Atypical Swallowing Research Articles

Rare Disorders: Diagnosis and Therapeutic Planning for Patients Seeking Orthodontic Treatment.

The available literature on the orthodontic treatment of patients with rare disorders is extremely scarce. The aim of this study was to analyze the diagnosis and orthodontic treatment of a group of 94 individuals with rare diseases, referred for orthodontic evaluation to a university special care dentistry center (University of Santiago de Compostela, Spain). We created a control group of 94 systemically healthy individuals, paired by sex and age range. For all participants, we recorded their dental and skeletal abnormalities, oromotor dysfunctions and the characteristics of their orthodontic treatment. Some of the morphological and functional abnormalities were more prevalent in the rare disorders group than in the control group, including dental agenesis, microdontia, enamel defects, maxillary hypoplasia, overbite, cleft lip/palate, mouth breathing, atypical swallowing, lingual/labial interposition, labial incompetence, modified consistency diet, bruxism, and muscle tone abnormalities. Compared with the control group, the 56 patients with rare disorders who underwent orthodontic treatment required more desensitization sessions, used mixed appliances (fixed and removable) more often and for longer periods and had more frequent complications, such as gingivitis, caries, mucosal ulcers and recurrent debonding of the device. In conclusion, for selected patients with rare disorders, it is feasible to perform orthodontic treatment, whose planning will be determined by the dental-skeletal abnormalities and oromotor dysfunctions. Although complications are more frequent, they can typically be solved without having to stop treatment.

Association between atypical swallowing and malocclusions: a systematic review.

This systematic review aims to answer the following focus question: "Is there an association between atypical swallowing and malocclusions?". Appropriate word combinations were chosen and tailored specifically for each of the following electronic databases: EMBASE, Latin American and Caribbean Literature in Health Sciences (LILACS), LIVIVO, PubMed/Medline, Scopus, Web of Science, and gray literature, without any restrictions, up to February 2021. According to the selection criteria, only cross-sectional studies were included. The following inclusion criteria were considered: a sample composed of children, adolescents, and adults; patients clinically diagnosed with atypical swallowing; patients with normal swallowing; and outcome of interest of atypical swallowing in patients with malocclusion. The data consisted of study characteristics, sample characteristics, results, and conclusion of each study. The risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies, and the certainty of evidence was assessed using the GRADE tool. 4,750 articles were identified. After a two-step selection, four studies were included. A higher frequency of distal occlusion, extreme maxillary overhang, and open bite was related to swallowing disorders; most studies pointed to posterior crossbite as a malocclusion more associated with atypical swallowing. All studies had a moderate to high risk of bias, and the certainty of evidence was very low. The results indicate that atypical swallowing is associated with malocclusions and that posterior crossbite is the main malocclusion found, but only in the young population (3-11 years). PROSPERO (42020215203).

Open bite and atypical swallowing: orthodontic treatment, speech therapy or both? A literature review.

The cause-effect relationship between anterior open bite and atypical swallowing, two frequently associated conditions, is currently not completely understood. These conditions are often accompanied by speech disorders and represent a problem for both young patients and untreated adult patients. Treatment of these complex cases may be orthodontic, logopedic therapy or both. The purpose of this review is to compare the various types of treatment to determine their effectiveness in improving skeletal condition, normalisation of muscle activity, and temporal stability. The present systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyzes (PRISMA) guidelines. In order to find the most appropriate articles for inclusion, an electronic and manual search was performed using PubMed and The Cochrane Library on May 23, 2021. No language restrictions or time limits were applied. Only human studies describing cases of patients in the developmental stage of dentition, i.e., deciduous dentition or mixed dentition with an anterior open bite related to a type of swallowing with tongue interposition between the arches, undergoing three different types of treatment (orthodontic only, myofunctional/logopedic only, combined) were included. The most effective treatment in cases of anterior open bite associated with atypical swallowing is a combination of the traditional orthodontic therapy and myofunctional therapy. Further studies are needed to devise an effective and universal logopaedic protocol to be followed in these cases.

