IADR Abstract Archives
Long Term Effects of Airway Obstruction Treatment on Dento-Facial Morphology
Objectives: Examine long-term dentofacial alterations in children treated by the pediatric otolaryngologist for airway blockage either surgically (adenoidectomy) or medically (nasal decongestants).
Methods: Out of over 200 mouth breathing children evaluated 10 to 15 years earlier (average 12.92±1.42years) for airway patency and treated by the referring otolaryngologist surgically (adenoidectomy) or medically, 57 subjects (35 males-22 females; age 19.09 years (range 15.1- 25.2 years) accepted to enroll in this follow-up study. Medical history, lateral cephalogram, intra-oral and extra-oral photographs, and an oral scan were taken. Epworth sleepiness scale and STOP-BANG questionnaires were completed to assess the risk of obstructive sleep apnea (OSA). Subjects were classified into surgical group A (n=34) and non-surgical group B (n=23), and sub-grouped on timing of the adenoidectomy: before (n=18) and after (n=16) (< or > 6years). Control groups were matched for age and sex.
Results: The angles ANB and SNA in group A normalized to control values. Group A had greater reductions lower face assessments [Ar-Go-Me (p=0.01), PP/MP (p=0.02), and MP/SN (p=0.00)] than group B indicating decreased mandibular divergence in the surgical group. The airway measurements in Group A were substantially greater than those in the corresponding control group (p=0.01). Children who had surgery before age 6 had significantly larger SNB (p=0.04) and smaller MP/SN (p=0.01) than corresponding controls. Children whose adenoids were removed after age 6 showed more mandibular crowding (p=0.00), increased proclination and protrusion of mandibular incisors, compared to values in the younger comparable to controls. The OSA questionnaires revealed better scores for the younger individuals in group A.
Conclusions: When performed before the age of six, adenoidectomy enhances horizontal mandibular growth and facial balance. Future research on larger samples is needed for further validation of this conclusion. Early diagnosis by the involved physicians and dentists is critical for timely treatment.
Methods: Out of over 200 mouth breathing children evaluated 10 to 15 years earlier (average 12.92±1.42years) for airway patency and treated by the referring otolaryngologist surgically (adenoidectomy) or medically, 57 subjects (35 males-22 females; age 19.09 years (range 15.1- 25.2 years) accepted to enroll in this follow-up study. Medical history, lateral cephalogram, intra-oral and extra-oral photographs, and an oral scan were taken. Epworth sleepiness scale and STOP-BANG questionnaires were completed to assess the risk of obstructive sleep apnea (OSA). Subjects were classified into surgical group A (n=34) and non-surgical group B (n=23), and sub-grouped on timing of the adenoidectomy: before (n=18) and after (n=16) (< or > 6years). Control groups were matched for age and sex.
Results: The angles ANB and SNA in group A normalized to control values. Group A had greater reductions lower face assessments [Ar-Go-Me (p=0.01), PP/MP (p=0.02), and MP/SN (p=0.00)] than group B indicating decreased mandibular divergence in the surgical group. The airway measurements in Group A were substantially greater than those in the corresponding control group (p=0.01). Children who had surgery before age 6 had significantly larger SNB (p=0.04) and smaller MP/SN (p=0.01) than corresponding controls. Children whose adenoids were removed after age 6 showed more mandibular crowding (p=0.00), increased proclination and protrusion of mandibular incisors, compared to values in the younger comparable to controls. The OSA questionnaires revealed better scores for the younger individuals in group A.
Conclusions: When performed before the age of six, adenoidectomy enhances horizontal mandibular growth and facial balance. Future research on larger samples is needed for further validation of this conclusion. Early diagnosis by the involved physicians and dentists is critical for timely treatment.