Three-dimensional morphological analysis of the palate of mouth-breathing children in mixed dentition

doi:10.7518/hxkq.2019.04.009

Abstract

Abstract:

Objective To study the effects of mouth-breathing on maxillary arch development by comparing the palatal morphology of mouth- and nose-breathing children in mixed dentition. Methods Children in mixed dentition were enrolled and categorized into mouth-breathing (test group) and nose-breathing groups (control group) according to their breathing patterns. Children’s plaster models were scanned with 3D laser scanner, and the 3D data were reconstructed and measured using Minics 15.0 and Geomagic 12.0 software. Measurement data (inter-molar width, palatal height, palatal volume, and palatal surface area) of the two groups were compared, and the correlation among the four measurement items was analyzed. Results The participants were 73 children (37 in test group and 36 in control group) with a mean age of (8.63±0.78) years old. The test group had significantly smaller inter-molar width, palatal volume, and palatal surface area but significantly higher palatal height than the control group (P<0.05). Inter-molar width and palatal volume were positively correlated with the palatal surface area in the test group (P<0.05). Inter-molar width and palatal height were positively correlated with the palatal surface area in the control group (P<0.01). Conclusion Mouth-breathing children have significantly reduced inter-molar width, palatal volume, and surface, and substantially increased palatal height, leading to different developmental patterns of the palatal morphology.

Key words: mouth-breathing, palate morphology, three-dimensional analysis, mixed dentition

CLC Number:

R783.5

Huan Tang,Qiao Liu,Juhong Lin,Huan Zeng. Three-dimensional morphological analysis of the palate of mouth-breathing children in mixed dentition[J]. West China Journal of Stomatology, 2019, 37(4): 389-393.