Evaluation of swallowing pattern sound in patients with temporomandibular disorder

Objectives: The impairment of the temporomandibular joint and masticatory muscles has a negative impact on functions of the stomatognathic system, such as swallowing. Thus, an atypical swallowing pattern may contribute to the development of temporomandibular disorder (TMD). The aim of the present study was to evaluate acoustic aspects of swallowing and determine the occurrence of atypical swallowing dynamics. Methods: Sixty-two individuals [16 males (25.8%) and 46 females (74.2%); mean age 39.84 (± 9.40); 47 with TMD and 15 without TMD] were evaluated using an ultrasound detector during the swallowing of three consistencies: liquid, pasty and solid. The acoustic signals were recorded and subsequently analyzed using the DeglutiSom® software. Results: The majority of the sample (81%) with TMD presented atypical swallowing biodynamics, with a significantly greater frequency of food residuals for the three consistencies. The signal suggestive of aspiration was more frequent with the liquid consistency (37% of the group). Conclusion: There is a relation between TMD and an atypical swallowing pattern, which underscores the need for the multidisciplinary evaluation of individuals with this disorder.

Innovative rehabilitation for orofacial praxis

Evaluation of the effectiveness of an anoetic network protocol for rehabilitation of swallowing and nasal breathing The swallowing re-education protocol lasted 10 weeks and involved a passive neuromuscular rehabilitation device: Froggymouth, 15 minutes per day in front of a TV. It modifies the patient's proprioceptive stimuli and involves the biochemical link between neurons. The glials cells are involved in the interconnections of the different oro-facial neuronal networks. 48 patients between 5- and 16-year-old were selected, all of them diagnosed with atypical swallowing. Study by Dr Cornut. The statistical analyses were conducted by the biostatistics department of the Lille University Hospital under the responsibility of Julien Labreuche (senior statistician of the department of Prof. A. Duhamel). After 10 weeks of treatment, secondary deglutition was obtained for 80% of the patients including 60% automatization and "a significant decrease in the percentage value of the oral ventilation flow". Anoetic rehabilitation with Froggymouth is a nonrestrictive approach that has shown significant results improving nasal breathing and swallowing rehabilitation in 10 weeks.

Tongue stretching: technique and clinical proposal.

The tongue is an organ with multiple functions, from sucking to phonation, from swallowing to postural control and equilibrium. An incorrect position or mechanics of the tongue can causes sucking problems in the newborn or atypical swallowing in the adult, with repercussions on the position of the head and neck, up to influencing upright posture and other problems. Tongue dysfunctions are quite frequent (10-15%) in the population. For the manual therapist, this frequency indicates one to two subjects every 30 patients. Exercises have been proposed to improve the tone and strength of the swallowing muscles but the results are not so clear in the literature. The aim of this study is to describe and provide a tongue muscle normalization technique that helps the manual therapist in the treatment of problems related to it. The literature has been investigated through pubmed, Google scholar of the last 10 years, the keywords used and combined with the Boolean operators AND and OR, are: "tongue, tongue habits, tongue diseases, taste disorder, neck pain, posture, postural balance, atypical swallowing, muscle stretching exercise, tissue expansion, soft tissue therapy, osteopathic manipulative treatment". The technique is possible to be executed even in a sitting position, in the case the patient is unable to assume a supine position, the subject should provides immediate feedback that allows the therapist to understand if the technique has been correctly executed. The simplicity of execution and application of the technique makes it a possible and immediate therapeutic tool in the clinical setting.

The impact of co-sleeping less than 6 months on children's anxiety, oral habits, and malocclusion in a Spanish sample between 2 and 5 years old: a cross-sectional study.

Families often use co-sleeping to mitigate potential physiological and emotional effects on infants. The purpose of this study was to investigate whether the early termination of co-sleeping is associated with high levels of anxiety, non-nutritive sucking habits for self-comfort, and increased malocclusion. A cross-sectional study was performed on the parents of 215 children [aged 2-5 years (3.94 ± 0.89)], who were divided according to the duration of co-sleeping (≤6 months or >6 months). The parents completed a questionnaire about co-sleeping, sucking, breastfeeding habits, and anxiety. Finally, a clinical examination was carried out to diagnose malocclusion according to the World Health Organization (WHO) index, and the aesthetic component of the Index of Orthodontic Treatment Need (IOTN-AC) was recorded. Children that co-slept for 6 months or less had an increased incidence of pacifier use (P < 0.05), finger sucking (P < 0.01), and atypical swallowing (P < 0.05). Lower anxiety levels were found in the group with a longer duration of co-sleeping (P < 0.01). In the assessment of malocclusions, the group that co-slept for ≤6 months had higher IOTN scores (P < 0.01) and WHO indices (P < 0.05); in addition, there were differences in anterior open bite (P < 0.05), posterior crossbite (P < 0.01), skeletal Class II (P < 0.01), canine Class II (P < 0.05), and overjet (P < 0.05). A co-sleeping duration of >6 months appears to be a protective factor associated with less anxiety, fewer negative sucking habits, and a decreased incidence of malocclusions in co-sleeping children.

