Clinical Characteristics of Patients with Dental Malocclusion: An Otolaryngologic Perspective

Abstract

Allergic rhinitis (AR), which is a major cause of upper airway obstruction, may affect the development of the dental malocclusion. This retrospective study was aimed to investigate association between AR and dental malocclusion in otolaryngologic perspectives. Methods: Patients (n = 217) referred to the otolaryngology department before initiating orthodontic treatment were recruited. The frequency and severity of AR symptoms, sinonasal outcome test (SNOT-22) scores, physical examination findings, acoustic rhinometry results, and treatment modalities were retrospectively assessed. Patients with positive skin prick test findings (SPT) (n = 173; orthodontic group) were compared with age- and sex-matched patients being treated for AR (AR group). Results: We found that 76.5% of the enrolled patients had subjective nasal symptoms, and 93.1% patients showed abnormal physical examination findings such as inferior turbinate hypertrophy (82.0%), adenotonsillar hypertrophy (31.8%), or deviated nasal septum (7.4%). The 173 (79.7%) patients with positive SPT results exhibited a significantly higher incidence of rhinorrhoea, sneezing, and inferior turbinate hypertrophy compared to those with negative SPT results. The proportion of patients who underwent pharmacological or surgical treatments was significantly higher among patients with nasal obstruction (92.0%) than among patients without nasal obstruction (36.9%). The frequency and mean visual analogue symptom scores for nasal obstruction, rhinorrhoea, and sneezing, as well as all SNOT-22 domain scores, were significantly higher in the AR group than in the orthodontic group. The minimal cross-sectional area measured with acoustic rhinometry showed no significant difference between groups. Conclusion: Patients with dental malocclusion had a high SPT (+) rate and a high prevalence of structural abnormalities of the upper airway. The early detection and treatment of subclinical AR, other rhinological problems, and structural abnormalities of the upper airway in patients with malocclusion may help us manage malocclusion from an otolaryngologic perspective.

Impact of the COVID-19 pandemic on paediatric otolaryngology: a nationwide study

“…Even though the current risk of contagion is significantly decreased thanks to vaccination and protective measures, an increased number of procedures in the waiting list accounting for 66.9%, as reported by our data, is worrying and could keep growing without the application of an integrated strategy. In fact, even a common diagnosis of adenotonsillar disease can lead to several comorbidities, such as cardiopulmonary complications, deficit of attention and dental malocclusions [9][10][11] . Medical management of severe obstructive sleep apnoea during the COVID-19 pandemic, including continuous positive airway pressure therapy in severe cases, showed that this kind of treatment is poorly tolerated, and that surgery remains the gold standard 12 .…”