Effects of mouth breathing on facial skeletal development in children: a systematic review and meta-analysis

Abstract Background Mouth breathing is closely related to the facial skeletal development and malocclusion. The purpose of this systematic review meta-analysis was assess effect mouth on malocclusion in children. Methods An electronic search PubMed, Cochrane Library, Medline, Web Science, EMBASE Sigle through February 23rd, 2020, conducted. Inclusion criteria were children under 18 years age with maxillofacial deformities due breathing. risk bias nonrandomized studies interventions (ROBINS-I) tool for controlled clinical trials. Grading Recommendation, Assessment, Development Evaluation (GRADE) approach used quality assessment. included indicators SNA, SNB, ANB, SN-OP, SN-PP, PP-MP, SNGoGn, MP-H, 1-NA, 1. NA, NB, 1-NB, Overjet, Overbite, SPAS, PAS, C3-H. Data concerning mean difference mesial molar movement extent canine retraction extracted statistical analysis. differences 95% confidence intervals analyzed continuous data. Review Manager 5.3, synthesize various parameters associated impact Results Following full-text evaluations eligibility, 10 final quantitative synthesis. In Sagittal direction, SNA (MD: − 1.63, P < 0.0001), SNB 1.96, 0.0001) mouth-breathing lower than that nasal-breathing ANB 0.90, NA = 0.009), 1-NA 0.66, 0.004), 1-NB 1.03, showed higher values vertical SN-PP 0.68, 0.0050), SN-OP 3.05, PP-MP 4.92, SNGoGn 4.10, individuals. airway, SPAS 3.48, 0.0009), PAS 2.11, C3-H 1.34, group. Conclusions results mandible maxilla rotated backward downward, occlusal plane steep. addition, presented a tendency labial inclination upper anterior teeth. Airway stenosis common Trial registration [email protected], number CRD42019129198.