Influence of orotracheal intubation on preterm infant palate shape between 12 and 24 months old

Abstract

Introduction: Mechanical ventilation (MV) is indicated in diverse clinical situations in which the individual develops acute or chronic respiratory failure. Objective: To evaluate the palate shape of preterm infants aged 12 to 24 months who were submitted to orotracheal intubation (OTI) and mechanical ventilation. Methods: This cross-sectional observational study included preterm infants submitted to MV by OTI for at least seven days, who weighed less than 2000 g at birth, and were attended at the Preterm Infant Care Outpatient Clinic of the University Hospital of the University of São Paulo and the Premature Infant Outpatient Clinic of the Children's Institute of the Clinics Hospital of the School of Medicine of the University of São Paulo. Sociodemographic data were collected from neonatal medical records of the participating children. The oral cavity was examined to classify palate shape into square, narrow or ovoid. Statistical analyses were performed using the ANOVA F, Kruskal-Wallis and Chi-square tests, with a 5% significance level. Results: The mean period of OTI was 25.3 ± 25.8 days, and the children presented a significantly higher percentage of narrow shaped palate (p<0.001). Conclusion: The palate in preterm infants submitted to invasive MV by OTI is predominantly narrow and deep.

Adverse pregnancy outcomes and occlusal traits in the primary dentition: A prospective cohort (BRISA)

“…However, the literature indicates that such APO predispose to etiological factors of malocclusions, such as respiratory infections, mouth breathing, morphological changes in the palate, decreased breastfeeding time and pacifier sucking habits. 2,19,20,33 Two main hypotheses were investigated in this study. In a morphological nature, the first one suggests that changes in the linear growth or the craniofacial structures could lead to occlusal dis- 21,22 tooth loss, 24 changes in the timing and sequence of tooth eruption.…”

“…There were no direct or indirect associations between APO and the occlusal traits investigated. However, the literature indicates that such APO predispose to etiological factors of malocclusions, such as respiratory infections, mouth breathing, morphological changes in the palate, decreased breastfeeding time and pacifier sucking habits 2,19,20,33 …”

“…Some researchers say that PTB children have smaller skull and head circumference, 15 deep and asymmetricpalate, 14,19,20 malocclusions, 13,14 changes in teeth mineralization, 21,22 more considerable risk of having caries 23 and precocious dental loss 24 …”

Dental complications associated with neonatal intubation in preterm infants

“…During the early stage of development of the oral cavity, the palatal bone is malleable and is easily influenced by extrinsic force [47]. Deformation of the median palatine suture may occur due to prolonged orotracheal intubation, since the endotracheal tube exerts continuous pressure on the palate [36374849].…”

“…Another study on the effects of orotracheal intubation on the palatal architecture in preterm infants classified the palatal shape of neonates into square, narrow, and ovoid. A narrow palate (67.6%) was more frequently observed than the square (14.7%) or ovoid (17.7%) morphology in neonates who had undergone intubation for 7 days or longer [37]. The narrow palatal morphology is maintained even after the patient has fully grown (Fig.…”