neurological Clinic, Department of Neurology and Neurosurgery, National Institute of Health, Yerevan 0051, Armenia;
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13
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Huang X, Gong X, Gao X. Age-related hypertrophy of adenoid and tonsil with its relationship with craniofacial morphology. BMC Pediatr 2023; 23:163. [PMID: 37024864 PMCID: PMC10077717 DOI: 10.1186/s12887-023-03979-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND When analyzing the relationship between adenotonsillar hypertrophy and craniofacial morphology, researchers generally regarded hypertrophied adenoids and tonsils as a whole. It remains unclear whether different enlarged sites of pharyngeal lymphoid tissue would correlate with multiple craniofacial subtypes. We hypothesized there would be craniofacial subtypes correlated with different locations of hypertrophied adenoid and tonsil. METHODS Lateral cephalometric radiographs were obtained from 466 children (171 boys and 295 girls, aged 12.27 ± 2.69 years). They were divided into four groups according to different sites of enlarged pharyngeal lymphoid tissue: adenoid hypertrophy group (AG, n = 126), tonsillar hypertrophy group (TG, n = 59), adenotonsillar hypertrophy group (ATG, n = 69) and control group (CG, n = 212). Five commonly used angles for cephalometric measurements were investigated: SNA (Sella-Nasion-Point A), SNB (Sella-Nasion-Point B), ANB (Point A-Nasion-Point B), mandibular plane angle (MP/SN) and Y-axis angle (SGn/FH). RESULTS Children with isolated tonsillar hypertrophy correlated with increased SNA (unstandardized regression coefficient B = 1.38, p = 0.009) and SNB (B = 1.99, p = 0.001) compared with controls. However, children with isolated adenoid hypertrophy correlated with decreased SNB (B=-0.94, p = 0.036), increased ANB (B = 0.74, p = 0.014) and increased MP/SN (B = 2.22, p < 0.001). Similarly, children with adenotonsillar hypertrophy correlated with decreased SNB (B=-1.36, p = 0.015), increased ANB (B = 1.35, p < 0.001) and increased MP/SN (B = 2.64, p = 0.001). CONCLUSIONS Isolated adenoid hypertrophy correlated with a retrognathic mandible, an increased maxillo-mandibular sagittal discrepancy, and an increased mandibular plane angle. Isolated tonsillar hypertrophy correlated with maxillary and mandibular protrusion. Adenotonsillar hypertrophy did not show a superimposed craniofacial pattern of the above two but showed the same craniofacial pattern as isolated adenoid hypertrophy.
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Affiliation(s)
- Xin Huang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, P.R. China
| | - Xu Gong
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, P.R. China
| | - Xuemei Gao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, P.R. China.
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14
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Liu Y, Zhao T, Ngan P, Qin D, Hua F, He H. The dental and craniofacial characteristics among children with obstructive sleep apnoea: a systematic review and meta-analysis. Eur J Orthod 2023; 45:346-355. [PMID: 36763565 DOI: 10.1093/ejo/cjac074] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Paediatric obstructive sleep apnoea (OSA) is a sleep breathing disorder which may have dramatic effects on childhood behaviour, neurodevelopment, metabolism, and overall health in children. Malocclusion and craniofacial morphology may be related to paediatric OSA, and therefore provide information for clinicians to recognize, evaluate and treat patients with this sleeping disorder. OBJECTIVE The aim of this systematic review was to summarize evidence regarding the association between paediatric OSA and children's dental and craniofacial characteristics. SEARCH METHODS PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to 1 June 2022. SELECTION CRITERIA Cross-sectional studies, comparing dental or craniofacial characteristics using clinical dental examinations or radiographic findings between OSA children (less than 18 year, diagnosed with overnight polysomnography) and healthy children, were included. DATA COLLECTION AND ANALYSIS The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies was used to assess the quality of included studies. RevMan software was used for performing the Meta-analyses. RESULTS Sixteen studies were included. Meta-analyses showed that the overjet (MD = 0.86, 95% CI: 0.20 to 1.51; P = 0.01), the saggital skeletal jaw discrepancy (ANB; MD = 1.78, 95% CI: 1.04 to 2.52; P < 0.00001) and mandibular plane angle (FH-MP; MD = 3.65, 95% CI: 2.45 to 4.85; P < 0.00001) were greater in OSA-affected children. In contrast, the upper molar arch width (upper first deciduous molar width; MD = -1.86, 95% CI: -3.52 to -0.20; P = 0.03), (Upper second deciduous molar width; MD = -1.06, 95% CI: -1.88 to -0.24; P = 0.01), SNB (MD = -2.10, 95% CI: -3.11 to -1.09; P < 0.0001), and maxillary length (ANS-PNS; MD = -1.62, 95% CI: -2.66 to -0.58; P = 0.002) were smaller in the OSA group. CONCLUSIONS This review shows that OSA-affected children tend to present with mandibular retroposition or retrognathia, increased mandibular plane angle and excess anterior overjet. However, these findings need to be viewed with caution as the corresponding differences may not be significant clinically. REGISTRATION PROSPERO (CRD42020162274).
