Mouth Breathing Subjects Research Articles

Analysis of maxillary arch morphology and its relationship with upper airway in mouth breathing subjects with different sagittal growth patterns

ObjectiveThis three-dimensional cone beam computed tomography(CBCT) study assessed pharyngeal airway and maxillary arch in mouth breathing subjects with different skeletal classifications and analyzed the factors associated with the upper airway morphological variations in mouth breathing (MB) and nasal breathing (NB) subjects. MethodsOne hundred and five subjects (52 MB and 53 NB children), divided into three skeletal groups: Class I (1° ≤ ANB° ≤ 5°), Class II (ANB° >5°), and Class III (ANB°<1°). An independent t-test and one-way ANOVA test were utilized in the group analysis of normal distributed data. The linear multiple regression test was applied to create a model for the airway volumes based on the maxillary arch parameters in different skeletal groups. ResultsIn three skeletal groups, NB individuals had greater oropharyngeal airway volume (OPV) and total pharyngeal airway volume (TPV) than MB. Maxillary arch parameters of intermolar width (IMW), intercanine width (ICW), and maxillary width of canines (MWC) were larger in NB participants than in MB subjects. In the MB group, we discovered that Class II individuals had lower NPV (nasopharyngeal airway volume) than Class I and Class III. MWC was lower in Class II subjects compared to Class I and Class III in both the NB and MB groups. ConclusionNB individuals had greater pharyngeal airway and maxillary arch parameters than MB subjects. Our model equation revealed that the inter-molar width (IMW) and palatal area (PA) parameters were the strongest predictors of total pharyngeal airway volume (TPV) in the skeletal Class II and Class I groups.

Three-dimensional evaluation of hyoid bone position in nasal and mouth breathing subjects with skeletal Class I, and Class II

BackgroundThis retrospective study investigated the effect of breathing pattern, skeletal class (Class I, Class II), and age on the hyoid bone position (HBP) in normodivergent subjects.MethodsA total of 126 subjects (61 males, 65 females) aged 7–9 years and 10–12 years were scanned using cone-beam computed tomography (CBCT). All participants were classified according to the anteroposterior skeletal pattern into (Class I, Class II). Each skeletal group was further divided according to the breathing mode into mouth breathers (MB) and nasal breathers (NB). The HBP was measured accordingly. Independent sample t-test and Mann Whitney U test were used to detect significant differences between the groups, and binary logistic regression was used to identify MB predictive indicators.ResultsThe breathing mode and skeletal class affected the vertical HBP in subjects with 7–9 years, while they affected the anteroposterior HBP in subjects with 10–12 years. Regarding the age effect, hyoid bone was located more anteriorly in the older NB subjects, and hyoid bone was more inferiorly in the older age group. A regression equation of the significant variables was formulated, C3-Me (P: 001, OR: 2.27), and H-EB (P: 0.046, OR: 1.16) were positively correlated with occurrence of MB.ConclusionThere were significantly different HBPs among subjects with different anteroposterior skeletal classes, breathing modes, and age cohorts. Moreover, C3-Me, and H-EB were significant predictors and correlated with increased likelihood of being MB subject.

Assessment of Nasal Breathing Using Lip Taping: A Simple and Effective Screening Tool

Objectives: Subjective assessment of nasal obstruction with patient-reported outcome measures such as visual analogue scale and NOSE score may be limited in chronic mouth breathing subjects who are not consciously aware of nasal breathing difficulties. This study investigates a simple objective screening tool to assess the capacity for comfortable nasal breathing that is based on sealing the lips and mouth with tape and assessing whether the subject can breathe comfortably through the nose for up to three minutes. Method: Cross-sectional, multi-center cohort study with 663 participants (ages: 3-83 years, 50.5% female). Lips were gently sealed using MicroPore paper tape; timer was used to assess how long the participants were able to breathe comfortably through the nose for up to 180 seconds. Other measures included subjective rating of perceived difficulty with nasal breathing (VAS, 0-100) as well as self-assessed reports of mouth breathing. Results: There were 9.3% of patients with subjective reports of moderate to severe nasal obstruction (VAS> 50) and 17.2% of patients with predominance of self-reported mouth breathing in this series. Overall, 93.4% of participants successfully passed the nasal breathing test. Among patients with habitual mouth breathing, 83.5% (91/109) were able to breathe comfortably through the nose when instructed to do so for the entire 3-minute duration tested. Similarly, there were 67% (40/59) patients with VAS score >50 who could breathe comfortably through the nose for >180 seconds despite subjective reports of moderate to severe nasal obstruction. Participants unable to breathe exclusively through the nose for 180 seconds had increased likelihood of mouth breathing while awake (OR 4.12, 95% confidence interval 2.14-7.89, p<.0001) as well as increased odds of mouth breathing while asleep (OR 3.05, 95% confidence interval 1.61-5.72, p=0.0003). Conclusion: Objectively testing whether a subject can breathe through the nose with the lips and mouth taped for three minutes can identify patients at risk of mouth breathing and is a simple and effecting screening tool to distinguish organic nasal obstruction from functional mouth breathing habit and or nasal resistance.

