Rossi Rosa Carrieri, Rossi Nelson José, Rossi Nelson José Carrieri, Yamashita Hélio Kiitiro, Pignatari Shirley Shizue Nagata
Division of Pediatric Otolaryngology, Federal University of Sao Paulo- UNIFESP Brasil, Rua Botucatu 740, 4 andar, V. Clementino, São Paulo, CEP:04023-062, Brazil,
Prog Orthod. 2015;16:23. doi: 10.1186/s40510-015-0092-y. Epub 2015 Jul 15.
This study aimed to investigate the dental and skeletal variables associated with disturbances of craniofacial development in oral-breathing (OB) individuals and the probability that these variables are related to this condition.
This is an observational retrospective case-control study of 1596 patients divided into three groups of age n1 5-12, n2 13-18, and n3 19-57 years. Radiographic, clinical, and models data were analyzed. The control group was consisted of nasal breathing (NB) individuals. Statistical analyses of the qualitative data were performed with x (2) test to identify associations, and odds ratio (OR) tests were performed for the variables that the chi-square test (x (2)) identified an association.
In the descriptive analysis of the data, we observed that the class II malocclusion was the most frequent in the total sample, but when divided by age group and mode of breathing, there is a random division of these variables. In n1 group, class II, (OR = 2.02) short and retruded mandible (SM and RM) (OR = 1.65 and1.89) were associated with OB and it was considered a risk factor. In n2 group, class II (OR = 1.73), SM (OR = 1.87) and increased lower anterior height (ILAFH) (OR = 1.84) seemed to be associated and to be risk factors for OB. In the n1 group, decreased lower anterior facial height (DLAFH) and brachycephalic facial pattern (BP) seemed to be associated with NB and a protective factor against oral breathing.
This study showed that dental and skeletal factors are associated with OB in children, and it seems that it becomes more severe until adolescence. But adults showed no associations between OB and skeletal factors, only in dental variables, indicating that there is no cause-effect relationship between the dental and skeletal factors and OB. The treatment of nose breathing patient should be multidisciplinary, since OB remains even when dental and skeletal factors slow down.
本研究旨在调查与口呼吸(OB)个体颅面发育紊乱相关的牙齿和骨骼变量,以及这些变量与该病症相关的可能性。
这是一项观察性回顾性病例对照研究,共纳入1596例患者,分为三个年龄组:n1组5 - 12岁,n2组13 - 18岁,n3组19 - 57岁。对影像学、临床和模型数据进行分析。对照组由鼻呼吸(NB)个体组成。对定性数据进行x(2)检验以确定关联,并对卡方检验(x(2))确定存在关联的变量进行优势比(OR)检验。
在数据的描述性分析中,我们观察到II类错牙合在总样本中最为常见,但按年龄组和呼吸方式划分时,这些变量存在随机分布。在n1组中,II类错牙合(OR = 2.02)、下颌短缩和后缩(SM和RM)(OR = 1.65和1.89)与口呼吸相关,被视为危险因素。在n2组中,II类错牙合(OR = 1.73)、SM(OR = 1.87)和下前牙高度增加(ILAFH)(OR = 1.84)似乎与口呼吸相关且为危险因素。在n1组中,下前面部高度降低(DLAFH)和短头面部模式(BP)似乎与鼻呼吸相关,是预防口呼吸的保护因素。
本研究表明,牙齿和骨骼因素与儿童口呼吸相关,且似乎在青春期前会变得更加严重。但成年人中口呼吸与骨骼因素无关联,仅在牙齿变量方面存在关联,这表明牙齿和骨骼因素与口呼吸之间不存在因果关系。鼻呼吸患者的治疗应是多学科的,因为即使牙齿和骨骼因素得到改善,口呼吸仍可能存在。