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rev port estomatol med dent cir maxilofac . 2017;58(4):199-204 201

Materials and methods Results
The present cross-sectional observational study was devel- The mean age of the 1002 children enrolled in the study was 6.7
oped at the Oral Respiratory Outpatient Center of the Hospi- ± 2.7 years, ranging from 1.4 to 12.9 years. The original sample
tal das Clínicas in the Federal University of Minas Gerais, lacked some data, which lead to a final number different from
Brazil, and was approved by its Ethics Committee. One thou- the total number of observed subjects. Table 1 shows the preva-
sand and two patients consecutively admitted to the Center lence of the studied variables according to gender. There were
from November 2002 to December 2015 enrolled the study. no statistically significant differences between boys and girls.
All patients had been referred by pediatricians and primary According to Table 1, 58.3% (n=516) of children were in the mixed
care physicians due to a mouth-breathing problem and were dentition, and 41.7% (n=369) were in the deciduous dentition. In
evaluated by a multidisciplinary team (otorhinolaryngolo- the sagittal plane, class I malocclusion was the most frequently
gists, pediatric allergists, orthodontists, speech therapists found condition in boys (46.7%) and girls (48.5%), followed by
and physiotherapists) in the same day. The patients’ clinical class II malocclusion (30.8% in the entire sample). More than
history included oral breathing complaints for at least three half of the oral breathing sample presented a normal relation-
months, an open-mouth posture during the day and/or the ship between upper and lower jaws in the sagittal (59.3%, n=548),
night, and snoring and sleep apnea in some cases. Oral transversal (75.1%, n=699) and vertical (53.0%, n=488) planes.
breathing was confirmed in the presence of at least one of Tonsil obstruction grades III and IV were found in 41.3% of the
the following airway pathologies: obstructive tonsillar hy- children, adenoid obstruction equal to or higher than 75% was
perplasia, obstructive adenoidal hyperplasia and allergic found in 54.1%, and allergic rhinitis was found in 68.0%.
rhinitis. The children who were not diagnosed with obstruc- Table 2 shows the prevalence of different variables stud-
tion caused by one of these conditions were classified as ied, according to deciduous or mixed dentition. Tonsillar hy-
functional mouth breathers. 13
The clinical examination was complemented with a fiber
nasopharyngoscopy using a 3.2-mm flexible nasopharyn- Table 1. Prevalence of dental and ear nose and throat
go-laryngoscope (Machida ENT-30PIII). Through clinical exam- findings according to gender
ination and fiber nasopharyngoscopy, the patients’ upper
airways were classified as non-obstructed or obstructed. Up- Variables Males Females Total
per airway obstruction was diagnosed when 75% or more of n % n % n %
the nasopharynx was occupied by adenoids and/or when ton- Stage of development (n=885)
sils were classified with grades III or IV according to the cri- Deciduous dentition 219 43.2 150 39.7 369 41.7
17
teria of Brodsky and Kock. The diagnosis of allergic rhinitis Mixed dentition 288 56.8 228 60.3 516 58.3
was performed by allergological assessment, which included Total 507 100.0 378 100.0 885 100.0
a structured medical interview and a physical examination Sagittal relationship (n=923)
using the standard volar forearm skin prick method for the Normal 63 11.9 47 11.9 110 11.9
common aeroallergens. 18 Class I malocclusion 247 46.7 191 48.5 438 47.4
A team of orthodontists, who were previously calibrated, Class II malocclusion 163 30.8 121 30.7 284 30.8
Class III malocclusion
56 10.6 35 8.9 91 9.9
performed the dental clinical examination. Vertical relation- Total 529 100.0 394 100.0 923 100.0
ships were classified as normal, as anterior deep bite when
more than half of the lower incisors were overlapped by the Vertical relationship (n=921) 281 52.9 207 53.1 488 53.0
Normal
incisal edges of the upper incisors or as anterior open bite Deep bite 82 15.5 55 14.1 137 14.9
when no overbite was observed, regardless of the amount can Open bite 168 31.6 128 32.8 296 32.1
be removed. In the transversal plane, the relationship was Total 531 100.0 390 100.0 921 100.0
classified as normal, as posterior crossbite without a man- Transversal relationship (n=931)
dibular functional shift or as posterior crossbite with a man- Normal 416 78.0 283 71.1 699 75.1
dibular functional shift. In the sagittal plane, the occlusion Posterior crossbite w/o shift 76 14.3 67 16.8 143 15.4
was classified as normal, as class I malocclusion, as class II Posterior crossbite w/ shift 41 7.7 48 12.1 89 9.5
533 100.0 398 100.0 931 100.0
Total
malocclusion or as class III malocclusion. In deciduous and
mixed dentitions, a class I dental relationship was considered Tonsils status (n=990)
when the upper deciduous canine cuspid was set between Grades 0, I, II 348 61.5 233 55.0 581 58.7
218 38.5 191 45.0 409 41.3
Grades III, IV
the lower deciduous canine and the first deciduous molar. Total 566 100.0 424 100.0 990 100.0
Syndromic children and children with permanent dentition
were excluded. Adenoid obstruction status (n=942) 269 49.6 163 40.8 432 45.9
<75%
Statistical analysis was performed with the SPSS software, ≥75% 273 50.4 237 59.2 510 54.1
version 12.0. The independent ear nose and throat (ENT) vari- Total 542 100.0 400 100.0 942 100.0
ables were the grade of tonsils and adenoids obstruction and Rhinitis (n=870)
the presence of allergic rhinitis. The dependent variables were Yes 349 70.4 243 65.0 592 68.0
class II, anterior open bite and posterior crossbite. Descriptive No 147 29.6 131 35.0 278 32.0
statistics and bivariate analysis were performed with the chi- Total 496 100.0 374 100.0 870 100.0
square test, with a significance level of p < 0.05. Number of children (n) and prevalence given in percentage (n/N X100)