Craniofacial morphology in preschool children with sleep‐related breathing disorder and hypertrophy of tonsils

Abstract

Rönning O. Craniofacial morphology in preschool children with sleep-related breathing disorder and hypertrophy of tonsils. Acta Paediatr 2002; 91: 71-77. Stockholm. ISSN 0803-5253The purpose of this study was to examine craniofacial morphology, pharyngeal airway space and hyoid bone position in preschool children with sleep-related breathing disorder associated with hypertrophy of tonsils (SBDT). Thirty-eight preschool children, mean age 4.7 y, with SBDT and with an apnoea index (AI) of 0 < AI <5, were divided into two groups. One consisted of 15 children with sleep-related breathing disorder (SBD) and more than 75% of the tonsils visible (GIII) and the other of 23 children with SBD and 25-75% of the tonsils visible (GII). The control group consisted of 31 children without ear, nose and throat disease and with GI (barely visible) tonsils. Compared with the controls, GIII children had a retrognathic mandible, a large posterior facial height, a large interincisal angle with retroclined lower incisors, a narrow pharyngeal airway space, an anterior tongue base position and a long soft palate. Compared with the controls, GII children had a large anterior lower facial height and a short nasal oor. However, like the controls, GII children did not have a retrognathic mandible. Conclusion:The ndings show that children with SBDT display a characteristic facial appearance at an early age. Since the condition has an effect on growth, it needs to be prevented by controlling morphology and function at the preschool age.

The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients

“…In the horizontal dimension, the mandible was located in a posterior position in relation to the maxilla in mouth breather patients, which was demonstrated by the increased overjet, SNB angle, and the distance between the lower lip to E‐line. These findings support previous evidence that retrognathic mandible and posterior inclination of the mandibular plane in mouth breathing children are higher than among nasal breathing children 17–19…”

Prevalence of malocclusion in children with obstructive sleep apnoea

“…These data do not agree with findings reported in some previous clinical studies but they agree with those of Cozza et al who report a significantly increased overbite in cephalometric findings of OSA patients compared to a control group. We hypothesize that the increased overbite in our sample could be an indication of a retruded position of the mandible, which has been regarded as a predisposing factor for the development of OSA …”

Dental Arch Morphology as a Predictor of Sleep Disordered Breathing

“…The selection of non-obstructed controls was based on occlusal criteria,since the purpose of the study was to compare the occlusal variables of patients with sleepdisordered breathing and normal controls having an ideal occlusion.The prevalence of a Class II molar relationship was increased in this sample of OSA patients and a retrognathic mandible, which is often related to Class II malocclusions,has often been reported in conjunction with obstructed sleep and has been regarded as a predisposing factor for the development of OSA (Kawashima, Peltomäki, Sakata, Mori, Happonen, & Rönning, 2002). The severity of OSA was also found to increasing in patients with severe Class II jaw relationship.…”