The aim of this study was to compare a number of dentofacial variables and airway space in children suffering from obstructive sleep apnoea (OSA) syndrome with the corresponding variables in control children exhibiting a normal breathing pattern, to study the development of these variables prospectively over a 5-year-period following treatment for OSA, and to compare the recorded changes with the corresponding changes occurring in the controls. The subjects were 17 children (10 boys and 7 girls, mean age 5.6 years) diagnosed with OSA syndrome. The treatment for the OSA was adeno-/tonsillectomy. The control group comprised 17 age- and gender-matched children (mean age 5.8 years) without breathing problems. Lateral cephalograms were taken of the OSA children at baseline and then at 1, 3, and 5 years post-treatment. The control records comprised registrations at baseline and then after 1 and 5 years. In comparison with the controls, the OSA children exhibited a more posteriorly inclined mandible (P < 0.05), a more anteriorly inclined maxilla (P < 0.001), a greater lower anterior face height (P < 0.01), a shorter anterior cranial base (P < 0.01), retroclined upper and lower incisors (P < 0.05 and P < 0.01, respectively), reduced airway space (P < 0.05 and P < 0.01), and a less pronounced nose (P < 0.05). At 5 years post-treatment, there were no statistically significant differences between the groups except for the lengths of the anterior cranial base and the nose which were still shorter (P < 0.05) in the patient group. OSA in young children has an unfavourable effect on the development of several dental and facial components. However, if OSA is diagnosed and treated at an early age, an almost complete normalization of dentofacial morphology may be achieved.

The findings are based on a study of 81 mouth-breathing patients with hypertrophic adenoid vegetations where adenoidectomy was performed. These patients have been compared with a similar number of control cases with the same sex and ages but without any nasal obstruction problems. A 5-year follow-up study on the same material has also been carried out. The results have shown that Children who had difficulties in nasal breathing were characterized by increases in both the lower and total facial heights; the sagittal depth of the bony nasopharynx was less; the tongue had a lower position; the upper arch was narrow; the upper and lower incisors were retroclined; the palatal vault was of normal height; there was a cross-bite or tendency towards cross-bite, a tendency towards open bite and normal antero-posterior relationship between upper and lower jaws. After adenoidectomy there was a normalization of the inclination of the upper and lower incisors, of the upper arch width, of the sagittal depth of the bony nasopharynx and of the inclination of the mandibular plane to the maxilla. The mechanism behind these changes is discussed. The results support the theory that disturbed nasal respiration can affect both facial morphology and the dentition.

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