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Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Research

Effect of breathing patterns on mandibular cortical bone quality in children and establishment of a preliminary screening model

Authors: Gaoli Wang, Badr Sultan Saif, Bo Cheng, Hongfei Li, Yutong Li, Jiawen Liu, Xiaoyong Ren, Rui Zou, Fei Wang

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Objective

This retrospective study analyzed breathing patterns and age subgroups effect on cortical bone quality of the mandible in growing subjects, aiming to explore the application value of facial skeletal pattern combined with cortical bone density detection in early screening diagnosis of mouth breathing.

Methods

One hundred twenty-six participants were divided into four groups: mouth breathing group (7–9, 10–12 years old) and nasal breathing group (7–9, 10–12 years old). The mandibular anterior, middle, and posterior cortical bone mineral density (CBMD), cortical bone width (MCW), ANB, and FMA values were measured. Independent T-test and Mann–Whitney U test were used to compare the measured values. Binary logistic regression was employed to analyze the correlation between measured variables and the children’s breathing patterns. ROC analysis was used to determine the ability of the cortical bone density measurements in early screening diagnosis of MB.

Results

Mouth breathing had a negative impact on CBMD and MCW of the pre-mandibular (Pog) in subjects aged 7–9 years and also impacted the development of (Pog) and submandibular (Me) sites in subjects aged 10–12 years. Older children in the nasal breathing group have higher CBMD, MCW, and SNB values and lower FMA values. Single-factor and multiple-factor logistic binary regression analysis showed that FMA, MSPogCBMD, MSPogMCW, and ANB are correlated factors for children at risk of mouth breathing.

