Facial skeletal alterations in mouth breathing paediatric patients: cephalometric evaluations

Abstract

The morphogenesis of the dento-maxillofacial district is related to epigenetic factors and intrinsicgenetic factors, and to local and general environmental factors, which interfere with the neuromuscularbalance. Among the several local environmental factors that can interfere with a harmonious andbalanced craniofacial growth, there are spoiled habits, such as mouth breathing. Mouth breathingrepresents the most serious condition, since not only plays a fundamental role in the development ofthe entire dento-maxillofacial apparatus, but also lead to negative consequences at the systemic levelas far as pulmonary, circulatory, nervous, endocrine and digestive functions. The orthodontist playsan important role in the diagnosis, since the most significant symptoms are of orthodontic nature suchas, for example, the alteration of the shape of the dental arches, of occlusion, and growth vectors of themaxillary. The aim of this study is to determine whether the tendency to develop a condition of skeletalhyper-divergence with high vertical anterior dimensions of the middle and lower facial third, are relatedto the degree of patency in the nasopharyngeal canal. Cephalometric data from 50 mouth-breathingsubjects and 30 prevalent nasal-breathing subjects were analyzed, looking for a correlation betweenthe degree of skeletal divergence of the jaw (the FMA angle in particular) and the degree of patencyof the nasopharyngeal canal (AD-PTV). Data confirmed the correlation between facial morphologyand the reduction of the nasopharyngeal space in mouth breathing subjects. The correlation betweenskeletal class II malocclusion and the reduction of the sagittal diameters of the rhino-pharyngealcanal wasn’t relevant. Finally, although the table of percentages shows an increase in the diametersof the upper airways in older subjects, demonstrating the physiological atrophy during the growth,this correlation is not statistically significant. This study demonstrated a significant correlation betweensmall nasopharyngeal canal size and facial skeletal hyper-divergence was also demonstrated.