A Systematic Review of Oropharyngeal Dysphagia Models in Rodents.

Oropharyngeal dysphagia is a condition characterized by swallowing difficulty in the mouth and pharynx, which can be due to various factors. Animal models of oropharyngeal dysphagia are essential to confirm the cause-specific symptoms, pathological findings, and the effect of treatment. Recently, various animal models of dysphagia have been reported. The purpose of this review is to organize the rodent models of oropharyngeal dysphagia reported to date. The articles were obtained from Medline, Embase, and the Cochrane library, and selected following the PRISMA guideline. The animal models in which oropharyngeal dysphagia was induced in rats or mice were selected and classified based on the diseases causing oropharyngeal dysphagia. The animal used, method of inducing dysphagia, and screening methods and results were collected from the selected 37 articles. Various rodent models of oropharyngeal dysphagia provide distinctive information on atypical swallowing. Applying and analyzing the treatment in rodent models of dysphagia induced from various causes is an essential process to develop symptom-specific treatments. Therefore, the results of this study provide fundamental and important data for selecting appropriate animal models to study dysphagia.

Clinical and Electromyographic Assessment of Swallowing in Individuals with Functional Dysphonia Associated with Dysphagia Due to Muscle Tension or Atypical Swallowing.

Introduction: Over the past few years, attention has been paid to the coexistence of dysphonia with dysphagia, in the context of functional disorders. The aim of this work was to objectify logopaedic examination of dysphonic patients with coexisting swallowing difficulties by surface electromyography. Methods: The material of the work included 58 patients with muscle tension dysphonia (MTD). Each patient underwent otolaryngologic, phoniatric and logopaedic examination. We collected information about medical history and asked patients to fill out Reflux Symptom Index (RSI), Eating Assessment Tool (EAT-10), Dysphagia Handicap Index (DHI) and Swallowing Disorder Scale (SDS). The algorithm of dysphagia diagnostics in our clinic assumes parallel surface electromyography (SEMG) during Functional Endoscopic Evaluation of Swallowing. Results: In comparison to patients suffering from atypical swallowing, patients with muscle tension dysphagia (MTDg) obtained higher values from almost all questionnaires. Logopaedic evaluation revealed abnormalities in the structure and efficiency of the articulatory organs and in the assessment of primary functions. Patients with more abnormalities in logopaedic examination had significantly higher infrahyoid muscle activity during swallowing observed in EMG. Patients with non-normative swallowing pattern had significantly greater asymmetry of the average and maximum amplitude of masseters, as well as submental muscles. Patients with higher percent of muscles asymmetry gained higher scores in questionnaires. Conclusions: Surface electromyography objectifies logopaedic examination of patients with swallowing difficulties. The results of this work showed that, apart from longer swallows, patients with MTDg differ from patients with non-normative swallowing patterns in the muscle activity measured by SEMG, abnormalities in logopaedic evaluation and the severity of complaints reported by patients.

Association between mouth-breathing and atypical swallowing in young orthodontic patients at Egas Moniz Dental Clinic

