Dental malocclusions in children with nasopharyngeal obstruction of allergic origin

Introduction: Allergic rhinitis is one of the most common allergic diseases in humans. According to the literature its frequency reaches 30% in children and 40% in adults. In the last two decades, allergies in children have drastically increased.Aim: The purpose of our study is to establish the effect of nasopharyngeal obstruction of allergic origin in the development of the dental arches and occlusion in children with primary and mixed dentition.Materials and Methods: A total of 1667 children from Varna aged between 3 and 12 years were examined. All children were examined by the same orthodontist, while children presenting with mouth breathing were diagnosed and examined by an otolaryngologist. The results of the orthodontic examination of each child were assessed according to 19 indicators, outlined in specially developed tables.Results: In primary dentition 63% are with Class I relationship, while in mixed dentition the precentage of the children with Class II relationship is increased—55% and with mesial occlusion—7%. In vertical dimension in mixed dentition, there are cases of open bite of more than 3 mm and cases of deep bite that are not present in primary dentition.Conclusion: Allergic rhinitis in children with primary and mixed dentition leads to reduction in the size of the jaws, in the sagittal and transverse planes, crossbite in the posterior segment, distal occlusion and overjet. Nasal obstruction of allergic origin creates a greater risk of development of open bite and to a lesser extent, development of deep bite.

The correlation between the rotation of upper first permanent molars and malocclusions in the individual dental arch and in the occlusion

IntroductionMalocclusions disturb the integrity of the dental arch and the interdental/occlusal relationship. All this leads to a change in the position of the upper molars in the sagittal, transversal and vertical plane. The rotation of the upper first molar leads to a shift of position of molar cups in a mesio-distal direction demonstrated by the great impact on the distribution of occlusal forces.AimThe rotation of upper first molars should not be underestimated in the biometrical analysis of diagnostic dental casts as this can lead to incomplete and improper treatment plan.Ðœaterials and MethodsOur study investigated 681 children aged 7-10 years who attended the Department of Orthodontics at the Faculty of Dental Medicine in Varna. All children were clinically evaluated and biometrical assessment of diagnostic dental casts was performed. Diagnostic records included also photo-analysis and measurements of diagnostic dental casts. The relationship between the rotation of upper first permanent molars and the transversal and sagittal dimension, and also the overjet were assessed. The degrees of rotation were classified using the Friel and Vigano methods.ResultsA regressional statistical analysis was conducted to determine the frequency of malocclusion and to establish the relationship between the rotation of upper first permanent molar and the length of the arch, the intercanine distance, and the overjet. The comparative analysis demonstrated inverse relationship not only between the rotational position of the molars and the length of the arch, but also between the canine distance and the rotation of the upper molars (p<0.01). It is reported that when an overjet up to 4 mm is present,  the mediopalatal rotation of the molars is negatively affected.ConclusionLosing the length of the arch leads to compression of the dental arch, medialization of permanent molars and crowding of the frontal teeth. The problem of mesiopalatal rotation of upper first permanent molars is manifested through increased overjet and increased overbite

Orofacial myofunctional characteristics in mouth-breathing children

Introduction: Normal breathing plays a significant role in the development of the maxillofacial region. People are born with an innate ability to breathe through the nose, but there are cases where they can become mouth-breathers.Aim: The purpose of our study is to establish the relationship between mouth breathing and the development of the orofacial system in children with mixed and permanent dentition.Materials and Methods: A total of 1667 children from Varna between 3 and 12 years of age were examined. The results of the clinical examination of each child were assessed according to 19 indicators, outlined in the statistical table. All children were examined by the same dentist, while children presenting with mouth breathing were diagnosed and examined by an otolaryngologist. For the analysis of the occlusion, Tscan was used.Results: Breathing through the mouth leads to increased depth of the palate in 58% of the children and to hypotonia of the orbicularis oris muscle in 68% of them (р < 0.001). In 69% of the mouth-breathing children, an increase in the facial height was found. A statistically significant difference regarding the type and frequency of malocclusions between mouth-breathing and nose-breathing children was established (р < 0.001).Discussion: Breathing through the nose ensures proper growth of the morphological and functional structures of the orofacial complex. Breathing through the mouth during the period of intensive muscular and skeletal growth of the craniofacial region impedes normal growth processes and leads to pathological changes.Conclusions: Children who breathe through the mouth present with the following characteristic orofacial myofunctional symptoms: muscular hypotonia, which includes the orbicularis muscle and the masticatory muscles, narrow maxillary arch, underdeveloped lower jaw, open bite in the anterior segment, and occlusal imbalance