Figures/Tables 4

Tab. 1

Tab. 2

Tab. 3

Tab. 4

References 37

[1]	Primozic J, Franchi L, Perinetti G , et al. Influence of sucking habits and breathing pattern on palatal constriction in unilateral posterior crossbite: a controlled study[J]. Eur J Orthod, 2013,35(5):706-712.
[2]	Baroni M, Ballanti F, Franchi L , et al. Craniofacial features of subjects with adenoid, tonsillar, or adenotonsillar hypertrophy[J]. Progress Orthod, 2011,12(1):38-44.
[3]	Berwig LC, Silva AM, Côrrea EC , et al. Hard palate dimensions in nasal and mouth breathers from different etiologies[J]. J Soc Bras Fonoaudiol, 2011,23(4):308-314.
[4]	Linder-Aronson S . Respiratory function in relation to facial morphology and the dentition[J]. Br J Orthod, 1979,6(2):59-71.
[5]	Bonuck KA, Chervin RD, Cole TJ , et al. Prevalence and persistence of sleep disordered breathing symptoms in young children: a 6-year population-based cohort study[J]. Sleep, 2011,34(7):875-884.
[6]	Kukwa W, Guilleminault C, Tomaszewska M , et al. Prevalence of upper respiratory tract infections in habitually snoring and mouth breathing children[J]. Int J Pediatr Otorhinolaryngol, 2018,107:37-41.
[7]	Abreu RR, Rocha RL, Lamounier JA , et al. Prevalence of mouth breathing among children[J]. J Pediatr (Rio J), 2008,84(5):467-470.
[8]	Lee SY, Guilleminault C, Chiu HY , et al. Mouth breathing, “nasal disuse, ” and pediatric sleep-disordered breathing[J]. Sleep Breath, 2015,19(4):1257-1264.
[9]	Trevisan ME, Bellinaso JH, Pacheco Ade B , et al. Respiratory mode, nasal patency and palatine dimensions[J]. Codas, 2015,27(2):201-206.
[10]	Moss ML . The functional matrix hypojournal revisited. 1. The role of mechanotransduction[J]. Am J Orthod Dentofacial Orthop, 1997,112(1):8-11.
[11]	Orthodontist TA . The role of the functional matrix in mandibular growth[J]. Angle Orthod, 1968,38(2):95.
[12]	Malhotra S, Pandey RK, Nagar A , et al. The effect of mouth breathing on dentofacial morphology of growing child[J]. J Indian Soc Pedod Prev Dent, 2012,30(1):27-31.
[13]	Chambi-Rocha A, Cabrera-Domínguez ME, Domínguez-Reyes A . Breathing mode influence on craniofacial development and head posture[J]. J Pediatr (Rio J), 2018,94(2):123-130.
[14]	Rossi RC, Rossi NJ, Rossi NJ , et al. Dentofacial characteristics of oral breathers in different ages: a retrospective case-control study[J]. Prog Orthod, 2015,16:23.
[15]	Kerr WJ . A longitudinal cephalometric study of dento-facial growth from 5 to 15 years[J]. Br J Orthod, 1979,6(3):115-121.
[16]	Townsend G, Richards L, Messer LB , et al. Genetic and environmental influences on dentofacial structures and oral health: studies of Australian twins and their families[J]. Twin Res Hum Genet, 2006,9(6):727-732.
[17]	Harari D, Redlich M, Miri S , et al. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients[J]. Laryngoscope, 2010,120(10):2089-2093.
[18]	Esteller Moré E, Pons Calabuig N, Romero Vilariño E , et al. Dentofacial development abnormalities in paediatric sleep-related breathing disorders[J]. Acta Otorrinolaringol Esp, 2011,62(2):132-139.
[19]	El Aouame A, Daoui A, El Quars F . Nasal breathing and the vertical dimension: a cephalometric study[J]. Int Orthod, 2016,14(4):491-502.
[20]	Vieira BB, Sanguino AC, Mattar SE , et al. Influence of adenotonsillectomy on hard palate dimensions[J]. Int J Pediatr Otorhinolaryngol, 2012,76(8):1140-1144.
[21]	Ramoglu SI, Sari Z . Maxillary expansion in the mixed dentition: rapid or semi-rapid[J]. Eur J Orthod, 2010,32(1):11-18.
[22]	Posnick JC, Agnihotri N . Consequences and management of nasal airway obstruction in the dentofacial deformity patient[J]. Curr Opin Otolaryngol Head Neck Surg, 2010,18(4):323-331.
[23]	Milanesi JM, Berwig LC, Marquezan M , et al. Variables associated with mouth breathing diagnosis in children based on a multidisciplinary assessment[J]. Codas, 2018,30(4):e20170071.
[24]	杜常欣, 朱敏, 于倩 , 等. 儿童阻塞性口呼吸的诊断[J]. 中国临床新医学, 2018,11(11):7-13.
	Du CX, Zhu M, Yu Q , et al. Diagnosis of obstructive mouth breathing in children[J]. Chin J New Clin Med, 2018,11(11):7-13.
[25]	Pacheco MC, Casagrande CF, Teixeira LP , et al. Guidelines proposal for clinical recognition of mouth breathing children [J]. Dent Press J Orthod, 2015,20(4):39-44.
[26]	Soh HJ, Rowe K, Davey MJ , et al. The OSA-5: development and validation of a brief questionnaire screening tool for obstructive sleep apnea in children[J]. Int J Pediatr Otorhinolaryngol, 2018,113:62-66.
[27]	Eslami Amirabadi G, Golshah A, Derakhshan S , et al. Palatal dimensions at different stages of dentition in 5 to 18-year-old Iranian children and adolescent with normal occlusion[J]. BMC Oral Health, 2018,18(1):87.
[28]	Bukhari A, Kennedy D, Hannam A , et al. Dimensional changes in the palate associated with slow maxillary expansion for early treatment of posterior crossbite[J]. Angle Orthod, 2018,88(4):390-396.
[29]	Primožič J, Perinetti G, Contardo L , et al. Diagnostic performance of 3-dimensional evaluation of palatal vault changes in assessing successful treatment of constricted maxilla in growing subjects[J]. Am J Orthod Dentofacial Orthop, 2013,143(1):42-49.
[30]	Fraga WS, Seixas VM, Santos JC , et al. Mouth breathing in children and its impact in dental malocclusion: a systematic review of observational studies[J]. Minerva Stomatol, 2018,67(3):129-138.
[31]	Cooper BC . Nasorespiratory function and orofacial development[J]. Otolaryngol Clin North Am, 1989,22(2):413-441.
[32]	Watson RM Jr, Warren DW, Fischer ND . Nasal resistance, skeletal classification, and mouth breathing in orthodontic patients[J]. Am J Orthod, 1968,54(5):367-379.
[33]	Lione R, Buongiorno M, Franchi L , et al. Evaluation of maxillary arch dimensions and palatal morphology in mouth-breathing children by using digital dental casts[J]. Int J Pediatr Otorhinolaryngol, 2014,78(1):91-95.
[34]	Lione R, Franchi L, Huanca Ghislanzoni LT , et al. Palatal surface and volume in mouth-breathing subjects evaluated with three-dimensional analysis of digital dental casts—a controlled study[J]. Eur J Orthod, 2015,37(1):101-104.
[35]	Carlson DS . Theories of craniofacial growth in the postgenomic era[J]. Semin Orthod, 2005,11(4):172-183.
[36]	Warren DW, Duany LF, Fischer ND . Nasal pathway resistance in normal and cleft lip and palate subjects[J]. Cleft Palate J, 1969,6:134-140.
[37]	Primozic J, Richmond S, Kau CH , et al. Three-dimensional evaluation of early crossbite correction: a longitudinal study[J]. Eur J Orthod, 2013,35(1):7-13.

测量项目	试验组	对照组	差值	95%可信区间	t值	P值
磨牙间牙弓宽度/mm	46.09±2.11	48.71±1.90	2.62±0.47	1.68,3.56	5.50	0.000**
磨牙区腭部高度/mm	13.92±1.74	12.54±1.67	1.38±0.40	0.58,2.17	3.45	0.001**
腭部体积/mm³	8 461.23±2 202.15	9 586.63±2 262.12	1 125.40±522.50	83.56,2 167.23	2.15	0.035*
腭部表面积/mm²	1 335.45±111.86	1 397.93±124.15	62.48±27.64	7.36,117.60	2.26	0.027*

变量	腭部体积		腭部表面积
变量	r值	P值	r值	P值
磨牙间牙弓宽度	0.214	0.204	0.325	0.050*
磨牙区腭部高度	0.142	0.403	0.234	0.163
腭部体积	-	-	0.400	0.014*

变量	腭部体积		腭部表面积
变量	r值	P值	r值	P值
磨牙间牙弓宽度	0.113	0.512	0.718	0.000**
磨牙区腭部高度	0.167	0.329	0.484	0.003**
腭部体积	-	-	0.195	0.255