Brunelli Valerio, Lione Roberta, Franchi Lorenzo, Cozza Paola, Becker Helena M G, Franco Letícia P, Souki Bernardo Q
Department of Clinical Sciences and Traslational Medicine, University of Rome "Tor Vergata", Rome, Italy.
Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, United States.
Int J Pediatr Otorhinolaryngol. 2016 Jul;86:135-41. doi: 10.1016/j.ijporl.2016.04.027. Epub 2016 Apr 26.
To measure the maxillary dentoskeletal and soft tissue changes of severely obstructed mouth breathing (MB) young children who had their mode of breathing normalized after adenotonsillectomy (T&A), in comparison with a matched group of severely obstructed untreated MB children (CG).
Seventy patients who had an Ear, Nose, and Throat examination (ENT), including flexible nasal endoscopy, to confirm the severe obstruction of the upper airways and the indication of T&A composed the sample. Cephalograms and dental casts were available from the patient's orthodontic records. Treatment group (TG) and CG included 35 children each. Groups were matched by gender (24 males and 11 females in each group), age (TG, 6.7 ± 1.8 years; CG, 6.9 ± 2.3 years), tooth development (TG, 13 primary dentition, 22 mixed dentition; CG, 14 primary dentition, 21 mixed dentition), and skeletal maturation status. Records were taken at baseline (T0) and 1-year after T&A (T1) for TG; while CG records were taken with a 1-year interval. Dentoskeletal measurements were performed in the lateral cephalograms, and dental casts were used to assess the palatal volume and occlusal changes.
TG showed a significant increase (503.3 mm(3), P < 0.001) in the palatal volume (10% of change), while CG palatal volume was stable. No dimensional occlusal changes were detected between T0 and T1 in both groups. Significant downward (point A, 2.1 mm; ANS, 2.1 mm) and forward displacements (point A, 0.7 mm; ANS, 1 mm) of the anterior region of the maxilla were observed in the TG, but CG presented only significant downward displacement (point A, 1.8 mm; ANS, 1.4 mm). The maxillary posterior region (PNS, PTM, and Molar) displaced downward in both groups (P < 0.05), however no sagittal change was found. The palatal plane inclination was stable in both groups.
TG presented significant increase in the palatal volume and in the forward displacement of the maxilla. No other significant maxillary dentoskeletal changes were found.
测量腺样体扁桃体切除术后（T&A）呼吸模式恢复正常的严重口呼吸（MB）幼儿的上颌牙颌面及软组织变化，并与一组未治疗的严重口呼吸匹配儿童组（CG）进行比较。
70例接受耳鼻喉科检查（ENT）（包括纤维鼻内镜检查）以确认上呼吸道严重阻塞及T&A指征的患者组成样本。头颅侧位片和石膏模型可从患者正畸记录中获取。治疗组（TG）和CG各包括35名儿童。两组按性别（每组24名男性和11名女性）、年龄（TG，6.7±1.8岁；CG，6.9±2.3岁）、牙齿发育情况（TG，13例乳牙列，22例混合牙列；CG，14例乳牙列，21例混合牙列）和骨骼成熟状态进行匹配。TG在基线（T0）和T&A术后1年（T1）进行记录；而CG记录则间隔1年进行。在头颅侧位片上进行牙颌面测量，并使用石膏模型评估腭部容积和咬合变化。
TG腭部容积显著增加（503.3mm³，P<0.001）（变化10%），而CG腭部容积稳定。两组在T0和T1之间均未检测到维度上的咬合变化。TG中观察到上颌前部明显向下（A点，2.1mm；ANS，2.1mm）和向前移位（A点，0.7mm；ANS，1mm），但CG仅表现出明显向下移位（A点，1.8mm；ANS，1.4mm）。两组上颌后部（PNS、PTM和磨牙区）均向下移位（P<0.05），但未发现矢状面变化。两组腭平面倾斜度均稳定。
TG腭部容积显著增加，上颌向前移位。未发现其他显著的上颌牙颌面变化。