Salivary Markers and Microbial Flora in Mouth Breathing Late Adolescents.

Objective This is a 6-month observational case-control study that aims to estimate plaque index (PI), salivary flow, buffering capacity of saliva, and specific Streptococcus mutans (S. mutans) and Lactobacillus rates in a mouth breathing late adolescents sample, after a professional oral hygiene procedure and home oral hygiene instructions. Subjects and Methods A sample of 20 mouth breathing late adolescents/young adults (average: 19.2 ± 2.5; range: 18–23 years) and a matched control group of nose breathing subjects (average: 18.3 ± 3.2; range 18–23 years) were included in the study. All the participants were subjected to a professional oral hygiene procedure and appropriate home oral hygiene instructions (t0). After three months (t1) and six months (t2), the PI, salivary flow, buffering capacity of saliva, and S. mutans and Lactobacilli rates were recorded. Results The mean buffering capacity of saliva and the salivary flow rate showed no significant difference between the two groups, all over the observational period. For PI, a significantly higher mode (score 1 of PI) was observed in the study group at t1 (score 0 = 35% of subjects; score 1 = 60%; score 2 = 5%) and t2 (score 1 = 65% of subjects, score 2 = 35%), with respect to control group. Furthermore, mouth breathing subjects show a significant 4 times higher risk to develop S. mutans CFU > 105 (CI lower limit: 0.95; CI upper limit: 9.48; chi-square: 4.28; p = 0.03), with respect to the control subjects. Conclusions Mouth breathing late adolescents show a significantly higher risk to develop S. mutans CFU > 105 and an increased level of PI. Interceptive orthodontic treatments in growing subjects, like palatal expansion, are encouraged to improve the nasal air flow. In older subjects, orthodontic treatments should be performed with removable appliances like clear aligners, in order to allow a better oral hygiene level.

Postural alterations and pulmonary function of mouth-breathing children

Mouth-breathing children have changes in their stomatognathic system, which result in head projection, stress increase in the scapular belt muscles and postural adaptations. Although thoracic shape and posture can influence ventilatory dynamics, we didn't find studies addressing pulmonary function of mouth-breathing children.Aimsthis study aimed at analyzing the posture of mouth-breathing children, and studying the existence of correlations between posture and pulmonary volumes.Material and Methodsprospective, observational and cross-sectional study, where the posture and pulmonary function of 17 mouth-breathing children and of 17 nasal-breathing children were evaluated by means of photogrammetry and forced spirometry.Resultswhen compared to nasal-breathing, mouth-breathing subjects presented an increment in head projection and cervical lordosis, forwarded gravity center and reduced pulmonary volumes. There was an association between head projection and forced vital capacity, and between postural alterations and age.Conclusionmouth-breathing children have postural alterations which increases with age and also reduced spirometry values. The vital capacity reduction correlates negatively with head projection.

Pharyngeal airway volume and its relationship to the facial morphology in nasal breathing and mouth breathing subjects (A comparative computerized tomography study)

The value of lateral cephalometric radiographs to evaluate the pharyngeal airway is limited because it provided 2-dimensional (2D) images of complex 3-dimensional (3D) anatomic structures. Three dimensional analyses of the airway volumes are required to understand oral and pharyngeal adaptations in mouth breathing and nasal breathing subjects. The aim of this study was to measure the pharyngeal airway volume and the size of the face, then compare between pharyngeal airway volume in mouth breathing and nasal breathing subjects and find the gender difference in each group, also to study the relation between pharyngeal airway volume and the size of the face. Material and Methods: Fifty patients including 28 males and 22 females with an age ranged between 18-35 years suffered from clinical symptoms of nasal obstruction and mouth breathing was detected by otolaryngolog ist and sent to be imaged by Brilliance™ 64, Philips multi-detector computed tomography. Twenty normal subjects (10 males and 10 females) were selected as control. Angular and linear variables were measured in addition to the size of the face and the pharyngeal airway volume. Results: A statistically significant relationship between the pharyngeal airway volume and the mode of respiration and between pharyngeal airway volume and genders were detected. The pharyngeal airway volume was larger in nasal breathers than in mouth breathers and it was larger in males than in females. The size of the face was larger in males than females. Conclusion: CT volumetric images provide more reliable and accurate information for measurement of the pharyngeal airway volume, so the changes in the pharyngeal airway volume can be studied before and after surgery and this will aid in selection of the best treatment option in addition to control the relapse after orthodontic treatment with mouth breathing patients. Keyword: Pharyngeal airway volume, size of the face, mouth breathing, computerized tomography. (J Bagh Coll

Palatal surface and volume in mouth-breathing subjects evaluated with three-dimensional analysis of digital dental casts-a controlled study.