Introduction Breathing and swallowing are functions of the stomatognathic system, since they are vital and innate to the human being, moreover, interrelated [1,2]. Most of the breathing is nasal, however mouth-breathing can occur, being a pathological adaptation that can lead to a series of changes, often irreversible, in the growth and development of a child, for instance causing changes in swallowing [3]. This mechanism differs between children and adults and, if identified in a child, up to five years, it is considered as infantile deglutition pattern being replaced by mature deglutition pattern after this period [4]. If it continues beyond the period in which it is considered normal, it is renamed as atypical [5]. Therefore, the aim of this study was to explore the possible relation between mouth-breathing and atypical swallowing in children. Materials and methods The study took place between January 2018 to February 2019, involving patients referred to the Care Consultation of Orthodontics Egas Moniz Dental Clinic (EMDC). The sample consisted of 86 patients, that n = 46 (53.4%) were females and n = 40 (46.6%) were males, with a mean age of 12.3 years. The study was approved by an Ethics Committee of Egas Moniz. Inclusion criteria were: children of both sexes aged 5–18 years, having clinical record at EMDC and with the correspondent informed consent signed by the parents. Exclusion criteria were: children who had past orthodontic treatment and having craniofacial anomalies or syndromes. The method used to assess breathing and swallowing patterns was adapted by Marchesan [2]. Data were analysed by using descriptive and inferential methodologies (chi-square test). A significance level of 5% was established in the latter case. Results A higher prevalence of mouth-breathers was found in women n = 49 (56.5%) than in men n = 37 (43.5%). Atypical swallowing, was also more prevalent in women n = 48 (56.1%) than in men n = 38 (43.9%), however, in both cases, the differences were not found to be statistically significant (p = .594, p = .570). n = 52 (83.9%) of the mouth-breathers were identified as having atypical swallowing, conversely to n = 14 (58.3%) of the normal (nasal) breathers. Overall, there was a statistically significant association between mouth-breathing and patients with atypical swallowing (p = .012). Discussion and conclusions The results show that mouth-breathing and atypical swallowing were found to be significantly associated n = 52 (83.9%) in this study, being closed to Lemos et al. who found higher results (97.2%) [1]. Other studies reported that is not statistically significant the association between mouth-breathing and atypical swallowing [6]. The results of this study are clinically relevant and encouraging the search for early diagnosis and intervention.

How the myobrace appliance works: Advantages and disadvantages

Myofunctional Dentistry is a treatment that acts in the re-education of facial and masticatory muscles, correcting bad myofunctional habits such as mouth breathing, atypical swallowing and incorrect tongue positioning,

Analysis of Tongue Function from the Orthodontist’s Point of View: Not Only a Matter of Deglutition

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.

Relación entre tipo de lactancia y la deglución atípica en pacientes concurrentes a una clínica odontopediátrica

El profesional en fonoaudiología identifica que la lactancia materna juega un papel determinante en la conformación estructural y funcional del sistema estomatognático; siendo la primera función que aporta información paratípica de crecimiento. Diversos autores mencionan que los movimientos de balanceo mandibular propios del amamantamiento, generan excitación sobre la articulación temporomandibular, proporcionando a la estructura estímulos paratípicos de crecimiento, generando acciones de crecimiento transversal del cráneo y la cara. Este estudio con paradigma cuantitativo, no experimental, enfocado en la búsqueda de una relación entre el tipo de lactancia o alimentación con el hábito de deglución atípica. Se utilizará como instrumento de recolección el protocolo de Evaluación Miofuncional, en sus secciones de evaluación cráneo-facial y funcional. Los resultados se centran en el análisis de la razón de momios de la prueba de regresión logística, que evidencia la existencia de un factor protector de la lactancia materna exclusiva, donde los niños que reciben lactancia artificial tienen 4,8 veces más probabilidades de presentar deglución atípica en comparación con los que reciben lactancia materna exclusiva, y 1,6 en el grupo de lactancia materna mixta, en comparación con los de lactancia exclusiva. Los aspectos preventivos de la lactancia materna exclusiva, denotan una gran importancia como abordaje de los procesos disfuncionales y parafuncionales, teniendo como sustento una regulación de las acciones fisiológicas vinculadas en principio a la alimentación inicial, que, para llevarse a cabo, necesita de estructuras anatómicas en estado óptimo, de acciones funcionales (sensitivas y motoras) efectivas y de una guía adecuada por parte del contexto.