Conclusion

Mouth breathing pattern is closely associated with decreased mandibular CBMD and MCW values in children aged 7–12, where the anterior (Pog) and inferior (Me) sites of anterior mandible are more significantly affected. Furthermore, in combination with facial skeletal pattern, it provides a basis for the early warning diagnosis of mouth breathing.
Literature
1.
go back to reference Huang P, Cai B, Zhou C, Wang W, Wang X, Gao D, Bao B. Contribution of the mandible position to the facial profile perception of a female facial profile: an eye-tracking study. Am J Orthod Dentofacial Orthop. 2019;156(5):641–52.CrossRefPubMed Huang P, Cai B, Zhou C, Wang W, Wang X, Gao D, Bao B. Contribution of the mandible position to the facial profile perception of a female facial profile: an eye-tracking study. Am J Orthod Dentofacial Orthop. 2019;156(5):641–52.CrossRefPubMed
2.
go back to reference Knigge RP, McNulty KP, Oh H, Hardin AM, Leary EV, Duren DL, Valiathan M, Sherwood RJ. Geometric morphometric analysis of growth patterns among facial types. Am J Orthod Dentofacial Orthop. 2021;160(3):430–41.CrossRefPubMedPubMedCentral Knigge RP, McNulty KP, Oh H, Hardin AM, Leary EV, Duren DL, Valiathan M, Sherwood RJ. Geometric morphometric analysis of growth patterns among facial types. Am J Orthod Dentofacial Orthop. 2021;160(3):430–41.CrossRefPubMedPubMedCentral
3.
go back to reference Fraga WS, Seixas VM, Santos JC, Paranhos LR, César CP. Mouth breathing in children and its impact in dental malocclusion: a systematic review of observational studies. Minerva Stomatol. 2018;67(3):129–38.PubMed Fraga WS, Seixas VM, Santos JC, Paranhos LR, César CP. Mouth breathing in children and its impact in dental malocclusion: a systematic review of observational studies. Minerva Stomatol. 2018;67(3):129–38.PubMed
4.
go back to reference Muñoz ICL, Orta PB. Comparison of cephalometric patterns in mouth breathing and nose breathing children. Int J Pediatr Otorhinolaryngol. 2014;78(7):1167–72.CrossRef Muñoz ICL, Orta PB. Comparison of cephalometric patterns in mouth breathing and nose breathing children. Int J Pediatr Otorhinolaryngol. 2014;78(7):1167–72.CrossRef
5.
go back to reference Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La Torre G, Deli R. Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngol Ital. 2016;36(5):386.CrossRefPubMedPubMedCentral Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La Torre G, Deli R. Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngol Ital. 2016;36(5):386.CrossRefPubMedPubMedCentral
6.
go back to reference Rakosi T, Schilli W. Class III anomalies: a coordinated approach to skeletal, dental, and soft tissue problems. J Oral Surg. 1981;39(11):860–70.PubMed Rakosi T, Schilli W. Class III anomalies: a coordinated approach to skeletal, dental, and soft tissue problems. J Oral Surg. 1981;39(11):860–70.PubMed
7.
go back to reference Eimar H, Al-Saleh M, Cortes AR, Gozal D, Graf D, Flores-Mir C. Sleep-disordered breathing is associated with reduced mandibular cortical width in children. JDR Clin Trans Res. 2019;4(1):58–67.PubMed Eimar H, Al-Saleh M, Cortes AR, Gozal D, Graf D, Flores-Mir C. Sleep-disordered breathing is associated with reduced mandibular cortical width in children. JDR Clin Trans Res. 2019;4(1):58–67.PubMed
8.
go back to reference FernandesFagundes NC, d’Apuzzo F, Perillo L, Puigdollers A, Gozal D, Graf D, Heo G, Flores-Mir C. Potential impact of pediatric obstructive sleep apnea on mandibular cortical width dimensions. J Clin Sleep Med. 2021;17(8):1627–34.CrossRef FernandesFagundes NC, d’Apuzzo F, Perillo L, Puigdollers A, Gozal D, Graf D, Heo G, Flores-Mir C. Potential impact of pediatric obstructive sleep apnea on mandibular cortical width dimensions. J Clin Sleep Med. 2021;17(8):1627–34.CrossRef
9.
go back to reference Jurczyszyn K, Kubasiewicz-Ross P, Nawrot-Hadzik I, Gedrange T, Dominiak M, Hadzik J. Fractal dimension analysis a supplementary mathematical method for bone defect regeneration measurement. Ann Anat. 2018;219:83–8.CrossRefPubMed Jurczyszyn K, Kubasiewicz-Ross P, Nawrot-Hadzik I, Gedrange T, Dominiak M, Hadzik J. Fractal dimension analysis a supplementary mathematical method for bone defect regeneration measurement. Ann Anat. 2018;219:83–8.CrossRefPubMed
10.
go back to reference Stratemann SA, Huang JC, Maki K, Hatcher DC, Miller AJ. Evaluating the mandible with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2010;137(4):S58–70.CrossRefPubMed Stratemann SA, Huang JC, Maki K, Hatcher DC, Miller AJ. Evaluating the mandible with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2010;137(4):S58–70.CrossRefPubMed
11.
go back to reference Berco M, Rigali PH Jr, Miner RM, DeLuca S, Anderson NK, Will LA. Accuracy and reliability of linear cephalometric measurements from cone-beam computed tomography scans of a dry human skull. Am J Orthod Dentofacial Orthop. 2009;136(1):17. e11-17. e19.CrossRef Berco M, Rigali PH Jr, Miner RM, DeLuca S, Anderson NK, Will LA. Accuracy and reliability of linear cephalometric measurements from cone-beam computed tomography scans of a dry human skull. Am J Orthod Dentofacial Orthop. 2009;136(1):17. e11-17. e19.CrossRef
12.
go back to reference Pandis N. Sample calculations for comparison of 2 means. Am J Orthod Dentofacial Orthop. 2012;141(4):519–21.CrossRefPubMed Pandis N. Sample calculations for comparison of 2 means. Am J Orthod Dentofacial Orthop. 2012;141(4):519–21.CrossRefPubMed