To compare the anatomical characteristics of the maxillary arch, identified as palatal surface area and volume, between mouth-breathing and nose-breathing subjects using a three-dimensional (3D) analysis of digital dental casts. Twenty-one Caucasian subjects (14 females and 7 males) with a mean age of 8.5 years [standard deviation (SD) 1.6 years] were selected according to the following criteria: mouth-breathing pattern due to allergic rhinitis, early mixed dentition, skeletal Class I relationship, and pre-pubertal stage of cervical vertebral maturation. This study group (SG) was compared with a control group (CG) of 17 nose-breathing subjects (9 females and 8 males, mean age: 8.5 years; SD: 1.7 years). For each subject, initial dental casts were taken and the upper arch was scanned using a 3D laser scanner. On each digital model, 3D measurements were performed to analyse maxillary arch morphology. Between-group differences were tested with the independent sample Student's t-test (P < 0.05). In mouth-breathing subjects, changes in physiological function of the upper respiratory tract resulted in skeletal adaptations of the maxillary arch. In the SG, both palatal surface area and volume were significantly smaller when compared with values of the CG. In particular, the palatal surface area and palatal volume were, respectively, 13.5 and 27.1 per cent smaller in the SG when compared to the CG. Subjects with prolonged mouth breathing showed a significant reduction of the palatal surface area and volume leading to a different development of the palatal morphology when compared with subjects with normal breathing pattern.

Qualidade de vida em sujeitos respiradores orais e oronasais

OBJETIVO: investigar a qualidade de vida de sujeitos com respiração oral ou oronasal. MÉTODO: compuseram a amostra 49 voluntários, distribuídos em dois grupos: grupo de respiradores orais com 24 sujeitos e grupo de respiradores oronasais com 25 sujeitos, com faixa etária ente 18 e 38 anos de idade, de ambos os sexos. O protocolo utilizado foi o WHOQOL-BREF (versão em português) e o registro e análise dos dados foi realizado pelo sistema Statistical Analysis System. RESULTADOS: os resultados obtidos foram submetidos aos testes de qui-quadrado de Mantel-Haenszele análise de variância. A qualidade de vida dos respiradores mistos se revelou inferior nos domínios ambiental, físico e psicológico em relação aos respiradores orais. CONCLUSÃO: com a detecção das diferenças obtidas, o estudo chama a atenção para a necessidade de aprofundar investigações sobre o perfil dos respiradores oronasais e sua relevância. Para que condutas como desconsiderar o grupo de respiradores oronasais ou agrupá-los como respiradores orais não sejam adotadas de forma inadequada.

Relação da postura cervical e oclusão dentária em crianças respiradoras orais

OBJETIVO: avaliar e comparar a postura de cabeça e pescoço e a relação com a classe oclusal, entre crianças respiradoras orais e respiradoras nasais. MÉTODOS: realizou-se um estudo observacional, de corte transversal em que participaram 110 crianças divididas em Grupo I: respiradoras nasais e Grupo II: respiradoras orais. Para avaliação da respiração utilizou-se o teste do vapor no espelho e água na boca, e exame clínico intra-oral para classificação oclusal de Angle. A análise da postura foi realizada por meio de fotogrametria e o software Alcimage® para mensuração do ângulo pré-definido pelos pontos Processo Espinhoso da sétima vértebra cervical, Manúbrio do Esterno e Ápice do Mento. Os dados obtidos foram tabulados e submetidos à análise estatística, utilizando o programa SPSS 12.0, num intervalo de confiança de 95%. RESULTADOS: foi possível observar valores significativamente maiores do ângulo cervical para o Grupo II (96,59º±8,79) quando comparado ao Grupo I (86,60º±8,53) (p&lt;0,001). As crianças respiradoras orais apresentaram oclusão classe II de Angle (p&lt;0,05). Os participantes classe II apresentaram maior ângulo cervical, diferindo estatisticamente dos pacientes classe I (p&lt;0,05). CONCLUSÃO: existe relação entre respiração oral, alteração na postura da cabeça e pescoço e oclusão classe II de Angle nas crianças estudadas, sendo a anteriorização da cabeça a alteração mais evidente em crianças respiradoras orais.