Relación entre un periodo de lactancia materna exclusiva menor de 6 meses y presencia de hábitos parafuncionales en un grupo de niños y adolescentes venezolanos

Objetivo. Relacionar un periodo de lactancia materna exclusiva menor a 6 meses con la presencia de hábitos parafuncionales en un grupo de niños y adolescentes venezolanos que acudieron al Servicio de Odontología del Hospital Pediátrico San Juan de Dios de Caracas en el periodo Julio-Octubre de 2016. Materiales y métodos. Estudio epidemiológico de corte transversal, no experimental, de campo y de nivel correlacional, realizado en 183 niños y adolescentes entre 7 y 12 años. Se tomó una muestra no probabilística a conveniencia, con análisis de frecuencias, porcentajes, prueba de significancia estadística chi cuadrado y correlación de Pearson. Resultados. El género femenino ocupó un 56,3%, el promedio de edad fue de 8,4 ±1,29 años. El 100% de la población recibió lactancia materna exclusiva por algún tiempo: en el 53% fue de 0-3 meses y en el 47% de 4-5 meses. 131 pacientes (71.58%) exhibieron uno o más hábitos parafuncionales, de los cuales, 83 pacientes (63,36%) fueron amamantados de forma exclusiva de 0 a 3 meses y 48 pacientes (36,64%) de 4 a 5 meses con una significancia estadística de p=0,000 (p-valor&lt;0,05) y r=25,30%. En esta población, un periodo de lactancia materna exclusiva menor de 6 meses se relacionó con la presencia de succión digital (p=0,015 y r=18,10%), succión de cuerpo extraño (p=0,001 y r=24,70%), deglución atípica (p=0,047 y r=10,80%) y respiración bucal (p=0,000 y r=33,10%). Conclusión. Se destaca la relación entre un periodo menor de 6 meses de lactancia materna exclusiva y la presencia de hábitos parafuncionales en la muestra analizada.

Tratamiento de mordida cruzada anterior con aparato de tracción extraoral: máscara Delaire en paciente con estrabismo. Reporte de caso

Introducción: En la maloclusión clase III con mordida cruzada anterior existe una alteración en la relación máxilo-mandibular: retrognatismo maxilar, prognatismo mandibular o combinada, esta desarmonía puede alterar la estética facial. Si se interviene a una edad temprana se puede lograr la normalidad de la funciones y armonía en la relación de los maxilares, llevando a mejorar la estética del paciente. Es importante tener en cuenta el factor etiológico para establecer un adecuado plan de tratamiento y lograr estabilidad a largo plazo. La etiología es multifactorial; hereditaria y ambiental (hábitos, agrandamiento de las amígdalas y postura mandibular). Existen varias opciones de tratamiento dependiendo de la edad como ortopedia maxilar, ortodoncia y cirugía ortognática.&#x0D; Caso clínico: se presenta una paciente de 9 años y 7 meses de edad, género femenino, con estrabismo, cuya madre consulta porque “se le está saliendo la mandíbula”; los hallazgos clínicos y cefalométricos determinan una maloclusión clase III con retrognatismo maxilar, mordida cruzada anterior, crecimiento vertical, respiración mixta con predominio nasal, deglución atípica y sigmatismo. El tratamiento que se realizó en este paciente fue en 2 fases: en la primera ortopedia mecánica con Hyrax y máscara facial de Delaire por 11 meses y en la segunda fase aparato de ortopedia funcional SN3 (pequeñas aletas inferiores).&#x0D; Conclusión: Los cambios obtenidos con máscara facial de Delaire se evidencian a nivel facial, dental y esquelético, sin comprometer la alteración de estrabismo que la paciente presenta y maneja con gafas.

Atypical swallowing behind an unusual case report of anterior open bite and an anterior midline Diastema

Atypical swallowing is a my functional problem consisting of an altered tongue position during the act of swallowing, connection with the presence of malocclusions such as anterior open bite made it a topic of strong interest and discussion in science.Anterior open bite is considered a malocclusion that still defies correction, especially in terms of stability, midline Diastema create an unpleasant appearance for individuals, sometimes it may lead to phonetic problems, particularly in cases with wide space. This article describes a clinical rare case of a severe anterior open bite and an unusual midline Diastema which resulted from an atypical swallowing and shows the importance to set up an early my functional rehabilitation procedure to correct the oral habit and to prevent such malocclusion with consequences on aesthetics and self-confidence.

Short-Term Effects of a Myofunctional Appliance on Atypical Swallowing and Lip Strength: A Prospective Study.

