Maxillary dentoskeletal changes 1-year after adenotonsillectomy.
OBJECTIVE
To measure the maxillary dentoskeletal and soft tissue changes of severely obstructed mouth breathing (MB) young children who had their mode of breathing normalized after adenotonsillectomy (T&A), in comparison with a matched group of severely obstructed untreated MB children (CG).


METHODS
Seventy patients who had an Ear, Nose, and Throat examination (ENT), including flexible nasal endoscopy, to confirm the severe obstruction of the upper airways and the indication of T&A composed the sample. Cephalograms and dental casts were available from the patient's orthodontic records. Treatment group (TG) and CG included 35 children each. Groups were matched by gender (24 males and 11 females in each group), age (TG, 6.7 ± 1.8 years; CG, 6.9 ± 2.3 years), tooth development (TG, 13 primary dentition, 22 mixed dentition; CG, 14 primary dentition, 21 mixed dentition), and skeletal maturation status. Records were taken at baseline (T0) and 1-year after T&A (T1) for TG; while CG records were taken with a 1-year interval. Dentoskeletal measurements were performed in the lateral cephalograms, and dental casts were used to assess the palatal volume and occlusal changes.


RESULTS
TG showed a significant increase (503.3 mm(3), P < 0.001) in the palatal volume (10% of change), while CG palatal volume was stable. No dimensional occlusal changes were detected between T0 and T1 in both groups. Significant downward (point A, 2.1 mm; ANS, 2.1 mm) and forward displacements (point A, 0.7 mm; ANS, 1 mm) of the anterior region of the maxilla were observed in the TG, but CG presented only significant downward displacement (point A, 1.8 mm; ANS, 1.4 mm). The maxillary posterior region (PNS, PTM, and Molar) displaced downward in both groups (P < 0.05), however no sagittal change was found. The palatal plane inclination was stable in both groups.


CONCLUSIONS
TG presented significant increase in the palatal volume and in the forward displacement of the maxilla. No other significant maxillary dentoskeletal changes were found.
Department of Clinical Sciences and Traslational Medicine, University of Rome "Tor Vergata", Rome, Italy.
Valerio
V
Brunelli
Department of Clinical Sciences and Traslational Medicine, University of Rome "Tor Vergata", Rome, Italy.
Roberta
R
Lione
Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, United States.
Lorenzo
L
Franchi
Department of Clinical Sciences and Traslational Medicine, University of Rome "Tor Vergata", Rome, Italy.
Paola
P
Cozza
Outpatient Clinic for Mouth-Breathers, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Helena M G
HM
Becker
Outpatient Clinic for Mouth-Breathers, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Letícia P
LP
Franco
Outpatient Clinic for Mouth-Breathers, Federal University of Minas Gerais, Belo Horizonte, Brazil; School of Dentistry, Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil. Electronic address: souki.bhe@terra.com.br.
Bernardo Q
BQ
Souki
D000233:Adenoidectomy; D000293:Adolescent; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D003818:Dentition, Mixed; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000254:growth & development*; D009058:Mouth Breathing / Q000209:etiology / Q000601:surgery*; D010159:Palate / Q000254:growth & development*; D012189:Retrospective Studies; D014068:Tonsillectomy
Adenoids; Cephalometrics; Mouth breathing; Palatal morphology; Tonsils