Dental Arch Dimensions of Nigerian Children with Hypertrophied Adenoids

Influences of Adenoid Hypertrophy on Children's Maxillofacial Development

This study aims to investigate the association between adenoid hypertrophy and facial development. A total of 388 children aged 1-13 years old who had undergone head MRI in Foshan Maternal and Child Health Hospital were collected, including 196 hypertrophic cases and 192 normal cases. The maxillofacial soft tissue indicators were measured and compared. The A/N ratio and adenoid thickness consistently increased with age in the hypertrophic group and the A/N ratio reached a maximum value three years earlier than the normal group. The pharyngeal airway space, vallecula of epiglottis to anterior plane distance of the third/fourth cervical vertebrae, angle of convexity, total angle of convexity, and the nasolabial angle in the hypertrophy group were smaller than those in the control group (p < 0.05). The thickness of adenoids, palate height, palate length, and tongue length in the hypertrophy group exceeded that of the control group (p < 0.05). To conclude, adenoid hypertrophy was associated with craniofacial features such as a convex facial profile, a narrowed nasopharyngeal airway, an elongated and heightened palate, a lengthened tongue or a lower tongue position. These findings emphasize the importance of early intervention for children with adenoid hypertrophy to mitigate potential adverse effects on maxillofacial development.

The impact of mouth breathing on dentofacial development: A concise review

Mouth breathing is one of the most common deleterious oral habits in children. It often results from upper airway obstruction, making the air enter completely or partially through oral cavity. In addition to nasal obstruction caused by various kinds of nasal diseases, the pathological hypertrophy of adenoids and/or tonsils is often the main etiologic factor of mouth breathing in children. Uncorrected mouth breathing can result in abnormal dental and maxillofacial development and affect the health of dentofacial system. Mouth breathers may present various types of growth patterns and malocclusion, depending on the exact etiology of mouth breathing. Furthermore, breathing through the oral cavity can negatively affect oral health, increasing the risk of caries and periodontal diseases. This review aims to provide a summary of recent publications with regard to the impact of mouth breathing on dentofacial development, describe their consistencies and differences, and briefly discuss potential reasons behind inconsistent findings.

Influence of Adenoid Hypertrophy on Malocclusion and Maxillofacial Development in Children

Objective

To investigate the effect of adenoid hypertrophy on malocclusion and maxillofacial development in children.

Methods

Total of 102 children with malocclusion or maxillofacial dysplasia admitted to our hospital from March 2017 to June 2020 were selected as the research subjects. All children were divided into a control group (50 cases with adenoid hypertrophy) and an observation group (52 cases without adenoid hypertrophy) according to the presence or absence of adenoid hypertrophy. The incidence of malocclusion was compared between the two groups, and lateral cranial radiographs were taken in both groups to measure and compare the malocclusion angle, jaw angle, and jaw length indexes between the two groups.

Results

The incidence of malocclusion in the observation group (71.15%) was higher than that in the control group (42.00%), and the difference was statistically significant (P < 0.05). The angle between the long axis of the upper central incisor and the nasal root point and the upper alveolar base point (U1-NA), the angle between the long axis of the lower central incisor and the nasal root point and the lower alveolar base point (L1-NB), the angle between mandibular plane and anterior cranial base plane (MP-SN), the angle between the long axis of upper central incisor and anterior cranial base plane (U1-SN), the angle between the long axis of lower central incisor and mandibular plane (L1-MP), the angle of Y axis, the overall height (N-Me), lower height (ANS-Me), overall height/back height (N-Me/S-Go), and lower height/overall height (ANS-Me/N-Me) values in the observation group were higher than those in the control group, while the mandibular length (Go-Gn) values in the observation group were lower than those in the control group (P < 0.05).

Conclusion

Adenoid hypertrophy can increase the incidence of malocclusion in children and can also increase the steepness and overall height and lower height of the mandible, resulting in the lengthening of the facial shape and the development of the maxillofacial deformity.

Comparison of dental arch measurements according to the grade and the obstructive character of adenoids

INTRODUCTION

Obstructive adenoid hypertrophy is cited as one of the causes of mouth breathing and leads to disharmony in the development of orofacial structures. The objective of this study was to compare the measurements of dental arches according to the grade and the obstructive character of adenoids.

MATERIALS AND METHODS

A cross-sectional study was carried out with 86 children. The grade and the obstructive character of adenoids were determined from Holmberg and Cohen's radiographic methods respectively. Dental arch measurements were taken on dental casts. A t-test and a Chi² test were performed respectively to compare the quantitative and qualitative variables of dental arches according to the obstructive character. An Anova test made it possible to compare the quantitative variables according to the grade as Holmberg defined it. For variables that showed significant differences, a Post Hoc test was used. The significance level was set at P=0.05.

RESULTS

Subjects with obstructive adenoids had a shorter posterior mandibular length (P=0.04) and a greater overbite (P=0.04) than those with non-obstructive adenoids. Those with grade 4 had a greater arch depth (P=0.02) and were more prone to open bite(P=0.03).

CONCLUSION

A prevention program involving the otorhinolaryngologist and the orthodontist for subjects with obstructive adenoids or grade 4 is necessary to minimize their influence on dental arch relationships.

[Relationships between the size of the adenoids and the dental arch measurements]

INTRODUCTION

Enlarged adenoids are often associated with oral breathing. The latter can impact the dental arches. The purpose of this study was to determine the relationships between dental arch measurements and the size of adenoids.

MATERIALS AND METHODS

A cross-sectional study was carried out on 86 children. The dimensions of the adenoids were determined from nine radiographic evaluation methods and the dental arch measurements made on the casts. The association between the grade of adenoids and the dental arch measurements was sought by Spearman correlation. That between the quantitative variables assessing adenoids and dental arch measurements was sought by Pearson correlation. The strength of these associations was analyzed using Cohen's values in 1988. The significance was set at p = 0.05.

RESULTS

Palatal depth was significantly and positively correlated with adenoid grade according to the method of Holmberg and Linder-Aronson (rho = 0.55, p = 0.005) and with the adenoid measurements according to the methods of Kemaloglu, Fujioka, Johannesson, De Menezes and Maran with r respectively equal to 0.65, 0.59, 0.63, 0.47, 0.74; and p respectively equal to 0.001, 0.002, 0.001, 0.019, and < 0.001. It was also significantly but negatively correlated with the adenoids measurements according to Hibbert's method (r = -0.52, p = 0.008). Overbite was significantly and negatively correlated with adenoid dimension using the De Menezes method (r = -0.541, p = 0.006).

DISCUSSION

The strength of the associations shows that using respectively Maran and De Menezes methods can allow to better highlight the association between the dimensions of the adenoids and the palatal depth and the overbite.