The relationship between the position of the hyoid bone and the head posture in mouth-breathing children

Introduction: Breathing through the nose allows proper growth and development of the craniofacial complex. Obstruction of the nose leads to breathing through the mouth, which leads to changes in the position of the tongue and lower jaw.Aim: The aim of this study was to establish the relationship between the position of the hyoid bone and the head posture in mouth-breathing children and nose-breathing children.Materials and Methods: We analyzed the profile cephalometric radiographs of 120 patients in mixed dentition. All of the studied children were examined by the same doctor of dental medicine, and the children with mouth breathing were consulted and diagnosed by an ear-nose-throat specialist as well. The analyses covered the following: craniocervical angle (NS/OPT), the length of the anterior cranial base (NS), the angle of maxillary prognathism (SNA), angle of mandibular prognathism (SNB), difference between angles SNA and SNB (ANB angle), the angle of the basal planes of the jaws (SpP/MP), and the cranial base angle (NSB).Results: There was a statistically significant difference in the studied children compared to the skeletal class. The average value of the craniocervical angle (NS/OPT) in mouth-breathing children was 102.5° which is significantly higher compared to nose-breathing children (p < 0.004). A statistically significant difference was found in the type of hyoid bone in mouth-breathing and nose-breathing children (χ2= 24.97; р < 0.001).Conclusion: In mouth-breathing children, a lower and posterior position of the hyoid bone is found compared to nasal breathing children. Mouth-breathing children show greater extension of the head related to the cervical spine and posterior rotation of the mandible

Epidemiological research on the incidence of malocclusions among mouth-breathing children with primary and mixed dentition

Introduction: A literature review established that the number of mouth-breathing children varies between 5-75%. Girls are more often diagnosed with this condition compared to the boys. In the 19th century Linder-Aronson established the relationship between mouth-breathing and malocclusions. The recognition of the mouth-breathing pattern and the habitual mouth breathing as factors in developing malocclusions requires prophylaxis and timely treatment.Aim: The purpose of this study is to establish the incidence and type of malocclusions among mouth-breathing children with primary and mixed dentition.Materials and Methods: A total of 412 children diagnosed with mouth breathing and 317 children diagnosed with habitual mouth breathing aged 3-12 years were examined. The dental occlusion of every child was assessed in the three planes of space - sagittal, transverse and horizontal in both segments - frontal and buccal.Results: In both groups a statistically significant difference in dental malocclusions was demonstrated (p<0.001) depending on type of dentition. In both groups the vast majority of children were diagnosed with class II Angle malocclusion in both primary and mixed dentition. The children with primary dentition were more often diagnosed with class I Angle malocclusion.Conclusion:In both groups the most frequent malocclusions present were class II Angle, overjet, bilateral posterior crossbite, open bite within 3 mm in the frontal segment. In primary dentition the most frequent type of malocclusion was class I Angle.Introduction: A literature review established that the number of mouth-breathing children varies between 5-75%. Girls are more often diagnosed with this condition compared to the boys. In the 19th century Linder-Aronson established the relationship between mouth-breathing and malocclusions. The recognition of the mouth-breathing pattern and the habitual mouth breathing as factors in developing malocclusions requires prophylaxis and timely treatment.Aim: The purpose of this study is to establish the incidence and type of malocclusions among mouth-breathing children with primary and mixed dentition.Materials and Methods: A total of 412 children diagnosed with mouth breathing and 317 children diagnosed with habitual mouth breathing aged 3-12 years were examined. The dental occlusion of every child was assessed in the three planes of space - sagittal, transverse and horizontal in both segments - frontal and buccal.Results: In both groups a statistically significant difference in dental malocclusions was demonstrated (p<0.001) depending on type of dentition. In both groups the vast majority of children were diagnosed with class II Angle malocclusion in both primary and mixed dentition. The children with primary dentition were more often diagnosed with class I Angle malocclusion.Conclusion:In both groups the most frequent malocclusions present were class II Angle, overjet, bilateral posterior crossbite, open bite within 3 mm in the frontal segment. In primary dentition the most frequent type of malocclusion was class I Angle

