Different sites of obstruction of the upper airway due to enlarged lymphoid tissue are associated with different types of dental malocclusion. Findings are relevant to orthodontic and surgical decision making in these mouth-breathing patients.

Altered craniofacial growth has been implicated in sleep-disordered breathing (SDB) in children. The authors aimed to evaluate the cephalometric measurements and pharyngeal dimensions related to SDB in snoring children with adenotonsillar hypertrophy (ATH) treated with an orthodontic and orthopedic oral appliance (OOA). Forty habitually snoring children, 6 to 9 years old with evidence of grade 3 to 4 ATH, maxillary constriction, and class II dental malocclusion were enrolled, with 24 children being treated with OOA, and 16 remaining untreated children as controls. All children underwent a cephalometric X-ray and acoustic pharyngometry for airway measurements at the start and 6 months after. Cephalometric measurements related to SDB reduced in the treated group (p < 0.01) as follows: maxillary–mandibular relationship: –2.2 ± 1.70°; maxillary–mandibular planes angle: –2.4 ± 3.80°; and hyoid bone position: –4 ± 3.8 mm (p < 0.001). OOA treatment revealed improvements in pharyngeal minimum cross-section area (MCA) (0.2 ± 0.2 cm2) and volume (V) (3.15 ± 2.5 cm3), while reductions in MCA (–0.2 ± 0.3 cm2) and in V (–1.25 ± 1.3 cm3) occurred in controls (p < 0.001 vs. OOA). Six months of OOA treatment in snoring children with SDB promotes enlargement of the pharyngeal dimensions and beneficial cephalometric changes.

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