Atypical swallowing needs treatment in order to eliminate harmful interferences of the tongue, which prevent the harmonious growth of the stomatognathic system. The purpose of this study was to assess the effects of a functional appliance on the presence of atypical swallowing, analyzing the lip strength and the altered facial mimics. The effects of a myofunctional appliance (the Froggy Mouth) were evaluated on 40 children (6 males; 24 females; mean age 9.6 ± 2.17) with atypical swallowing—with tongue thrust diagnosed by an expert orthodontist—before and during a 6 month treatment. Data were analyzed over time with a paired samples t-test for normally distributed data. After 6 months of treatment, 33 children out of 40 achieved clinical correction of atypical swallowing due to their good compliance, even at an early stage. Seven children showed low compliance and did not obtain any result. Lip strength in compliant subjects went from 190.30 ± 86.04 cN to 489.39 ± 123.36 cN (t = p < 0.001). Facial mimics improved in 28 out of 33 compliant subjects, and four children with the initial diagnosis of labial incompetence achieved correction. This observational study demonstrates the short-term efficacy of this myofunctional appliance in the treatment of atypical swallowing, achieving correction of the facial mimics and labial incompetence with a significant improvement of the lip strength.

The efficacy of myofunctional therapy in patients with atypical swallowing.

The myofunctional treatment (MFT) is a conventional therapy in the treatment of oral disease like atypical swallowing (AS). Functional (standardized surface electromyographic analysis-ssEMG) and clinical ("orofacial muscular evaluation with score" protocol-OMES) analyses were conducted to detect the effects of MFT (10weeks session) in a group of patients with AS. ssEMG was performed to analyze the activity of masseter (MM), temporalis (TA), and submental (SM) muscles before (T1) and after (T2) the MFT in a group of 15 patients. OMES was completed at the same timepoints. A Student-t test was carried out to detect differences between T1 and T2 for ssEMG data, and a signed RANK test was used for OMES ones. One-way ANOVA variance test was performed to detect any differences between the different couples of muscles at each timepoint. After MFT, patients showed a shorter duration of the whole act of swallowing (p < .0001), higher intensity of the SM activity (p < .01) than at T1. At T2 masticatory muscles showed lower values for the activation index (ANOVA, p < .0001) and for the spike position (ANOVA, p < .01) than SM. The OMES protocol showed a significant increase for the total evaluation score (p < .01), appearance-posture (p < .01) and functions (p < .001). MFT permits a shortening of the muscular activation pattern and an increase in SM activity. The improvement of oral functionalities is possible and identifiable thanks to the use of standardized protocols.

Cephalometric traits in children and adolescents with and without atypical swallowing: A retrospective study.

It has been suggested that atypical swallowing (AS) may negatively influence the skeletal and alveolar development, but its specific effects are still unclear. The aim of this work is to compare the cephalometric characteristics of children and adolescents with and without AS. Study design: Case-control retrospective cross-sectional study. One hundred patients with (AS group) and 100 patients without AS (control group, C) were retrospectively selected. Their cephalometric data before orthodontic treatment were compared using a 3-way ANOVA variance test to detect any differences between groups considering: the type of swallowing (AS vs C); whether or not the second dentition was completed (SDC vs SDNC); and the gender (males-M and females-F). In addition, a Student-t test for unpaired data was carried out to detect differences between M and F within the AS and C groups. When compared to the controls, AS patients showed a significantly decreased SNB angle (p<.01), increased ANB and SN^Go. Me angles (p<.0001), increased overjet and lower facial height (p<.01), decreased overbite (p<.0001), and increased proclination of the upper incisors. AS-SDC patients also showed significantly increased alveolar length. Within the AS and C groups, skeletal and alveolar measurements were larger in males, with higher significance in the C group, suggesting a different trend of growth in AS patients. AS seems to affect the skeletal growth causing mandibular clockwise rotation, skeletal Class II, open bite and incisor proclination. To compensate for these effects, an increase in alveolar growth together with molar eruption seems to be induced.

Importance of orthodontic intervention of the Class III malocclusion in mixed dentition.

ABSTRACTIntroduction: Supervising the development of occlusion, managing problems during the transition from mixed to permanent dentition, as well as controlling environmental factors that contribute to establishing malocclusion, are important actions to achieve a Class I occlusion with facial balance. Among these problems, the malocclusions associated with dysfunctions such as mouth breathing or obstructive sleep apnea syndrome (OSAS), atypical swallowing and abnormal tongue position, open bites, crossbites and maxillomandibular discrepancies, and especially the Class III malocclusion can be listed. Objective: The purpose of this article is to present and discuss the main aspects relevant to the benefits of performing the treatment of Class III malocclusion in patients with growth.