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Affiliation(s)
- Yanxiaoxue Liu
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Tingting Zhao
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, School of Dentistry, Morgantown, WV, USA
| | - Danchen Qin
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Center for Evidence-Based Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Hong He
- Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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15
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Oku Y, Iwasaki T, Tsujii T, Sakoda-Iwata R, Hisagai S, Ban Y, Sato H, Ishii H, Kanomi R, Yamasaki Y. Effect of palatine tonsil hypertrophy on tongue posture and maxillofacial dentition: A pharyngeal airway computational fluid dynamics study. PEDIATRIC DENTAL JOURNAL 2023. [DOI: 10.1016/j.pdj.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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16
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Invisalign Treatment of a Three-Year-Old Child with Bilateral Posterior Scissor Bite and Multisite Upper Airway Obstruction: A Case Report. J Clin Med 2023; 12:jcm12010333. [PMID: 36615136 PMCID: PMC9820877 DOI: 10.3390/jcm12010333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/19/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Scissor bites have been reported in relatively few epidemiological studies because of their extremely low prevalence rate (below 1%). The etiology of scissor bites remains obscure, but its impact on growth and function should not be ignored. METHODS In this case report, a novel treatment that utilizes Invisalign aligners was performed on a 3-year-old child who presented with a bilateral posterior scissor bite and anterior crossbite, accompanied by multisite obstruction in the upper airway. The aligners functioned as occlusion pads to unlock the scissor bite relationship and combined with cross-traction to narrow the maxillary arch and enlarge the mandibular arch simultaneously. RESULTS The duration of orthodontic therapy was 28 weeks. A multidisciplinary consultation (orthodontics department, ENT department, and spinal surgery) was conducted and a stable result was achieved. A healthy occlusal relationship, improved dental esthetics and a better lateral profile were eventually obtained. CONCLUSIONS Positive treatment outcomes rely on patients' good compliance in this case. In addition, we hope that clinicians will consider our situation in terms of alternative treatments and interprofessional experience.
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Cheng B, Mohamed AS, Habumugisha J, Guo Y, Zou R, Wang F. A Study of the Facial Soft Tissue Morphology in Nasal- and Mouth-Breathing Patients. Int Dent J 2022; 73:403-409. [DOI: 10.1016/j.identj.2022.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/03/2022] [Accepted: 09/10/2022] [Indexed: 11/05/2022] Open
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Lin L, Zhao T, Qin D, Hua F, He H. The impact of mouth breathing on dentofacial development: A concise review. Front Public Health 2022; 10:929165. [PMID: 36159237 PMCID: PMC9498581 DOI: 10.3389/fpubh.2022.929165] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/24/2022] [Indexed: 01/24/2023] Open
Abstract
Mouth breathing is one of the most common deleterious oral habits in children. It often results from upper airway obstruction, making the air enter completely or partially through oral cavity. In addition to nasal obstruction caused by various kinds of nasal diseases, the pathological hypertrophy of adenoids and/or tonsils is often the main etiologic factor of mouth breathing in children. Uncorrected mouth breathing can result in abnormal dental and maxillofacial development and affect the health of dentofacial system. Mouth breathers may present various types of growth patterns and malocclusion, depending on the exact etiology of mouth breathing. Furthermore, breathing through the oral cavity can negatively affect oral health, increasing the risk of caries and periodontal diseases. This review aims to provide a summary of recent publications with regard to the impact of mouth breathing on dentofacial development, describe their consistencies and differences, and briefly discuss potential reasons behind inconsistent findings.
