scholarly journals Age-related hypertrophy of adenoid and tonsil with its effects on craniofacial morphology

Author(s):  
Xin Huang ◽  
Xu Gong ◽  
Xuemei Gao

Abstract The present retrospective cross-sectional study was to compare craniofacial patterns resulted from different locations of upper airway obstruction. The study was conducted among 466 consecutive orthodontic patients who were divided into four groups: adenoid hypertrophy group (AG: 70 girls and 56 boys, 11.73±2.51 years), tonsillar hypertrophy group (TG: 38 girls and 21 boys, 12.47±2.72 years), adenotonsillar hypertrophy group (ATG: 36 girls and 33 boys, 11.07±3.35 years) and control group (CG: 151 girls and 61 boys, 12.92±2.34 years). Standard cephalometric examinations were used to compare the craniofacial differences between groups. The result indicated that adenoids and tonsils reached peak at around 6 years of age, after which the tonsils decreased more remarkably than the adenoids. Compared with CG, the proportions of skeletal class II in AG (43.7%) and ATG (44.9%) were significantly increased and the proportion of skeletal class III in TG (32.2%) was significantly increased. In age- and sex-adjusted linear regression models regarding CG as a benchmark, AG and ATG were positively correlated with ANB, MP/SN and FH/SGn but negatively correlated with SNB. In contrast, TG was positively correlated with SNA and SNB. Conclusion: Adenoid hypertrophy tended to lead to mandibular retrusion and high mandibular plane angle. In contrast, tonsillar hypertrophy showed a trend in mandibular protrusion. However, children with adenotonsillar hypertrophy did not show a mean facial pattern of the above two but were rather similar to those with isolated adenoid hypertrophy. It seemed that adenoid hypertrophy lasted longer and played a greater role.

2021 ◽  
Author(s):  
Gisela Vasconcelos ◽  
Jo Stenehjem ◽  
Stefan Axelsson ◽  
Ronnaug Saeves

Abstract Background: Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder with distinct genetic and clinical features. Among other clinical symptoms, PWS is characterized by severe infantile hypotonia with feeding problems, childhood onset hyperphagia, obesity, scoliosis, short stature combined with growth hormone deficiency and developmental delay. PWS is associated with facial dysmorphology, orofacial dysfunction, oral abnormalities, low salivary flow and subsequent severe tooth wear. Little is known about the craniofacial growth direction or dental and skeletal relationships in individuals with PWS in different ages. The purpose of this study was to assess the craniofacial and dentoalveolar characteristics and to investigate the craniofacial growth direction separately in children, young adults and adults with PWS, using a cephalometric analysis of lateral cephalograms. Results: Lateral cephalograms of 42 individuals with a confirmed genetic diagnosis of PWS were analysed and divided into three groups according to their age: Children (< 12 years), young adults (12 – 20 years) and adults (> 20 years). Cephalometric variables were compared between PWS patients and healthy age- and sex-matched controls.Significant deviations and distinct craniofacial patterns were found in children, young adults and adults with PWS compared with the control group. Children showed retrognatic mandible with a skeletal class II relationship, posterior growth direction and longer anterior face height. The young adults had smaller cranial base angle, a skeletal class II pattern and a higher anterior lower face than the control group. Adults with PWS had a prognathic mandible, skeletal class III relationship with anterior growth direction, more retroclined lower incisors and proclined upper incisors than the controls. Similar results were found when comparing the three groups with PWS; the adults had a prognathic mandible, skeletal class III pattern and anterior growth direction. Children had a retropositioned mandibula, skeletal class II relationship and posterior growth direction. Conclusion: This study may contribute to a better understanding of the craniofacial growth pattern in children, young adults and adults with PWS and may have a clinical importance when planning dental treatment, such as prosthodontics and/or orthodontics.


2021 ◽  
pp. 1-10
Author(s):  
Sanjeev Verma ◽  
Nameksh Raj Bhupali ◽  
Satinder Pal Singh ◽  
Dharam Vir ◽  
Chaman Lal

