Electromyographic Muscular Activity Improvement in Class II Patients Treated with the Pre-Orthodontic Trainer

Aims: Review of evidence in support of an oral-facial growth impairment in the development of pediatric sleep apnea in non-obese children. Method: Review of experimental data from infant monkeys with experimentally induced nasal resistance. Review of early historical data in the orthodontic literature indicating the abnormal oral-facial development associated with mouth breathing and nasal resistance. Review of the progressive demonstration of sleep-disordered-breathing (SDB) in children who underwent incomplete treatment of OSA with adenotonsillectomy, and demonstration of abnormal oral-facial anatomy that must often be treated in order for the resolution of OSA. Review of data of long-term recurrence of OSA and indication of oral-facial myofunctional dysfunction in association with the recurrence of OSA. Results:Presentation of prospective data on premature infants and SDB-treated children, supporting the concept of oral-facial hypotonia. Presentation of evidence supporting hypotonia as a primary element in the development of oral-facial anatomic abnormalities leading to abnormal breathing during sleep. Continuous interaction between oral-facial muscle tone, maxillary-mandibular growth and development of SDB. Role of myofunctional reeducation with orthodontics and elimination of upper airway soft tissue in the treatment of non-obese SDB children. Conclusion: Pediatric OSA in non-obese children is a disorder of oral-facial growth. Filename: F.Airway Frontiers in Neurology041.pdf Application of functional orthodontic appliances to treatment of “mandibular retrusion syndrome” — Effective use of the Trainer SystemTM Akira Kanao, Masanori Mashiko, Kosho Kanao Japanese Journal of Clinical Dentistry for Children Abstract: There have recently been an increasing number of parents complaining of their children’s health-related problems other than caries, such as decline in exercise ability, open-mouth posture, slow eating, allergy and misaligned teeth. Indeed, studies have shown increases in the number of children with difficulty masticating hard chewy food or inability to swallow correctly1,2). The decline in oral function is attributed to dietary changes among children in the modern Japanese society including the eating of soft foods at home and elsewhere3,4). It has also been shown that the perioral muscles in growing children influence body posture, respiration, mastication, deglutition, speech and morphology of the jaws and teeth5,6). When it is difficult to breathe through the nose due to, for example, tonsillitis or allergic rhinitis, habitual mouth-breathing is inevitable. Mouth breathing has been shown to adversely affect the morphology of the dental arch and jaw bones7). It causes dryness of oral and pharyngeal mucosa. Dry mucosa is more sensitive and susceptible to inflammation. Inflamed mucosa is more vulnerable to bacterial infection, which in turn aggravates the inflammatory condition. The pharynx gets swollen when inflamed, making the airway narrower. Airway constriction increases breathing difficulty, which induces mouth breathing further. Pharyngeal inflammation caused by mouth breathing spreads to the tonsils. The tonsils have an immunoprotective function, but become a source of infection once infected8). Infected tonsils cause further narrowing of the upper and lower airways. Mouth breathing habit thus has negative impact, particularly on the morphology of the jaws and dental arches in growing children. The morphology of the jaws and dental arches then begins to control function, perpetuating a downward or negative spiral of vicious circle. Pediatric dentists are in a better position to discover this downward spiral through the dental health checkup system they have established and promoted, which will give them a chance not only to help children with dental problems but to collaborate with otorhinolaryngologists, pediatricians and other specialists. Filename: G.Japanese Journal.pdf There have recently been an increasing number of parents complaining of their children’s health-related problems other than caries, such as decline in exercise ability, open-mouth posture, slow eating, allergy and misaligned teeth. Indeed, studies have shown increases in the number of children with difficulty masticating hard chewy food or inability to swallow correctly1,2). The decline in oral function is attributed to dietary changes among children in the modern Japanese society including the eating of soft foods at home and elsewhere3,4). It has also been shown that the perioral muscles in growing children influence body posture, respiration, mastication, deglutition, speech and morphology of the jaws and teeth5,6). When it is difficult to breathe through the nose due to, for example, tonsillitis or allergic rhinitis, habitual mouth-breathing is inevitable. Mouth breathing has been shown to adversely affect the morphology of the dental arch and jaw bones7). It causes dryness of oral and pharyngeal mucosa. Dry mucosa is more sensitive and susceptible to inflammation. Inflamed mucosa is more vulnerable to bacterial infection, which in turn aggravates the inflammatory condition. The pharynx gets swollen when inflamed, making the airway narrower. Airway constriction increases breathing difficulty, which induces mouth breathing further. Pharyngeal inflammation caused by mouth breathing spreads to the tonsils. The tonsils have an immunoprotective function, but become a source of infection once infected8). Infected tonsils cause further narrowing of the upper and lower airways. Mouth breathing habit thus has negative impact, particularly on the morphology of the jaws and dental arches in growing children. The morphology of the jaws and dental arches then begins to control function, perpetuating a downward or negative spiral of vicious circle. Pediatric dentists are in a better position to discover this downward spiral through the dental health checkup system they have established and promoted, which will give them a chance not only to help children with dental problems but to collaborate with otorhinolaryngologists, pediatricians and other specialists. Filename: G.Japanese Journal.pdf The Effect of Mouth Breathing Versus Nasal Breathing on Dentofacial and Craniofacial Development in Orthodontic Patients Doron Harari, DMD; Meir Redlich, DMD; Shalish Miri, DMD; Tachsin Hamud, DMD; Menachem Gross, MD The Laryngoscope Objectives/Hypothesis: To determine the effect of mouth breathing during childhood on craniofacial and dentofacial development compared to nasal breathing in malocclusion patients treated in the orthodontic clinic. Study Design: Retrospective study in a tertiary medical center. Methods: Clinical variables and cephalometric parameters of 116 pediatric patients who had undergone orthodontic treatment were reviewed. The study group included 55 pediatric patients who suffered from symptoms and signs of nasal obstruction, and the control group included 61 patients who were normal nasal breathers. Results: Mouth breathers demonstrated considerable backward and downward rotation of the mandible, increased overjet, increase in the mandible plane angle, a higher palatal plane, and narrowing of both upper and lower arches at the level of canines and first molars compared to the nasal breathers group. The prevalence of a posterior cross bite was significantly more frequent in the mouth breathers group (49%) than nose breathers (26%), (P 1⁄4 .006). Abnormal lip-to-tongue anterior oral seal was significantly more frequent in the mouth breathers group (56%) than in the nose breathers group (30%) (P 1⁄4 .05). Conclusions: Naso-respiratory obstruction with mouth breathing during critical growth periods in children has a higher tendency for clockwise rotation of the growing mandible, with a disproportionate increase in anterior lower vertical face height and decreased posterior facial height. Filename: C.Harari 2010 Laryngoscope 12