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Affiliation(s)
- Lizhuo Lin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Zhao
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Danchen Qin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom,*Correspondence: Fang Hua
| | - Hong He
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China,Hong He
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Habumugisha J, Cheng B, Ma SY, Zhao MY, Bu WQ, Wang GL, Liu Q, Zou R, Wang F. A non-randomized concurrent controlled trial of myofunctional treatment in the mixed dentition children with functional mouth breathing assessed by cephalometric radiographs and study models. BMC Pediatr 2022; 22:506. [PMID: 36008795 PMCID: PMC9413933 DOI: 10.1186/s12887-022-03559-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study aimed to examine the clinical effects of myofunctional treatment on children with functional mouth breathing by cephalometric radiographs and study models. METHODS A total of 224 children (6-10 years old; 114 males and 110 females; SNA°: 82.24 ± 1.67°; ANB°: 2.79 ± 0.80°, 28° < SN-GoGn° < 37°) formed three groups: MB-M group (mouth breathers with myofunctional treatment,n = 75); MB-N group (mouth breathers with no treatment,n = 70); NB group (nasal breathers with no treatment, n = 79). A blind evaluation of cephalometric radiographs and study models was conducted at T1(pre-study) and T2 (post-study), respectively. RESULTS Two hundred four children (MB-M:66, MB-N:68, NB:70) completed the present study. At T1, MB-M and MB-N groups, compared to their NB counterpart, had greater anterior lower facial height(P < 0.01) and overjet(P < 0.001) but shorter overbite and maxillary canines width (P < 0.001). At T2, the MB-N group exhibited a higher ANB angle, anterior lower facial height, and overjet, but shorter overbite and maxillary canines width (P < 0.001). From T1 to T2, the anterior lower facial height increased, overbite and the maxillary canines width further decreased in the MB-N group (P < 0.001). However, in the MB-M group, the incisors were retracted, overbite increased (P < 0.001), anterior lower facial height increased insignificantly (P > 0.05), and maxillary canines width increased slightly (P < 0.05). In the NB and MB-M groups, the mandible showed a normal tendency to grow forward, whereas, in the MB-N group, the mandible showed a tendency to grow downward (P < 0.001). CONCLUSIONS Mouth breathers demonstrated increased anterior facial height and overjet but reduced overbite and maxillary arch width, which improved significantly following myofunctional treatment. TRIAL REGISTRATION TCTR: TCTR20220401001 . Registered 1stApril 2022-Retrospectively registered.
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Affiliation(s)
- Janvier Habumugisha
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Bo Cheng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Shu-Yu Ma
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Min-Yue Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Wen-Qing Bu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Gao-Li Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Qiong Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China
| | - Rui Zou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China.
| | - Fei Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xi Wu Road, Xi'an, Shaanxi, 710004, People's Republic of China.
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Lyu L, Zhao Z, Tang Q, Zhao J, Huang H. Skeletal class II malocclusion caused by mouth breathing in a pediatric patient undergoing treatment by interceptive guidance of occlusion. J Int Med Res 2021; 49:3000605211021037. [PMID: 34098781 PMCID: PMC8191086 DOI: 10.1177/03000605211021037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 7-year 10-month-old boy was evaluated for mouth breathing and snoring habits. Examination revealed soft convex tissues, maxillary protrusion, mandibular retrusion, and a class II sagittal osteofascial pattern. The patient failed a water holding test. He was clinically diagnosed with skeletal class II malocclusion caused by mouth breathing. Under interceptive guidance of occlusion (iGo), the malocclusion improved with fixed maxillary expansion using functional appliances and interventional treatment of mouth breathing by lip closure exercises. These treatments enabled the patient to gradually return to nasal breathing and guided him to develop physiological occlusion for a coordinated jaw-to-jaw relation. At the 5-year 2-month post-correction follow-up visit (at the age of 13 years), the patient had stable occlusion, a coordinated osteofascial pattern, and normal dentition, periodontium, and temporomandibular joints.
