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rev port estomatol med dent cir maxilofac . 2017;58(4):199-204 203

transition to mixed dentition stages would be helpful in test- Ethical disclosures
ing these hypotheses.
The prevalence of open bite in the mouth-breathing sam-
ple, including children both in the deciduous and mixed den- Protection of human and animal subjects. The authors
titions, was 32.5% (Table 2). This percentage is in agreement declare that the procedures followed were in accordance with
with the prevalence of open bite in the general Brazilian chil- the regulations of the relevant clinical research ethics com-
dren population, described as between 20.6% and 46.3%. 23,25-27 mittee and with those of the Code of Ethics of the World Med-
On the other hand, the prevalence of open bite reported in ical Association (Declaration of Helsinki).
some reference articles that analyzed only children in mixed
dentition was lower than in our study (12.0% and 20.1%). 28-30 Confidentiality of data. The authors declare that they have
Environmental factors such as non-nutritious sucking habits followed the protocols of their work center on the publication
and mouth breathing act as secondary causes of anterior open of patient data.
bite. However, during mixed and permanent dentitions, these
sucking habits decline in the general population, and this fact Right to privacy and informed consent. The authors declare
could explain the discrepant results. that no patient data appear in this article.
Posterior crossbite was more prevalent in the children in
mixed dentition (25.5%) than deciduous dentition (21.6%).
Transversal dental relationships, although guided by individ- Conflict of interest
ual facial genotype, can be greatly changed by deleterious en-
vironmental factors, and one can expect a higher prevalence The authors have no conflicts of interest to declare.
of transversal problems as growth occurs. In general, our sam-
ple showed 23.9% of crossbite malocclusion. Previous studies
showed a wide variation (8% to 22%) in the presence of cross- references
bite in the general population. 31
rd
Although class II malocclusions (30.8%), anterior open 1. Enlow DH. Facial growth. 3 ed. Philadelphia: Saunders, 1990.
th
bites (32.1%) and posterior crossbites (24.9%) in the present 2. Kenna MA. Nelson textbook of pediatrics, 16 ed.
sample of mouth breathers were high, more than half of Philadelphia, PA: WB Saunders, 2000.
children showed a normal inter-arch relationship on the 3. O’Ryan FS, Gallagher DM, LaBanc JP, Epker BN. The relation
sagittal (59.3%), transversal (75.1%) and vertical (53.0%) between nasorespiratory function and dentofacial
morphology: a review. Am J Orthod.1982;82:403-10.
planes (Table 1). Epigenetic factors such as oral habits or 4. Subtelny JD. Oral respiration: facial maldevelopment and
mouth breathing can act as contributive agents but other corrective dentofacial orthopedics. Angle Orthod.
determinant factors, like heredity, should be involved in 1980;50;147-64.
malocclusion development. 5. Hultcrantz, E Larson M, Hellquist T, Ahqvist-Rastad J,
There were no associations between different types of mal- Svanholm H, Jakobsson OP. The influence of tonsillar
occlusion and adenoid or tonsil obstruction, with or without obstruction and tonsillectomy on facial growth and dental
arch morphology. Int J Pediatr Otorhinol. 1991;22:125-34.
allergic rhinitis, in the mouth breathers studied. Malocclusion 6. Moyers RE, Bookstein FL, Guire KE. The concept of pattern in
development is probably related to individual genetic suscep- craniofacial growth. Am J Orthod.1979;76:136-48.
tibility, even though some authors have reached different con- 7. McNamara, JA. Influence of respiratory pattern on
clusions. 19,32-34 One limitation of this study was the absence of craniofacial growth. Angle Orthod.1981;51:269-300.
a cephalometric analysis, thus not allowing the evaluation of 8. Woodside D, Linder-Aronson S, Lundstrom, A. Mandibular
skeletal problems. On the other hand, a strong point of the and maxillary growth after changed mode of breathing.
Am J Orthod Dent Orthop.1991;100:1-18.
present study was the large number of mouth-breathing pa- 9. Moss ML. The functional matrix: functional cranial
tients evaluated, which helped obtain valid epidemiological components. In: Kraus BS, editors. Vistas in orthodontics.
data. Since no associations were found between upper airway Philadelphia: Lea and Febiger.1962; 85-90.
obstruction or allergic rhinitis and dental malocclusions, with- 10. Tomes CS. On the development origin of the V-shaped
in the limitations of this study, mouth-breathing problems contracted maxilla (1872) in Rubin RM. Mode of respiration
cannot be considered as determinant factors in the develop- and facial growth. Am J Orthod. 1980;78:504-10.
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12. Souki BQ, Lopes PB, Pereira TBJ, Franco LP, Becker HMG,
Oliveira DD. Mouth breathing children and cephalometric
Conclusions pattern: Does the stage of dental development matter? Int J
Pediatr Otorhinol. 2012;76:837-41.
In the present sample, 30.8% of the mouth-breathing children 13. Souki BQ, Pimenta GB, Souki MQ, Franco LP, Becker HM, Pinto
presented class II malocclusion, 32.1% presented anterior JA. Prevalence of malocclusion among mouth breathing
open bite and 24.9% posterior crossbite. No association was children: Do expectations meet reality? Int J Pediatr
Otorhinolaryngol. 2009;73:767-73.
found between the type of obstruction (tonsils, adenoids and 14. Souki MQ, Souki BQ, Franco LP, Becker HMG, Araújo EA.
rhinitis) and the different malocclusions. More than half of Reliability of subjective linear, ratio and area cephalometric
the children presented a normal inter-arch relationship in the measurements in assessing adenoid hypertrophy among
sagittal, transversal and vertical dimensions. different age groups. Angle Orthod.2012;82:1001-7.