Electromyographic activity evaluation and comparison of the orbicularis oris (lower fascicle) and mentalis muscles in predominantly nose- or mouth-breathing subjects

The objective of this study was to evaluate and compare the electromyographic (EMG) activity of the orbicularis oris--lower fascicle (LOO) muscle and the mentalis muscle (MT)--in predominantly nose-breathing (PNB) and mouth-breathing (PMB) subjects. Thirty-four subjects, 22 PNB and 12 PMB, with Class II Division 1 malocclusions were evaluated in 2001 (T1) and again in 2004 (T2), 2 years 5 months later. The age ranges of the sample were 11 years to 14 years 11 months at T1, and 13 years 4 months to 16 years 6 months at T2. EMG activity was recorded with bipolar surface electrodes at rest and during 12 movements; data were processed and normalized by the EMG highest value. The Student t test and the Mann-Whitney nonparametric test were used to compare the mean values and the variables between the observation times. Greater EMG activity of the MT was observed in the PMB group at rest and swallowing at T1 and T2. At T2, increased EMG activity of the LOO at blowing and pronunciation of the phoneme \b\ was observed as well as a greater increment of EMG activity of this muscle at blowing, pronunciation of the phoneme \m\, and chewing in the PMB group. In addition, greater EMG activity of the MT at chewing in the PMB group was observed at T2. These results suggest that mouth breathing influences EMG activity of the LOO and MT muscles.

Rinometria acústica em crianças submetidas à disjunção maxilar

OBJETIVO: este estudo foi realizado na Disciplina de Otorrinolaringologia Pediátrica da Escola Paulista de Medicina - UNIFESP, com o objetivo de verificar o comportamento da disjunção maxilar e sua influência na cavidade nasal em crianças de 7 a 8 anos de idade submetidas à rinometria acústica. METODOLOGIA: foram avaliadas 20 crianças respiradoras bucais, portadoras de atresia maxilar diagnosticada clinicamente e submetidas à avaliação objetiva da cavidade nasal pré-disjunção maxilar e pós-disjunção maxilar por meio de rinometria acústica, analisando-se os resultados das áreas transversais mínimas (MCA1 e MCA2) e volumes nasais (VOL1 e VOL2). RESULTADOS: os resultados de MCA1 e MCA2 pré-disjunção maxilar apresentaram-se menores que os valores de MCA1 e MCA2 pós-disjunção maxilar do lado esquerdo; à direita, a MCA1 pré-disjunção maxilar mostrou-se menor que a MCA1 pós-disjunção maxilar, aumentos estes estatisticamente significantes, já os VOL1 e VOL2 pré-disjunção foram menores que o VOL1 e VOL2 pós-disjunção maxilar em ambos os lados, ou seja, os resultados desta diferença foram estatisticamente significantes. CONCLUSÃO: a rinometria acústica é um método objetivo para avaliar a variação da cavidade nasal. A disjunção maxilar promove um aumento significante da área e volume da cavidade nasal.

Mouth breathing in allergic children: Its relationship to dentofacial development

While there are many claims that abnormal breathing patterns alter facial growth, there are limited controlled data to confirm this. We evaluated forty-five North American Caucasians of both sexes, ranging in age from 6 to 12 years. Thirty chronically allergic mouth-breathing subjects were selected from a pediatric allergy practice, and fifteen nonallergic nose breathers were selected from a general pediatric practice. Each subject underwent an intraoral clinical examination and a cephalometric radiograph analysis. Various skeletal and dental relationships were evaluated for statistical differences related to mode of breathing and age. The upper anterior facial height and the total anterior facial height were significantly larger in the mouth breathers. Angular relationships of the sella-nasion, palatal, and occlusal planes to the mandibular plane were greater in the mouth breathers, and their gonial angles were larger. The mouth breathers' maxillae and mandibles were more retrognathic. Palatal height was higher, and overjet was greater in the mouth breathers. Maxillary intermolar width was narrower in the mouth breathers and was associated with a higher prevalence of posterior cross-bite. Over all, mouth breathers had longer faces with narrower maxillae and retrognathic jaws. This supports previous claims that nasal airway obstruction is associated with aberrant facial growth. Longitudinal studies are needed to evaluate the effectiveness of early intervention in preventing these growth alterations.

Regional deposition of 2.5–7.5 μm diameter inhaled particles in healthy male non-smokers

Airborne monodisperse particles in the size range 2.5–7.5 μm dia., labelled with 99mTc, were systematically administered to mouth breathing subjects under different but predetermined breathing patterns ranging from 0.5–2.01, tidal volume and 10–25 breaths/min. The subjects were all healthy, non-smoking males. Measurements were made of both total and regional deposition. The results show the increasing significance of pulmonary deposition as the particle size decreases and consequently the importance of accurate data in this range for the purposes of radiological protection. Both total and regional deposition are a function of the impaction parameter ( D 2 F) suggesting that inertial impaction is the main mechanism of deposition under the conditions studied. The work supports the predicted values of deposition given in the lung model of the International Commission on Radiological Protection. Subsidiary experiments showed the value of faecal sampling in establishing the accuracy of total deposition estimates and in elucidating full regional deposition.