<b><i>Objective:</i></b> The objective of this study is quantitative assessment of nasalance for skeletal Class I (normative values), Class II, and III malocclusion in the English language for the North Indian population and to compare the normative values with the nasalance scores obtained from individuals with skeletal Class II and III malocclusion and to evaluate the normative values as a function of gender. <b><i>Material and Methods:</i></b> The study was conducted on a total sample of 200 patients with 100, 50, and 50 in group 1 (control group, Skeletal Class I), group 2 (Skeletal Class II), and group 3 (Skeletal Class III), respectively. ANB angle (anteroposterior angle formed by point A, nasion, and point B) measured on lateral cephalogram was used to categorize the patients into 3 groups. The normative nasalance scores were compared for males and females in the control group. The nasalance scores of skeletal Class II and III subjects were compared to the combined normative scores of the control group. The NasalView was used for the objective assessment of nasalance. Oral syllables (/pa/and/pi/), nasal syllables (/ma/and/mi/), and 3 passages (Zoo passage, Rainbow passage, and Nasal sentences) were used to determine the nasalance scores. <b><i>Results:</i></b> The intragroup comparison of nasalance scores in group 1 showed statistically significant differences for different stimuli. The gender-related comparison showed no statistically significant differences in nasalance scores. The intergroup comparison of nasalance scores for skeletal malocclusion showed no statistically significant differences for different stimuli except statistically significant lower nasalance values for nasal sentences in group 3 compared to the control group. <b><i>Conclusion:</i></b> The study concluded that the nasalance scores for nasal sentences in skeletal Class III malocclusion were significantly lower than in the control group and were not statistically significant between the 3 groups for all other stimuli.


2019 ◽  
Vol 57 (3) ◽  
pp. 371-377 ◽  
Author(s):  
Alexandre de Almeida Ribeiro ◽  
Francis Joel Smith ◽  
Hugo Nary Filho ◽  
Inge E. K. Trindade ◽  
Cristiano Tonello ◽  
...  

Objectives: The purpose of this investigation was to assess the pharyngeal dimensions and the craniofacial morphology of individuals with Treacher Collins syndrome (TCS) when compared to vertical skeletal class II individuals. It is our hypothesis that the upper airways of individuals with TCS are reduced in view of the skeletal pattern and the maxillomandibular dysmorphologies. Materials and Methods: Cone-beam computed tomography scans of 26 individuals had the pharyngeal volume (V) and minimal cross-sectional area (mCSA) evaluated. Study group (TCS) was formed by 13 scans of patients with TCS (7 males and 6 females; 20.2 ± 4.7 years). Control group (CG) assembled 13 scans of nonaffected individuals with the same type of skeletal pattern (2 males and 11 females; 26.6 ± 5.4 years). Cephalometric data of maxillomandibular position, maxillomandibular dimensions, and growth pattern were assessed. Statistical analysis ( P ≤ .05) included Student t test and Pearson correlation coefficient. Results: Although reduced, pharyngeal V and mCSA of TCS were not statistically different from the CG. On both groups, mCSA was mostly at the oropharyngeal level. Individuals with TCS presented retrognathic chin, reduced maxillomandibular dimensions, and increased clockwise rotation of the palatal plane. Maxillary and mandibular lengths were correlated with pharyngeal V and mCSA. Conclusions: The pharyngeal dimensions of individuals with TCS are impacted by the micrognathia and retrognathia. In association with the skeletal pattern, the reduction of the airways, although not statistically significant, may explain the increased prevalence of airways disorder in this syndrome.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Alessandro Nota ◽  
Shideh Ehsani ◽  
Laura Pittari ◽  
Giorgio Gastaldi ◽  
Simona Tecco

Abstract Background The median solitary maxillary central incisor syndrome (SMMCI) is a rare malformative syndrome consisting of multiple defects, mainly found on the body midline. It can be correlated to the etiopathological and phenotypic pattern of panhypopituitarism. This case-report describes the rare case of a patient suffering from SMMCI and panhypopituitarism, showing an unusual craniofacial morphology. Case presentation From the cephalometric analysis, a skeletal class III was identified (despite the other cases described in literature described as skeletal class II), derived from hypomaxillia and mandibular protrusion. A convex lip profile, with tendency to mandibular hyper-divergency, airway patency, anterior and posterior cross-bite were observed. At the clinical examination, a maxillary cant was evident on the frontal plane that appeared asymmetric, with the prevalence of the third lower part of the face. There were some dysmorphic signs such as: small nose, rectilinear eyelid line and reduced interocular distance. Conclusions The present clinical case shows how, despite the literature, SMMCI can be associated with a III skeletal class, with maxillary hypoplasia and mandibular protrusion. The interdisciplinary collaboration between dentist and pediatrician is therefore important for the early interception of the malocclusions associated with these syndromes.


Author(s):  
Anjana Atteeri ◽  
Praveen Kumar Neela ◽  
Pavan Kumar Mamillapalli ◽  
Vasu M. Sesham ◽  
Sreekanth Keesara ◽  
...  

