title: Are distinct etiologies of upper airway obstruction in mouth-breathing children associated with different cephalometric patterns?
abstract: OBJECTIVE
  To test the null hypothesis that mouth-breathing (MB) children by distinct obstructive tissues present a similar cephalometric pattern.
  
  
  METHODS
  The sample included 226 prepubescent children (113 MB and 113 nasal breathing (NB) controls). An ENT clinical examination, including flexible nasal endoscopy, orthodontic clinical and cephalometric examinations, was performed on the MB population. MB children were grouped into three categories, according to the obstructive tissues: 1) adenoid group (AG), 2) tonsillar group (TG), and 3) adenotonsillar group (ATG). The NB controls were matched by gender, age, sagittal dental relationship and skeletal maturation status. Lateral cephalometric radiography provided the cephalometric pattern comparisons between the MB and NB groups.
  
  
  RESULTS
  MB cephalometric measurements were significantly different from those of NB children, exception in the SNB° (P=0.056). All comparisons between the three groups of MB children with the NB children showed a significant difference. Finally, even among the three groups of MB children, a significant difference was observed in the measurements of the SNB° (P<0.036), NSGn° (P<0.028) and PFH/TAFH ratio (posterior facial height/total anterior facial height) (P<0.012).
  
  
  CONCLUSIONS
  The cephalometric pattern of MB and NB children was not similar. Cephalometric measurements of the MB group differed according to the etiology of upper airway obstruction. Children with isolated hypertrophy of the palatine tonsils presented with a mandible that was positioned more forward and upward compared to children obstructed only by the enlarged adenoid.
authors.affiliation: Federal University of Minas Gerais, Outpatient Clinic for Mouth-Breathers, Belo Horizonte, Brazil.
authors.forename: Letícia P
authors.initials: LP
authors.lastname: Franco
authors.affiliation: Federal University of Minas Gerais, Outpatient Clinic for Mouth-Breathers, Belo Horizonte, Brazil; Pontifical Catholic University of Minas Gerais, School of Dentistry, Orthodontics, Belo Horizonte, Brazil. Electronic address: souki.bhe@terra.com.br.
authors.forename: Bernardo Q
authors.initials: BQ
authors.lastname: Souki
authors.affiliation: Pontifical Catholic University of Minas Gerais, School of Dentistry, Orthodontics, Belo Horizonte, Brazil.
authors.forename: Paula L
authors.initials: PL
authors.lastname: Cheib
authors.affiliation: Pontifical Catholic University of Minas Gerais, School of Dentistry, Orthodontics, Belo Horizonte, Brazil.
authors.forename: Marcel
authors.initials: M
authors.lastname: Abrão
authors.affiliation: Pontifical Catholic University of Minas Gerais, School of Dentistry, Orthodontics, Belo Horizonte, Brazil.
authors.forename: Tatiana B J
authors.initials: TB
authors.lastname: Pereira
authors.affiliation: Federal University of Minas Gerais, Outpatient Clinic for Mouth-Breathers, Belo Horizonte, Brazil.
authors.forename: Helena M G
authors.initials: HM
authors.lastname: Becker
authors.affiliation: Federal University of Minas Gerais, Outpatient Clinic for Mouth-Breathers, Belo Horizonte, Brazil.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Pinto
mesh_terms: D000234:Adenoids / Q000473:pathology; D000402:Airway Obstruction / Q000209:etiology*; D016022:Case-Control Studies; D002508:Cephalometry; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D009058:Mouth Breathing; D014066:Palatine Tonsil / Q000473:pathology; D011378:Prognathism / Q000150:complications; D012189:Retrospective Studies
keywords: Adenoids; Cephalometry dentofacial growth; Mouth breathing; Palatine tonsil