Maxillary dentoskeletal changes 1-year after adenotonsillectomy

Objective:To measure the maxillary dentoskeletal and soft tissue changes of severely obstructed mouthbreathing (MB) young children who had their mode of breathing normalized after adenotonsillectomy(T&A), in comparison with a matched group of severely obstructed untreated MB children (CG).Methods:Seventy patients who had an Ear, Nose, and Throat examination (ENT), including flexible nasalendoscopy, to confirm the severe obstruction of the upper airways and the indication of T&A composedthe sample. Cephalograms and dental casts were available from the patient’s orthodontic records. Treat-ment group (TG) and CG included 35 children each. Groups were matched by gender (24 males and 11females in each group), age (TG, 6.7±1.8 years; CG, 6.9±2.3 years), tooth development (TG, 13 primarydentition, 22 mixed dentition; CG, 14 primary dentition, 21 mixed dentition), and skeletal maturationstatus. Records were taken at baseline (T0) and 1-year after T&A (T1) for TG; while CG records were takenwith a 1-year interval. Dentoskeletal measurements were performed in the lateral cephalograms, anddental casts were used to assess the palatal volume and occlusal changes.Results:TG showed a significant increase (503.3 mm3,P<0.001) in the palatal volume (10% of change),while CG palatal volume was stable. No dimensional occlusal changes were detected between T0 andT1 in both groups. Significant downward (point A, 2.1 mm; ANS, 2.1 mm) and forward displacements (pointA, 0.7 mm; ANS, 1 mm) of the anterior region of the maxilla were observed in the TG, but CG presentedonly significant downward displacement (point A, 1.8 mm; ANS, 1.4 mm). The maxillary posterior region(PNS, PTM, and Molar) displaced downward in both groups (P<0.05), however no sagittal change wasfound. The palatal plane inclination was stable in both groups.Conclusions:TG presented significant increase in the palatal volume and in the forward displacementof the maxilla. No other significant maxillary dentoskeletal changes were found.