Effects of mouth breathing on facial skeletal development  in children: A systematic review and meta-analysis.

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.

Risk assessment of orthodontic anomalies in children in suburban areas

“…Pored toga, disanje na usta predstavlja tendenciju labijalne inklinacije gornjih sekutića. Stenoza disajnih puteva bila je česta kod dece koja dišu na usta 36 . Potrebna je bliska saradnja između različitih stručnjaka (pedijatar, alergolog, ORL specijalista, ortodont, logoped) za promovisanje rane dijagnoze i lečenja ovih nepravilnosti 37 .…”

“…In addition, mouth breathing is a tendency of the labial inclination of the upper incisors. Respiratory stenosis was common in children who breathed through the mouth 36 . Close cooperation between different specialists (pediatrician, allergist, ENT specialist, orthodontist, speech therapist) is needed to promote early diagnosis and treatment of these anomalies 37 .…”

Relationship of maxillary and mandibular effective base length, arch length and dental crowding in different vertical growth pattern

“…ese clinical conditions become more complicated in the late mixed and permanent dentition if mouth breathing continues to persist. [29,36,37] is study shows association between the clockwise rotation of the mandible and the amount of mandibular anterior crowding. e current results suggest that besides dental factors and skeletal factors such as effective base lengths, the different vertical growth pattern is also an important factor in dental crowding.…”

Manejo de los hábitos orales en odontopediatría: Revisión de literatura

“…Además, puede estar relacionada con alergias respiratorias, condiciones climáticas, una mala posición para dormir o la lactancia materna 24 .…”

“…Asimismo, presentan incompetencia del labio superior, una retroposición del hueso hioides, un arco superior estrecho 24 . El establecimiento de un modo correcto de respiración puede prevenir el desarrollo de un patrón de crecimiento facial no deseado, como el síndrome de la cara larga, o la cara adenoidea 26 .…”