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Affiliation(s)
- Lihua Lyu
- Department of Stomatology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Zheshan Zhao
- Department of Stomatology, Civil Aviation General Hospital, Beijing, China
| | - Qianwei Tang
- Pediatric Dentistry, Guangxi Medical University College & Hospital of Stomatology, Nanning, Guangxi, China
| | - Jingjing Zhao
- Pediatric Dentistry, Guangxi Medical University College & Hospital of Stomatology, Nanning, Guangxi, China
| | - Hua Huang
- Pediatric Dentistry, Guangxi Medical University College & Hospital of Stomatology, Nanning, Guangxi, China
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Pediatric Obstructive Sleep Apnea Syndrome: Emerging Evidence and Treatment Approach. ScientificWorldJournal 2021; 2021:5591251. [PMID: 33981185 PMCID: PMC8088382 DOI: 10.1155/2021/5591251] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/07/2021] [Accepted: 04/17/2021] [Indexed: 11/17/2022] Open
Abstract
OSA pediatric subjects suffer from episodes of upper airway obstruction that can be partial or complete, with atypical sleep patterns and blood-gas level alteration. If poor treated and/or diagnosed, it can cause cardiovascular disease, learning difficulties, behavioural issues, and retardation of growth. In the literature, there are conflicting evidence about OSA assessment and treatment in pediatric age, so the aim of this paper is to highlight the multidisciplinary approach in the management of sleep disorders, stressing the role of the pediatric dentist in both diagnosing and treating the OSAS in children, according to the current evidence of the treatment options effectiveness of the syndrome itself. Conclusions. Scientific evidence shows that OSAS management requires a multidisciplinary approach in order to make an early diagnosis and a correct treatment plan. The orthodontic treatment approach includes orthopedic maxillary expansion and mandibular advancement using intraoral appliances. Hence, the orthodontist and the pediatric dentist play an important role not only in early diagnosis but also in the treatment of pediatric OSAS.
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Zhao Z, Zheng L, Huang X, Li C, Liu J, Hu Y. Effects of mouth breathing on facial skeletal development in children: a systematic review and meta-analysis. BMC Oral Health 2021; 21:108. [PMID: 33691678 PMCID: PMC7944632 DOI: 10.1186/s12903-021-01458-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mouth breathing is closely related to the facial skeletal development and malocclusion. The purpose of this systematic review and meta-analysis was to assess the effect of mouth breathing on facial skeletal development and malocclusion in children. METHODS An electronic search in PubMed, the Cochrane Library, Medline, Web of Science, EMBASE and Sigle through February 23rd, 2020, was conducted. Inclusion criteria were children under 18 years of age with maxillofacial deformities due to mouth breathing. The risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. The included indicators were SNA, SNB, ANB, SN-OP, SN-PP, PP-MP, SNGoGn, MP-H, 1-NA, 1. NA, 1. NB, 1-NB, Overjet, Overbite, SPAS, PAS, and C3-H. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. Review Manager 5.3, was used to synthesize various parameters associated with the impact of mouth breathing on facial skeletal development and malocclusion. RESULTS Following full-text evaluations for eligibility, 10 studies were included in the final quantitative synthesis. In Sagittal direction, SNA (MD: - 1.63, P < 0.0001), SNB (MD: - 1.96, P < 0.0001) in mouth-breathing children was lower than that in nasal-breathing children. ANB (MD: 0.90, P < 0.0001), 1. NA (MD: 1.96, P = 0.009), 1-NA (MD: 0.66, P = 0.004), and 1-NB (MD: 1.03, P < 0.0001) showed higher values in children with mouth breathing. In vertical direction, SN-PP (MD: 0.68, P = 0.0050), SN-OP (MD: 3.05, P < 0.0001), PP-MP (MD: 4.92, P < 0.0001) and SNGoGn (MD: 4.10, P < 0.0001) were higher in mouth-breathing individuals. In airway, SPAS (MD: - 3.48, P = 0.0009), PAS (MD: - 2.11, P < 0.0001), and C3-H (MD: - 1.34, P < 0.0001) were lower in mouth breathing group. CONCLUSIONS The results showed that the mandible and maxilla rotated backward and downward, and the occlusal plane was steep. In addition, mouth breathing presented a tendency of labial inclination of the upper anterior teeth. Airway stenosis was common in mouth-breathing children. Trial registration crd-register@york.ac.uk, registration number CRD42019129198.
