Children with hypertrophic tonsils and adenoids may have adverse effects on dental occlusion, which tend to worsen during the growth period. Diagnosis and early treatment is essential. Aim Prospective clinical study to compare the cephalometric measurements before and after adenotonsillectomy in mouth breathing patients. Material and Method We had 38 patients of both genders, aged between 7 and 11 years in our sample, broken down into: oral group, 18 patients with obstructive hypertrophy of pharyngeal tonsil and/or palate grade 3 or 4; control group, 20 patients with normal breathing. Angular and linear dental measurements were compared between the groups in a 14 months interval. We used the “t” Student and Wilcoxon tests for unpaired samples, at 5% significance, for statistical purposes. Results The sagittal position and axial angle of the lower incisors increased significantly in the group with oral breathing, the sagittal position of the upper incisors increased significantly in the oral group, which still had a significant increase in overbite. Conclusion Adenotonsillectomy was very effective in improving some dental measurements, with benefits to growing patients preventing malocclusions from becoming difficult to treat or permanent.

Obstructive hypertrophy of the tonsils and/or adenoids is associated with mouth breathing and can lead to facial imbalances. Adenotonsillectomy is not enough to treat the anatomic changes. Facial orthopedic techniques aid in morphological and functional recovery. This prospective longitudinal clinical study aimed to observe craniofacial changes after adenotonsillectomy and to verify the importance of linking rapid maxillary expansion to treatment. Method Fifty-three children of both genders, aged 6 to 12 years, were allocated to: Group 1, 20 children with nasal breathing; and group 2, 33 children with obstructive hypertrophy of pharyngeal and/or palate undergoing adenotonsillectomy. After surgery, this group was subdivided into Group 2A, 16 patients not treated with rapid maxillary expansion; and Group 2B, 17 patients treated with maxillary rapid expansion. Frontal and lateral cephalometric measurements were made prior to surgery and after 14 months. Statistical analysis used the Kruskal-Wallis and Wilcoxon tests – significance level of 5%. Results Adenotonsillectomy balanced transversal, sagittal and vertical growth in both groups, and was more effective in the group undergoing combined treatment. Conclusions Adenotonsillectomy improved the facial growth of children with obstructive hypertrophy, which was more evident when associated with rapid maxillary expansion.