Influence of adenotomy/adenoidectomy on the respiration and occlusion in mouth-breathing children

Introduction: Difficult nasal breathing is a common problem, which may be a result of multiple factors, leading to physiological disturbance and/or anatomical disorders of the nose and paranasal sinuses. One of the most frequent reasons in childhood age is adenoid hypertrophy.Aim: The aim of the current article is to determine the influence of adenotomy and adenoidectomy on the respiration and occlusion of children with difficult nasal breathingMaterials and Methods: A total of 412 children, diagnosed with difficult nasal breathing, took part in the study. Of them, 139 underwent a second clinical examination in the period of 1 to 3 months to determine the way of breathing after adenotomy/adenoidectomy.Results: In primary dentition, after removing the etiological factor for difficult nasal breathing, 68.00% of the children began to breathe spontaneously through the nose. In mixed dentition, there was a higher percentage of children, who maintained mouth breathing as a bad habit. In comparison to the dental class after adenotomy/adenectomy, there was a higher percentage of Angle class II. In the saggital plane there was an increase of the frequency of the overjet from 1 to 3mm, which led to preservation of mouth breathing.Conclusion: After adenotomy/adenectomy we have determined that in primary dentition a higher percent of children begin to breathe spontaneously through the nose, whereas in mixed dentition mouth breathing is preserved as a bad habit. In children with preserved mouth breathing, there is an increase in the degree of severity of orthodontic deformations and complications of the deformation

Determining the main reasons for difficult nasal breathing among children with primary and mixed dentition

Introduction: Difficult nasal breathing is the condition where there is a partial or full, temporary or permanent obstruction of the airways and the processes of inhalation and exhalation are carried out through the mouth.Aim: The aim of this paper is to define and analyse the reasons for mouth breathing among children with primary and mixed dentition.  Materials and Methods: A total of 1 667 children between the ages 3 and 12 years were examined. We used the methods of anterior and posterior rhinoscopy, acoustic rhinometry, and rhinomanometryResults: Among all the studied mouth-breathing children with deciduous dentition, the main reason for the difficult nasal breathing was allergic rhinitis. The children with first degree of obstruction predominated (54.50%), The second cause in this studied age group was adenoid hypertrophy. In early mixed dentition, the percentage distribution of second and third degree of obstruction was the same (45.70%). In the early mixed dentition, the most common cause of difficult nasal breathing was adenoid hypertrophy. The percentage of children in late mixed dentition who were with adenoid hypertrophy was lower.Conclusion: The main reason for difficult nasal breathing in primary dentition is allergic rhinitis, but in early mixed dentition it is adenoid hypertrophy. Our results showed that of all the children with difficult nasal breathing 24% had first degree of nasal obstruction, 39.30% had second degree, followed by 36.70% children with third degree

Conventional vs. digital impression technique for manufacturing of three-unit zirconia bridges: Evaluation of patients’ perception, preference, and treatment comfort