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Affiliation(s)
- Ziyi Zhao
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Leilei Zheng
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Xiaoya Huang
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Caiyu Li
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Jing Liu
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China
| | - Yun Hu
- The Affiliated Stomatology Hospital of Chongqing Medical University, No.426 Songshi North Road, Yubei district, Chongqing, 401147, China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 401147, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 401147, China.
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Do breastfed children have a lower chance of developing mouth breathing? A systematic review and meta-analysis. Clin Oral Investig 2021; 25:1641-1654. [PMID: 33506425 DOI: 10.1007/s00784-021-03791-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/08/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Determine the association between breastfeeding and the development of mouth breathing in children. MATERIALS AND METHODS Seven databases were searched for studies investigating the association between the type of feeding and the development of the breathing pattern in children. Descriptive analysis and meta-analysis were performed, with the calculation of the prevalence and likelihood (odds ratios (95% CI)) of mouth breathing according to the duration of breastfeeding. RESULTS The overall prevalence of mouth breathing was 44% (95% CI: 38-49) (N total = 1182). Breastfeeding was a protection factor against the development of mouth breathing (OR = 0.62; 95% CI: 0.41-0.93). The likelihood of developing mouth breathing was 41% and 34% lower among children that were breastfed for more than 12 and more than 24 months, respectively. No association was found between exclusive breastfeeding for up to 6 months and the occurrence of mouth breathing (OR = 0.60; 95% CI: 0.31-1.18). CONCLUSIONS Due to the scarcity of cohort studies that met the inclusion criteria and the low certainty of the evidence, no strong evidence-based conclusion can be drawn. However, breastfeeding should be encouraged due to its possible protective effect, evidenced by the substantial reduction in the prevalence of mouth breathing pattern when performed for up to 2 years. Exclusive breastfeeding was not associated with the development of the breathing pattern. CLINICAL RELEVANCE The results reveal that breastfeeding can protect children from the development of mouth breathing. Thus, healthcare providers should offer support so that mothers feel prepared and encouraged to perform breastfeeding. TRIAL REGISTRATION PROSPERO registry: CRD42017062172.
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Araújo BCL, de Magalhães Simões S, de Gois-Santos VT, Martins-Filho PRS. Association Between Mouth Breathing and Asthma: a Systematic Review and Meta-analysis. Curr Allergy Asthma Rep 2020; 20:24. [PMID: 32430704 DOI: 10.1007/s11882-020-00921-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW This systematic review and meta-analysis evaluated the association between asthma and mouth breathing. We performed a systematic search in the PubMed, SCOPUS, Lilacs, Web of Science, Google Scholar and OpenThesis databases. RECENT FINDINGS Asthma is defined as a heterogeneous disease characterized by variable symptoms of wheezing, shortness of breath, chest oppression and/or cough, and limitation of expiratory airflow. Although several studies have examined the association between asthma and mouth breathing, there are no systematic reviews or meta-analyses that synthesize the available bodies of evidence. We used the odds ratio as a measure of the association between asthma and mouth breathing. Summary estimates were calculated using random-effects models, and the risk of bias was estimated using the Newcastle-Ottawa Scale for case-control studies and the National Institutes of Health tool for cross-sectional studies. Nine studies were included in the present systematic review. Data from 12,147 subjects were analyzed, of which 2083 were children and adolescents and 10,064 were adults. We found an association between mouth breathing and asthma in children and adolescents (OR 2.46, 95% CI 1.78-3.39) and in adults (OR 4.60, 95% CI 1.49-14.20). However, limitations were found in the methodological description of the included studies, as well as high heterogeneity among studies evaluating adult populations. This meta-analysis showed an association between mouth breathing and asthma in children, adolescents and adults, but the results should be interpreted with caution. Further studies with standardized criteria for the investigation of mouth breathing are needed.