Abstract Background Mandibular prognathism (MP) is a craniofacial deformity resulting from the combined effects of environmental and genetic factors. Although various linkage and genome-wide association studies for mandibular prognathism have identified multiple strongly associated regions and genes, the causal genes and variants responsible for the deformity remained ambiguous. Aim This research work was aimed to study the association between polymorphism rs10850110 of the MYO1H gene and skeletal class-III malocclusion in our local population. Materials and Methods Thirty patients with skeletal class III due to mandibular prognathism in the study group and 30 patients with skeletal class I in the control group were selected for this study. These patients were from both sexes and above age 10 years. Based on the cephalometric values, patients were categorized into study and control groups. SNB (angle between sella, nasion and point B at nasion) greater than 82 degrees with an ANB (angle between point A, nasion and point B at nasion) of less than 0 degrees in the study group and ANB (angle between point A, nasion and point B at nasion) of 2 to 4 degrees in the control group were categorized. The polymorphism (rs10850110) of the MYO1H gene was genotyped using polymerase chain reaction and restriction fragment length polymorphism. Associations were tested with SNP exact test using SNPstats software. Results The single-nucleotide polymorphism rs10850110 showed a statistically significant association with mandibular prognathism. The G allele of marker rs10850110 (5′ of myosin1H - MYO1H) was overrepresented when compared with the “A” allele in mandibular prognathism cases (p < 0.0001), and this was very significant. Conclusion These results suggest that the rs10850110 polymorphism of the MYO1H gene is associated with an increased risk for mandibular prognathism.


2021 ◽  
Vol 11 (6) ◽  
pp. 2520
Author(s):  
Andrea Deregibus ◽  
Simone Parrini ◽  
Maria Chiara Domini ◽  
Jacopo Colombini ◽  
Tommaso Castroflorio

Many studies report that maxillofacial growth is influenced by genetic and environmental elements and that incorrect breathing, chewing, sucking, and swallowing are promoting factors of malocclusion. This study aims to evaluate the function and the influence of the tongue positions in patients with Angle class III malocclusion, maxillary hypoplasia, and posterior crossbite. One hundred patients, aged between 6 and 12 years old, were enrolled for the study. In the first group, patients with a diagnosis of class III malocclusion, affected by maxillary hypoplasia, skeletal class III, and posterior dental crossbite were recruited. In the control group, not treated patients with no malocclusion, skeletal class I, and without posterior dental crossbite were selected. Regarding atypical deglutition, no statistical differences were reported between the two groups, and 14% of patients reported ankyloglossia. Statistical differences were found in tongue rest position and during the execution of “hold and pull” and “chuck” exercises. Results obtained in this observational study showed that the clinician (orthodontist or general dentist) should analyze the presence/absence of atypical swallowing, the anatomical and functional aspects, and the tongue behavior in the rest position.


2021 ◽  
Vol 11 (14) ◽  
pp. 6439
Author(s):  
Ewa Zawiślak ◽  
Szymon Przywitowski ◽  
Anna Olejnik ◽  
Hanna Gerber ◽  
Paweł Golusiński ◽  
...  

The analysis aims at assessing the current trends in orthognathic surgery. The retrospective study covered a group of 124 patients with skeletal malocclusion treated by one team of maxillofacial surgeons at the University Hospital in Zielona Góra, Poland. Various variables were analysed, including demographic characteristics of the group, type of deformity, type of osteotomy used, order in which osteotomy was performed and duration of types of surgery. The mean age of the patients was 28 (ranging from 17 to 48, SD = 7). The group included a slightly bigger number of females (59.7%), with the dominant skeletal Class III (64.5%), and asymmetries were found in 21.8% of cases. Types of osteotomy performed during surgeries were divided as follows: LeFort I, segmental LeFort I, BSSO, BSSO with genioplasty, LeFort I with BSSO, LeFort I with BSSO and genioplasty, segmental LeFort I with BSSO, isolated genioplasty. Bimaxillary surgeries with and without genioplasty constituted the largest group of orthognathic surgeries (49.1%), and a slightly smaller percentage were one jaw surgeries (46.7%). A statistically significant correlation was found between the type of surgery and the skeletal class. In patients with skeletal Class III, bimaxillary surgeries were performed significantly more often than in patients with skeletal Class II (57.5% vs. 20.0%; p = 0.0002). The most common type of osteotomy in all surgeries was bilateral osteotomy of the mandible modo Obwegeser–Epker in combination with Le Fort I maxillary osteotomy (42.7%). The order of osteotomies in bimaxillary surgeries was mandible first in 61.3% of cases. The longest surgery was bimaxillary osteotomy with genioplasty (mean = 265 min), and the shortest surgery was isolated genioplasty (mean = 96 min). The results of the analysis show a significant differentiation between the needs of orthognathic surgery and the types of corrective osteotomy applied to the facial skeleton.


