Journal Article

The effect of mode of breathing on craniofacial growth—revisited

Timo Peltomäki

in The European Journal of Orthodontics

Published on behalf of European Orthodontics Society

Volume 29, issue 5, pages 426-429
Published in print October 2007 | ISSN: 0141-5387
Published online September 2007 | e-ISSN: 1460-2210 | DOI: http://dx.doi.org/10.1093/ejo/cjm055
The effect of mode of breathing on craniofacial growth—revisited

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It has been maintained that because of large adenoids, nasal breathing is obstructed leading to mouth breathing and an ‘adenoid face’, characterized by an incompetent lip seal, a narrow upper dental arch, increased anterior face height, a steep mandibular plane angle, and a retrognathic mandible. This development has been explained as occurring by changes in head and tongue position and muscular balance. After adenoidectomy and change in head and tongue position, accelerated mandibular growth and closure of the mandibular plane angle have been reported. Children with obstructive sleep apnoea (OSA) have similar craniofacial characteristics as those with large adenoids and tonsils, and the first treatment of choice of OSA children is removal of adenoids and tonsils. It is probable that some children with an adenoid face would nowadays be diagnosed as having OSA. These children also have abnormal nocturnal growth hormone (GH) secretion and somatic growth impairment, which is normalized following adenotonsillectomy.

It is hypothesized that decreased mandibular growth in adenoid face children is due to abnormal secretion of GH and its mediators. After normalization of hormonal status, ramus growth is enhanced by more intensive endochondral bone formation in the condylar cartilage and/or by appositional bone growth in the lower border of the mandible. This would, in part, explain the noted acceleration in the growth of the mandible and alteration in its growth direction, following the change in the mode of breathing after adenotonsillectomy.

Journal Article.  1985 words.  Illustrated.

Subjects: Restorative Dentistry and Orthodontics

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