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Affiliation(s)
- Brenda Carla Lima Araújo
- Department of Speech Therapy, Federal University of Sergipe, Aracaju, Brazil. .,Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil. .,Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil.
| | - Silvia de Magalhães Simões
- Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.,Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Vanessa Tavares de Gois-Santos
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil.,Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Paulo Ricardo Saquete Martins-Filho
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n. Bairro Sanatório, Aracaju, SE, 49060-100, Brazil.,Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil
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Pawłowska-Seredyńska K, Umławska W, Resler K, Morawska-Kochman M, Pazdro-Zastawny K, Kręcicki T. Craniofacial proportions in children with adenoid or adenotonsillar hypertrophy are related to disease duration and nasopharyngeal obstruction. Int J Pediatr Otorhinolaryngol 2020; 132:109911. [PMID: 32032918 DOI: 10.1016/j.ijporl.2020.109911] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/25/2020] [Accepted: 01/27/2020] [Indexed: 01/17/2023]
Affiliation(s)
| | - Wioleta Umławska
- Department of Human Biology, University of Wroclaw, Ul. Kuźnicza 35, 50-138, Wroclaw, Poland
| | - Katarzyna Resler
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Monika Morawska-Kochman
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Katarzyna Pazdro-Zastawny
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Tomasz Kręcicki
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
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Milanesi JDM, Berwig LC, Marquezan M, Schuch LH, Moraes ABD, Silva AMTD, Corrêa ECR. Variables associated with mouth breathing diagnosis in children based on a multidisciplinary assessment. Codas 2018; 30:e20170071. [DOI: 10.1590/2317-1782/20182017071] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/31/2017] [Indexed: 12/14/2022] Open
Abstract
ABSTRACT Purpose : This study was conducted to identify variables associated with mouth breathing diagnosis in children, based on multidisciplinary domains. Methods 119 children, six to 12 years old, underwent anamnesis, speech therapy (orofacial structures and stomatognathic functions), otorhinolaryngologic (OTRL) with clinical and endoscopic examinations, dental (occlusion) and physiotherapy (body posture and nasal patency) assessments. Nasal patency was evaluated using Peak Nasal Inspiratory Flow (PNIF) and the Nasal Obstruction Symptom Evaluation (NOSE) scale. A multiple logistic regression was performed considering breathing mode as the dependent variable and the co-variables from each multidisciplinary assessment as associated variables. Results Association with MB diagnosis was found in each professional domain with: nasal obstruction report (Odds ratio - OR=5.55), time of pacifier use (OR=1.25), convex facial type (OR=3.78), obtuse nasal angle (OR=4.30), half-open or open lip posture (OR=4.13), tongue position on the mouth floor (OR=5.88), reduced hard palate width (OR=2.99), unexpected contraction during mastication (OR=2.97), obstructive pharyngeal tonsils (OR=8.37), Angle Class II malocclusion (OR=10.85) and regular gingival maintenance (OR=2.89). Conclusion We concluded that a multidisciplinary diagnosis is important, given that each evaluation domain, including OTRL, dental and speech therapy, presented variables associated with MB diagnosis. Body posture and nasal patency variables were not associated with MB.
