Dentofacial characteristics of oral breathers in different ages: a retrospective case–control study

Abstract

BackgroundThis study aimed to investigate the dental and skeletal variables associated with disturbances of craniofacial development in oral-breathing (OB) individuals and the probability that these variables are related to this condition.MethodsThis is an observational retrospective case–control study of 1596 patients divided into three groups of age n1 5–12, n2 13–18, and n3 19–57 years. Radiographic, clinical, and models data were analyzed. The control group was consisted of nasal breathing (NB) individuals. Statistical analyses of the qualitative data were performed with x2 test to identify associations, and odds ratio (OR) tests were performed for the variables that the chi-square test (x2) identified an association.ResultsIn the descriptive analysis of the data, we observed that the class II malocclusion was the most frequent in the total sample, but when divided by age group and mode of breathing, there is a random division of these variables. In n1 group, class II, (OR = 2.02) short and retruded mandible (SM and RM) (OR = 1.65 and1.89) were associated with OB and it was considered a risk factor. In n2 group, class II (OR = 1.73), SM (OR = 1.87) and increased lower anterior height (ILAFH) (OR = 1.84) seemed to be associated and to be risk factors for OB. In the n1 group, decreased lower anterior facial height (DLAFH) and brachycephalic facial pattern (BP) seemed to be associated with NB and a protective factor against oral breathing.ConclusionsThis study showed that dental and skeletal factors are associated with OB in children, and it seems that it becomes more severe until adolescence. But adults showed no associations between OB and skeletal factors, only in dental variables, indicating that there is no cause–effect relationship between the dental and skeletal factors and OB. The treatment of nose breathing patient should be multidisciplinary, since OB remains even when dental and skeletal factors slow down.

Assessment of Craniofacial Morphology in Mouth Breathing Children. A retrospective case-control study

“…In order to determine if an altered respiratory function is a risk factor in developing the adenoid face, we compare three facial quantitative variables of 42 oral breathing children to 38 nose breathing children. Our results support the findings of other articles in the literature, that there are major craniofacial differences between the two groups [17][18][19][20][21][22][23]. Breathing impaired subjects showed a significantly higher facial index and lower facial height ratio, than the controls.…”

“…Breathing impaired subjects showed a significantly higher facial index and lower facial height ratio, than the controls. The argument for this change in facial morphology is based on a cascade of events, which had the starting point in altered respiratory function [18][19] The first and immediate effect is the perturbed neuromuscular balance, characterized by head extension, posterior rotation of mandible, lower and backward tongue position associated with unbalance buccinator pressure on the maxilla. If these changes are kept for a long period of time in a growing patient the consequences will be upon the developing skeletal system [11][12][13].…”

Variables associated with mouth breathing diagnosis in children based on a multidisciplinary assessment

“…Angle Class II subdivision 1 (on the left side) malocclusion and regular gingival maintenance presenting, respectively, a 10.85 and 2.89-times greater chance of MB diagnosis. A current study with 487 children, 5-12 year old, has investigated an association between dental and skeletal variables and MB (12) , finding Angle class II malocclusion, mandibular retrusion and short mandible as factors that increase the probability of MB diagnosis. Previous studies also found an association between Angle Class II and MB (1,4) .…”

“…Some exams and tests may be complementary, identifying its etiologic factors (6) . There are uncertainties regarding MB diagnosis, given that etiologic factors may be concomitant, acting intermittently or continuously, in addition to the complexity of quantifying its magnitude/severity (11,12) . A recent study has investigated MB perception by orthodontists, as well as proposed and tested guidelines for MB recognition, through visual assessment, semi-structured interview and breathing tests (11) .…”

Treatment Of Severe Crowding And a Narrow Maxilla With Surgically Assisted Rapid Maxillary Expansion (SARME) : A Case Report

“…Radiographic and clinical examination should be performed for the exact diagnosis of this type of deformity. The clinical findings are unilateral or bilateral crossbite, narrow palatal vault, rotated, crowded and palatally or buccally displaced teeth and a narrow and V shaped maxillary arch form (2)(3)(4). The cause of crossbite in adult patients is either skeletal or dental.…”