INTRODUCTION: Taking an impression of the oral cavity, which accurately recreates the prosthetic field, the surrounding hard dental and soft tissues, is one of the main and most important stages in the process of making any fixed prosthetic structure.AIM: The aim of the present study is to compare the comfort and satisfaction of patients in need of prosthetic restoration of a defect in the dentition, using conventional and digital impression techniques and to determine their preference for any of them.MATERIALS AND METHODS: The satisfaction of 36 patients in need of prosthetic rehabilitation treatment with conventional and digital impression techniques was analyzed and compared. After completing the stages of conventional and digital impressions, patients were asked to complete a comparative questionnaire of 9 questions using a numerical rating scale (NRS), stating their preference for one of the two techniques.RESULTS: Regarding the conventional impression technique, we obtained the lowest average values according to the criteria “general discomfort” (6.44±2.09), “total time for execution of the impression technique” (6.14±1.53), and “nausea” (6.17±2.86). The results of the same criteria in digital impression technology showed a significantly better response. All examined patients preferred the digital impression technique in cases where more than one impression had to be taken. DISCUSSION: Our results show that patients identify digital impressions as more comfortable for them. Differences in the level of comfort, which included nausea, difficulty breathing, discomfort in the TMJ with a wide open mouth, were statistically significant (p <0.001).CONCLUSION: In terms of patient comfort and satisfaction, the digital impression technique is better perceived than the conventional one.

Comparison between conventional and digital impression techniques in prosthetic dentistry: a literature review

INTRODUCTION:In modern prosthetic dentistry, there are mainly two approaches when manufacturing any prosthetic restoration: conventional and digital. In these approaches, the methods for reproducing the prosthetic field can be divided into: conventional impression methods, digital impression methods, and combined impression methods.AIM:The aim of the present literature review is to identify the advantages and disadvantages of taking a digital impression over conventional impression, and to determine whether the digital impression is as accurate as a conventional one.MATERIALS AND METHODS:A total of 209 articles were analyzed. The electronic databases of ResearchGate, Embase, Google Scholar, PubMed, and Scopus were used. The search was limited to entire articles written in English and published in peer-reviewed scientific journals. RESULTS:The studied articles were published in the period from 1961 to 2019 and over 60% of them were in the last 10 years. Among these studies, 10 are previous literature reviews, 85 are in vivo clinical trials, 6 are randomized controlled/crossover studies, 11 are controlled comparative studies, 7 are clinical case reports, and 90 are in vitro comparative studies.CONCLUSION:The present study has its limitations due to the fact that it is a literature review. However, we can conclude that the digital impression technique has a number of advantages over the conventional impression technique, one of the most important of which is the reduced patient discomfort.

THE ROLE OF MOUTH BREATHING ON DENTITION DEVELOPMENT AND FORMATION

Introduction: The influence of mouth breathing on the development of the dentition and dento-facial deformities is a problem causes concerns among the medical specialists. Mouth breathing has a major impact on the development of the maxillo-facial region, occlusion and muscle tonus. Aim: The aim of this study is to assess the relationship between etiological factors, pathogenesis and disturbances in mastication in mouth breathing patients. Material and methods: For this article, data is obtained from 43 medical, literary sources. Results: Literature review demonstrated that mouth breathing habit affects mostly children aged 7 - 12 years. In the vast majority of studies, the authors established a relation between mouth breathing and the development of maxillo-facial region and occlusion. The malocclusions described include a distal occlusion, anterior open bite, increase overjet, posterior crossbite, crowding and average incisors inclination disturbances. These clinical conditions become more complicated in the late-mixed and permanent dentition if mouth breathing continues to persist. Conclusion: The habitual mouth breathing is a great medical problem nowadays. An increasing numbers of patients with this condition although the development of technology for early diagnostic is embarrassing. This condition is strongly related with different malocclusions such as anterior open bite, overjet, distal occlusion, underdeveloped and narrow upper jaw, increased anterior facial height