Adenoid hypertrophy and oral respiration: effects on maxillofacial growth and early orthodontic treatment

Background: The purpose of this study was to investigate the oral and maxillofacial developmental characteristics and early corrective effects of physiological adenoid hypertrophy in children with oral respiration. Physiological adenoid hypertrophy refers to a ratio of adenoid thickness to nasopharyngeal width (A/N) between 60% and 70%. Methods: Firstly, forty-two children with physiological adenoid hypertrophy, accompanied by Class II malocclusion were selected from Hebei General Hospital and divided into oral respiration group (O) (n = 21) and nasal respiration group (N) (n = 21) according to their breathing patterns. Measurement and statistical analysis of two groups of cephalometric were conducted by specific experts. Secondly, 10 children with oral respiratory and physiological gonadal hypertrophy suitable for early functional treatment were selected, with an average treatment time of 7 months. A comparative analysis was conducted on the cephalometric before and after treatment. Each cephalometric measurement was tested three times and the average was taken to reduce errors. Results: The comparison between O and N groups showed statistically significant differences in the position of maxilla and mandible relative to skull (SNA, SNB), the angle of upper incisors (U1-SN, U1-NA), lower incisors FMIA), and the angle of soft tissue facial protrusion (N’-SN Mg’). These indicated that maxillary protrusion and upper incisor forward inclination were the main features of the oral breathing group. In the second part, the functional treatment showed statistically significant differences in the A/N, SNB, angle of the mandible relative to the maxilla (ANB), nasopharyngeal (PNS-R, PNS-UPW) and laryngopharyngeal (V-LPW) airways (p < 0.05), which indicating that orthodontic treatment can widen the nasopharyngeal and laryngopharyngeal airways and may promote mandibular growth. Conclusions: Children with Class II malocclusion and physiological adenoid hypertrophy, accompanied by oral respiration, can lead to abnormal facial development. Early orthodontic treatment can alleviate oral respiratory symptoms and improve maxillofacial abnormalities in children with Class II malocclusion.

Oral respiration; Physiological adenoid hypertrophy; Cephalometric measurement; Maxillofacial development; Early orthodontic treatment; Functional appliance

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