Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 23;21(1):607.
doi: 10.1186/s12903-021-01974-6.

The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study

Shishir Ram Shetty  1 , Saad Wahby Al Bayatti  2 , Natheer Hashim Al-Rawi  2 , Vinayak Kamath  3 , Sesha Reddy  4 , Sangeetha Narasimhan  2 , Sausan Al Kawas  2 , Medhini Madi  5 , Sonika Achalli  6 , Supriya Bhat  6
Affiliations

The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study

Shishir Ram Shetty et al. BMC Oral Health. .

Abstract

Introduction: Nasal septal deviation (NSD) and concha bullosa (CB) are associated with airway obstruction in mouth breathers. Mouth breathing is associated with alterations in maxillary growth and palatal architecture. The aim of our study was to determine the effect of the presence of CB and NSD on the dimensions of the hard palate using cone-beam computed tomography (CBCT).

Materials and methods: A retrospective study was conducted using CBCT scans of 200 study subjects. The study subjects were divided into four groups based on the presence of CB and NSD. Septal deviation angle (SDA), palatal interalveolar length (PIL), palatal depth (PD) and maxillopalatal arch angle (MPAA) were measured in the study groups.

Results: The presence of NSD and CB was associated with significant (p < 0.001) differences in the palatal dimensions of the study subjects. The PIL and MPA (p < 0.001) were significantly reduced (p < 0.001), whereas the PD was significantly increased (p < 0.001) in study subjects with NSD and CB. There was no significant change in the palatal dimensions between the unilateral and bilateral types of CB. Among the palatal dimensions, the PIL had the most significant association (R2 = 0.53) with SDA and CB. There was a significant correlation between the palatal dimensions and SDA when CB was present along with NSD.

Conclusion: Based on the results of this study, it can be concluded that the presence of NSD and CB have a significant effect on the palatal dimensions and, therefore, they may be associated with skeletal malocclusion.

Keywords: Concha bullosa; Cone beam computed tomography; Nasal septum; Palate; Turbinate.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Coronal CBCT section showing the landmarks used for measuring the SDA. The thickening of the sinonasal mucosa was also observed in this image
Fig. 2
Fig. 2
Coronal CBCT section showing landmarks for the palatal dimension measurements. The palatal interalveolar length (PIL) is the distance between the mid-centres of the cervical portion of the available tooth, from one side to the other. If there was no tooth, then the mid-centre of the alveolar bone near the crest was considered the reference point. Palatal arch depth (PAD) is the length of the line from "P" (junction of the nasal septum and hard palate) to the interalveolar line. The maxillopalatal arch angle (MPAA) is the angle that is formed by the lines from "P" to both points of the mid-centre of the available tooth or the midpoint maxillary alveolar bone for patients missing teeth
Fig. 3
Fig. 3
Coronal CBCT view showing the method used for identifying CB as per the criteria by Stallman et al. Line E1E2 represents the vertical length of the middle turbinate. Line F1F2 represents the extent of pneumatization caused by CB
See this image and copyright information in PMC

References

    1. Occasi F, Perri L, Saccucci M, Di Carlo G, Ierardo G, Luzzi V, De Castro G, Brindisi G, Loffredo L, Duse M, Polimeni A, Zicari AM. Malocclusion and rhinitis in children: an easy-going relationship or a yet to be resolved paradox? A systematic literature revision. Ital J Pediatr. 2018;44(1):100. doi: 10.1186/s13052-018-0537-2. - DOI - PMC - PubMed
    1. Souki BQ, Pimenta GB, Souki MQ, Franco LP, Becker HM, Pinto JA. Prevalence of malocclusion among mouth breathing children: do expectations meet reality? Int J Pediatr Otorhinolaryngol. 2009;73(5):767–773. doi: 10.1016/j.ijporl.2009.02.006. - DOI - PubMed
    1. Farid M, Metwalli N. Computed tomographic evaluation of mouth breathers among paediatric patients. Dentomaxillofac Radiol. 2010;39(1):1–10. doi: 10.1259/dmfr/80778956. - DOI - PMC - PubMed
    1. Balikci HH, Gurdal MM, Celebi S, Ozbay I, Karakas M. Relationships among concha bullosa, nasal septal deviation, and sinusitis: retrospective analysis of 296 cases. Ear Nose Throat J. 2016;95(12):487–491. doi: 10.1177/014556131609501209. - DOI - PubMed
    1. Uygur K, Tüz M, Doğru H. The correlation between septal deviation and concha bullosa. Otolaryngol Head Neck Surg. 2003;129(1):33–36. doi: 10.1016/S0194-5998(03)00479-0. - DOI - PubMed

Publication types