Influence of nasal obstruction in face dimensions according to different growth phases

Abstract

Objectives: The objectives of this study are investigating the facial and occlusal abnormalities in different phases of growth and correlate them to nasal obstruction in patients that need orthodontic treatment. Methods: We selected 86 patients from 6 to 25 years old (37 male; 49 female) that needed orthodontic treatment. They were divided according to the skeletal phase of maturity (hand and wrist x-ray) into 3 phases of growth (prepuberal, puberal and postpuberal). Patients were submitted to ENT doctor’s exam to determine if nasal obstruction was present. Patients were submitted to the orthodontist’s examination that evaluated also the orthodontic casts, lateral and frontal cephalometric x-rays. Facial and dental findings of patients with and without nasal obstruction were compared by statistical analysis. Results: This series showed that nasal obstruction was present in around half of the patients. It was associated to: higher frequency of dolychofacial pattern, class II skeletal pattern, palatal atresia, skeletal openbite, smaller nasal wideness, distance intermolars decreased, smaller maxillary and mandibular dimensions, and increased overjet. The majority of these characteristics were more prevalent in puberal and postpuberal phases of growth and in patients with a dolychofacial pattern. Conclusion: These findings suggest that the longer the nasal obstruction, the worse the orthodontic abnormalities, mainly in dolychofacial patients and that the multidisciplinary approach may be very important to a successful treatment.