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Milanesi JDM, Berwig LC, Schuch LH, Ritzel RA, Silva AMTD, Corrêa ECR. Nasal patency and otorhinolaryngologic-orofacial features in children. Braz J Otorhinolaryngol 2017; 85:83-91. [PMID: 29233518 PMCID: PMC9442814 DOI: 10.1016/j.bjorl.2017.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 10/11/2017] [Accepted: 10/27/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Nasal obstruction is a common symptom in childhood, related to rhinitis and pharyngeal tonsil hypertrophy. In the presence of nasal obstruction, nasal patency may be reduced, and nasal breathing is replaced by mouth breathing. Orofacial and otorhinolaryngologic changes are related to this breathing mode. Objective evaluation of upper airways may be obtained through nasal patency measurement. OBJECTIVE To compare nasal patency and otorhinolaryngologic-orofacial features in children. METHODS One hundred and twenty three children, 6-12 year-old, and of both sexes underwent speech therapy evaluation, according to Orofacial Myofunctional Evaluation protocol, clinical and endoscopic otorhinolaryngologic examination and nasal patency measurement, using the absolute and predicted (%) peak nasal inspiratory flow values. RESULTS Lower values of absolute and estimated peak nasal inspiratory flow values were found in children with restless sleep (p=0.006 and p=0.002), nasal obstruction report (p=0.027 and p=0.023), runny nose (p=0.004 and p=0.012), unsystematic lip closure during mastication (p=0.040 and p=0.026), masticatory speed reduced (p=0.006 and p=0.008) and altered solid food swallowing (p=0.006 and p=0.001). Absolute peak nasal inspiratory flow was lower in children with pale inferior turbinate (p=0.040), reduced hard palate width (p=0.037) and altered speech (p=0.004). Higher absolute values were found in children with increased tongue width (p=0.027) and, higher absolute and predicted (%) in children with mild everted lip (p=0.008 and p=0.000). CONCLUSIONS Nasal patency was lower in children with restless sleep, rhinitis signs and symptoms, hard palate width reduced and with changes in mastication, deglutition and speech functions. It is also emphasized that most of the children presented signs and symptom of allergic rhinitis.
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Affiliation(s)
- Jovana de Moura Milanesi
- Universidade Federal de Santa Maria, Programa de Distúrbios de Comunicação Humana, Santa Maria, RS, Brazil.
| | - Luana Cristina Berwig
- Universidade Federal de Santa Maria, Programa de Distúrbios de Comunicação Humana, Santa Maria, RS, Brazil
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Milanesi JM, Berwig LC, Busanello-Stella AR, Trevisan ME, Silva AMTD, Corrêa ECR. Nasal patency and craniocervical posture in scholar children. FISIOTERAPIA E PESQUISA 2017. [DOI: 10.1590/1809-2950/17648424032017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Changes in head posture have been observed as a compensatory mechanism for the nasal airflow impairment. This study aimed to compare the craniocervical posture between children with normal and decreased nasal patency and correlate nasal patency with craniocervical posture. Children aging from six to twelve years went through nasal patency and craniocervical assessments. The biophotogrammetric measures of craniocervical posture used were Cervical Distance (CD), Head Horizontal Alignment (HHA) and Flexion-Extension Head Position (FE), evaluated by SAPO software (v.0.68). Nasal patency was measured using Peak Nasal Inspiratory Flow meter (PNIF) and Nasal Obstruction Symptom Evaluation (NOSE) scale. One hundred thirty-three children were distributed into two groups: G1 (normal nasal patency - PNIF higher than 80% of predicted value) with 90 children; G2 (decreased nasal patency - PNIF lower than 80% of predicted value) with 43 children. Differences between groups were not found in CD and HHA measures. FE was significantly higher in G2 than G1 (p=0.023). Negative weak correlation between FE and %PNIF (r=-0.266; p=0.002) and positive weak correlation between CD and PNIF (r=0.209; p=0.016) were found. NOSE scores negatively correlated with PNIF (r=-0.179; p=0.039). Children with decreased nasal patency presented greater head extension. This postural deviation is prone to increase as nasal airflow decreases, thus indicating the relationship between craniocervical posture and nasal patency. Lower values of PNIF reflected on additional problems caused by nasal obstruction symptoms.
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Relationships among nasal resistance, adenoids, tonsils, and tongue posture and maxillofacial form in Class II and Class III children. Am J Orthod Dentofacial Orthop 2017; 151:929-940. [PMID: 28457271 DOI: 10.1016/j.ajodo.2016.10.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The purpose of this study was to clarify the relationships between upper airway factors (nasal resistance, adenoids, tonsils, and tongue posture) and maxillofacial forms in Class II and III children. METHODS Sixty-four subjects (mean age, 9.3 years) with malocclusion were divided into Class II and Class III groups by ANB angles. Nasal resistance was calculated using computational fluid dynamics from cone-beam computed tomography data. Adenoids, tonsils, and tongue posture were evaluated in the cone-beam computed tomography images. The groups were compared using Mann-Whitney U tests and Student t tests. The Spearman rank correlations test assessed the relationships between the upper airway factors and maxillofacial form. RESULTS Nasal resistance of the Class II group was significantly larger than that of the Class III group (P = 0.005). Nasal resistance of the Class II group was significantly correlated with inferior tongue posture (P <0.001) and negatively correlated with intermolar width (P = 0.028). Tonsil size of the Class III group was significantly correlated with anterior tongue posture (P <0.001) and mandibular incisor anterior position (P = 0.007). Anterior tongue posture of the Class III group was significantly correlated with mandibular protrusion. CONCLUSIONS The relationships of upper airway factors differ between Class II and Class III children.