2020 ◽  
Vol 10 (3) ◽  
pp. 40-43
Author(s):  
Farah Saleem ◽  
Zubair H Awiasi

Introduction: Accurate classification and treatment planning relies on correct diagnosis of skeletal and dentalrelationships. Commonly used measurements used to classify sagittal relationship ANB and Wit’s appraisal are not without potential inherent problems which might lead to less accurate classification of sagittal dysplasia. To avoid these problems, a new approach Beta angle was introduced by Baik in 2004. Beta angle as it involves different landmarks of classifying anterior-posterior relationships is said to be devoid of those problems thus more reliable. We conducted a cross sectional study to measure the angle among patients presenting in Nishtar Institute of Dentistry Multan Pakistan. Materials and Method: Ninety pretreatment cephalometric x-rays of patients between ages 12 to 30 years were selected and studied. They were divided into three classes based on ANB angle and Wit’s appraisal. For the measurement of Beta angle, a line was drawn from the center of condyle (C) to point A and other to point B. A third line joining A to B was drawn. A line from point A perpendicular to line C-B was drawn and angle was measured between this perpendicular and line joining A-B. ANOVA was used to compare means of three groups. Pearson correlational coefficient was used to correlate relationship between Beta angle and ANB angle. Result: The results showed Beta angle ranged between 27° and 34° for class I. Subjects having angle less than 27° can be classified as skeletal class II and those with angles larger than 34° as skeletal class III subjects. Conclusion: Beta angle is reliable method for assessing and classifying sagittal skeletal discrepancies 


2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Mohammad Zandi ◽  
Abbas Shokri ◽  
Vahid Mollabashi ◽  
Zahed Eghdami ◽  
Payam Amini

Objetive: This study aimed to compare the anatomical characteristics of the mandible in patients with skeletal class I, II and class III disorders using cone beam computed tomography (CBCT). Material and Methods: CBCT scans of patients between 17 to 40 years taken with NewTom 3G CBCT system with 12-inch field of view (FOV) were selected from the archive. Lateral cephalograms were obtained from CBCT scans of patients, and type of skeletal malocclusion was determined (Class I, II or III). All CBCT scans were evaluated in the sagittal, coronal and axial planes using the N.N.T viewer software. Results: The ramus height and distance from the mandibular foramen to the sigmoid notch in class II patients were significantly different from those in skeletal class I (P < 0.005). Distance from the mandibular canal to the anterior border of ramus in class III individuals was significantly different from that in skeletal class I individuals (P < .005). Conclusion: Length of the body of mandible in skeletal class I was significantly different from that in skeletal class II and III patients. Also, ramus height in skeletal class I was significantly different from that in skeletal class II patients. CBCT had high efficacy for accurate identification of anatomical landmarks.   Keywords Prognathism; Retrognathism; Mandible; Anatomy; Cone beam computed tomography.


2012 ◽  
Vol 06 (02) ◽  
pp. 123-132 ◽  
Author(s):  
Elcin Esenlik ◽  
Fidan Alakus Sabuncuoglu

ABSTRACTObjectives: The aim of this study was to investigate the alveolar and symphysis region properties in hyper-, hypo-, and normodivergent Class II division 1 anomaliesMethods: Pretreatment lateral cephalograms of 111 young adult female patients with skeletal Class II division 1 anomalies were compared to those of 54 Class I normal subjects (control group). Class II cases were divided into hyperdivergent (n = 58), hypodivergent (n = 19), and normodivergent groups (n = 34). The heights and widths of the symphysis and alveolus and the depth of maxillary palate were measured on the lateral cephalogramsResults: Mean symphysis width was wider in the hypodivergent Class II group than in the other groups, while mean symphysis height was similar among all groups. Maxillary palatal depth, upper incisor angle, upper and lower molar alveolar heights, and Id–Id′ width were also similar among groupsConclusion: Symphysis width is the main factor in the differential diagnosis of Class II division 1 anomaly rather than symphysis height and hypodivergent Class II Division 1 anomaly is more suitable for mandibular incisors movements. (Eur J Dent 2012;6:123-132)


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