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. 2021 Oct;41(5):436-442.
doi: 10.14639/0392-100X-N1225.

Association between upper airway obstruction and malocclusion in mouth-breathing children

Paola Festa  1   2 , Nicola Mansi  1 , Alfonso Maria Varricchio  1 , Fabio Savoia  3 , Camilla Calì  3 , Carmela Marraudino  4 , Giovanni Carlo De Vincentiis  5 , Angela Galeotti  2
Affiliations

Association between upper airway obstruction and malocclusion in mouth-breathing children

Paola Festa et al. Acta Otorhinolaryngol Ital. 2021 Oct.

Abstract
in English, Italian

Objectives: To evaluate the association between upper airway obstruction and occlusal anomalies in mouth-breathing children.

Methods: 356 mouth-breathing children were evaluated by ENT physicians and specialists in orthodontics. ENT examination included nasal endoscopy to assess the adenoidal hypertrophy, tonsillar grading and presence of nasal septum deviation. Clinical orthodontic examination was performed to record occlusal variables. Univariate and multivariable logistic regression were performed to study the association between registered variables.

Results: 221 patients (mean age ± sd = 6.2 ± 2.5 years) met inclusion criteria. 81.4% of children presented malocclusion. A significant association between tonsillar grade 2 and the presence of malocclusion, Class II relation and increased overjet was shown. Tonsillar grade 4 showed a significant association with the presence of malocclusion and increased overjet. Adenoidal hypertrophy and nasal septum deviation did not show any association with occlusal findings.

Conclusions: A high frequency of orthodontic problems was seen in mouth-breathing children. Our results suggested that severe tonsillar hypertrophy may determine presence of malocclusion and increased overjet. On the other hand, the association between mild tonsillar hypertrophy and many occlusal anomalies in mouth-breathers suggest an important role of malocclusion in the onset of oral breathing in children.

Associazione tra l’ostruzione delle vie aeree superiori e le malocclusioni in bambini con respirazione orale.

Razionale: Valutare l’associazione tra l’ostruzione delle vie aeree superiori e le anomalie occlusali in bambini con respirazione orale.

Metodi: 356 pazienti pediatrici con respirazione orale sono stati valutati in un ambulatorio multidisciplinare composto da specialisti in otorinolaringoiatria ed ortognatodonzia. La visita prevedeva valutazione otorinolaringoiatrica con rinofibroscopia e valutazione ortodontica.

Risultati: 221 pazienti (età media ± dev st = 6,2 ± 2,5 anni) rispondevano ai criteri di inclusione e sono stati inseriti nel presente studio. L’81,4% dei pazienti presentava una malocclusione. Un’associazione statisticamente significativa è stata evidenziata tra il 2° grado di ipertrofia tonsillare e presenza di malocclusione, malocclusione di Classe II e overjet aumentato. L’ipertrofia tonsillare di 4° grado è risultata associata alla presenza di malocclusione e overjet aumentato. L’ipertrofia adenoidea e la deviazione del setto nasale non sono risultate associate alle variabili occlusali.

Conclusioni: Nei bambini con respirazione orale è presente un’elevata frequenza di anomalie occlusali. I nostri risultati suggeriscono che una grave ipertrofia tonsillare può determinare la presenza di malocclusione e aumento dell’overjet. D’altra parte, l’associazione tra una ipertrofia tonsillare di grado lieve e diverse anomalie occlusali suggerisce un ruolo importante della malocclusione nell’insorgenza della respirazione orale nei bambini.

Keywords: adenoids; malocclusion; mouth-breathing; nasal septum deviation; tonsils.

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Conflict of interest statement

Conflict of interest

The Authors declare no conflict of interest.

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