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Anderson SM, Lim HJ, Kim KB, Kim SW, Kim SJ. Clustering of craniofacial patterns in Korean children with snoring. Korean J Orthod 2017; 47:248-255. [PMID: 28670566 PMCID: PMC5466907 DOI: 10.4041/kjod.2017.47.4.248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/20/2017] [Accepted: 02/07/2017] [Indexed: 11/10/2022] Open
Abstract
Objective The purpose of this study was to investigate whether the craniofacial patterns of Korean children with snoring and adenotonsillar hypertrophy (ATH) could be categorized into characteristic clusters according to age. Methods We enrolled 236 children with snoring and ATH (age range, 5–12 years) in this study. They were subdivided into four age groups: 5–6, 7–8, 9–10, and 11–12 years. Based on cephalometric analysis, the sagittal and vertical skeletal patterns of each individual were divided into Class I, II, and III, as well as the normodivergent, hypodivergent, and hyperdivergent patterns, respectively. Cluster analysis was performed using cephalometric principal components in addition to the age factor. Results Three heterogeneous clusters of craniofacial patterns were obtained in relation to age: cluster 1 (41.9%) included patients aged 5–8 years with a skeletal Class I or mild Class II and hyperdivergent pattern; cluster 2 (45.3%) included patients aged 9–12 years with a Class II and hyperdivergent pattern; and cluster 3 (12.8%) included patients aged 7–8 years with a Class III and hyperdivergent pattern. Conclusions This study found that the craniofacial patterns of Korean children with snoring and ATH could be categorized into three characteristic clusters according to age groups. Although no significantly dominant sagittal skeletal discrepancy was observed, hyperdivergent vertical discrepancy was consistently evident in all clusters.
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Affiliation(s)
| | - Hoi-Jeong Lim
- Department of Orthodontics, Chonnam National University School of Dentistry, Gwangju, Korea
| | - Ki-Beom Kim
- Department of Orthodontics, Center for Advanced Dental Education, Saint Louis University, St. Louis, MO, USA
| | - Sung-Wan Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, Kyung Hee University School of Dentistry, Seoul, Korea
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RODRIGUES JA, SOUZA-SILVA BN, BALDRIGHI SEZDM, PARANHOS LR, CÉSAR CPHAR. Interference of mouth breathing with orthodontic treatment duration in Angle Class II, Division 1. REVISTA DE ODONTOLOGIA DA UNESP 2017. [DOI: 10.1590/1807-2577.18916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction Several factors can interfere with orthodontic treatment, and it is important to verify which ones may hinder its success. Objective To compare the duration of orthodontic treatment between nasal and mouth breathers with Angle Class II, Division 1 malocclusion. Material and method This is an analytical observational study which used the records of orthodontic patients cared at a higher education institution in Sao Paulo state, Brazil, between 1999 and 2009. Data from the following variables were analyzed: age, gender, breathing mode (nasal or oral breathing), and treatment duration (beginning and end). Patients were matched for age and treatment used. The ANOVA test was applied to analyze the study data at 5% significance level (p<0.05). Result The study sample consisted of 36 individuals, 16 female (10 nasal breathers and six mouth breathers) and 20 males (eight nasal breathers and 12 mouth breathers), aged nine to 15 years (mean age=13.021). As for orthodontic treatment duration, individuals in the nasal breathing group remained between 27 and 74 months (mean duration=39.61) under treatment, whereas treatment of individuals in the mouth breathing group lasted between 29 and 50 months (mean duration=36.66). No statistically significant differences were observed between the study groups. Conclusions We conclude that the variable altered breathing mode does not interfere with treatment duration.
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