13.
go back to reference Giotakis AI, Tomazic PV, Riechelmann H, Vent J. Objective assessment of nasal patency. Facial Plast Surg. 2017;33(04):378–87.CrossRefPubMed Giotakis AI, Tomazic PV, Riechelmann H, Vent J. Objective assessment of nasal patency. Facial Plast Surg. 2017;33(04):378–87.CrossRefPubMed
14.
go back to reference Harari D, Redlich M, Miri S, Hamud T, Gross M. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope. 2010;120(10):2089–93.CrossRefPubMed Harari D, Redlich M, Miri S, Hamud T, Gross M. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope. 2010;120(10):2089–93.CrossRefPubMed
15.
go back to reference Gousman J, Park JH, Chae JM. Evaluating mandibular symphysis bone density according to various skeletal patterns with CBCT. Orthod Craniofac Res. 2021;24(1):70–7.CrossRefPubMed Gousman J, Park JH, Chae JM. Evaluating mandibular symphysis bone density according to various skeletal patterns with CBCT. Orthod Craniofac Res. 2021;24(1):70–7.CrossRefPubMed
16.
go back to reference Calciolari E, Donos N, Park J, Petrie A, Mardas N. Panoramic measures for oral bone mass in detecting osteoporosis: a systematic review and meta-analysis. J Dent Res. 2015;94(3_suppl):17S-27S.CrossRefPubMedPubMedCentral Calciolari E, Donos N, Park J, Petrie A, Mardas N. Panoramic measures for oral bone mass in detecting osteoporosis: a systematic review and meta-analysis. J Dent Res. 2015;94(3_suppl):17S-27S.CrossRefPubMedPubMedCentral
17.
go back to reference Han M, Wang RY, Liu H, Zhu XJ, Wei FL, Lv T, Wang NN, Hu LH, Li GJ, Liu DX. Association between mandibular posterior alveolar morphology and growth pattern in a Chinese population with normal occlusion. J Zhejiang Univ Sci B. 2013;14:25–32.CrossRefPubMedPubMedCentral Han M, Wang RY, Liu H, Zhu XJ, Wei FL, Lv T, Wang NN, Hu LH, Li GJ, Liu DX. Association between mandibular posterior alveolar morphology and growth pattern in a Chinese population with normal occlusion. J Zhejiang Univ Sci B. 2013;14:25–32.CrossRefPubMedPubMedCentral
18.
go back to reference Hong H, Hosomichi J, Maeda H, Ishida Y, Usumi-Fujita R, Yoshida KI, Ono T. Selective β2-adrenoceptor blockade rescues mandibular growth retardation in adolescent rats exposed to chronic intermittent hypoxia. Front Physiol. 2021;12:676270.CrossRefPubMedPubMedCentral Hong H, Hosomichi J, Maeda H, Ishida Y, Usumi-Fujita R, Yoshida KI, Ono T. Selective β2-adrenoceptor blockade rescues mandibular growth retardation in adolescent rats exposed to chronic intermittent hypoxia. Front Physiol. 2021;12:676270.CrossRefPubMedPubMedCentral
19.
go back to reference Swanson CM, Shea SA, Stone KL, Cauley JA, Rosen CJ, Redline S, Karsenty G, Orwoll ES. Obstructive sleep apnea and metabolic bone disease: insights into the relationship between bone and sleep. J Bone Miner Res. 2015;30(2):199–211.CrossRefPubMed Swanson CM, Shea SA, Stone KL, Cauley JA, Rosen CJ, Redline S, Karsenty G, Orwoll ES. Obstructive sleep apnea and metabolic bone disease: insights into the relationship between bone and sleep. J Bone Miner Res. 2015;30(2):199–211.CrossRefPubMed
20.
go back to reference Vidal-Manyari PA, Arriola-Guillén LE, Jimenez-Valdivia LM, Dias-Da Silveira HL, Boessio-Vizzotto M. Effect of the application of software on the volumetric and cross-sectional assessment of the oropharyngeal airway of patients with and without an open bite: a CBCT study. Dent Med Probl. 2022;59:397–405.CrossRefPubMed Vidal-Manyari PA, Arriola-Guillén LE, Jimenez-Valdivia LM, Dias-Da Silveira HL, Boessio-Vizzotto M. Effect of the application of software on the volumetric and cross-sectional assessment of the oropharyngeal airway of patients with and without an open bite: a CBCT study. Dent Med Probl. 2022;59:397–405.CrossRefPubMed
21.
go back to reference Boening K, Wieckiewicz M, Paradowska-Stolarz A, Wiland P, Shiau YY. Temporomandibular disorders and oral parafunctions: mechanism, diagnostics, and therapy. BioMed Res Int. 2015;2015:354759. Boening K, Wieckiewicz M, Paradowska-Stolarz A, Wiland P, Shiau YY. Temporomandibular disorders and oral parafunctions: mechanism, diagnostics, and therapy. BioMed Res Int. 2015;2015:354759.
22.
go back to reference Raff H, Bruder E, Jankowski B, Colman R. Effect of neonatal hypoxia on leptin, insulin, growth hormone and body composition in the rat. Horm Metab Res. 2001;33(03):151–5.CrossRefPubMed Raff H, Bruder E, Jankowski B, Colman R. Effect of neonatal hypoxia on leptin, insulin, growth hormone and body composition in the rat. Horm Metab Res. 2001;33(03):151–5.CrossRefPubMed
23.
go back to reference Song L, Liang X, Zhou Y. Estrogen-mimicking isoflavone genistein prevents bone loss in a rat model of obstructive sleep apnea-hypopnea syndrome. Int J Clin Exp Pathol. 2014;7(4):1687.PubMedPubMedCentral Song L, Liang X, Zhou Y. Estrogen-mimicking isoflavone genistein prevents bone loss in a rat model of obstructive sleep apnea-hypopnea syndrome. Int J Clin Exp Pathol. 2014;7(4):1687.PubMedPubMedCentral
24.
go back to reference Kim JE, Man PP, Jang S, Yi HK. Nasal obstruction promotes alveolar bone destruction in the juvenile rat model. J Dent Sci. 2022;17(1):176–83.CrossRefPubMed Kim JE, Man PP, Jang S, Yi HK. Nasal obstruction promotes alveolar bone destruction in the juvenile rat model. J Dent Sci. 2022;17(1):176–83.CrossRefPubMed
25.
go back to reference Wang X, Cao Y, Liu Z, Wang Z, Chu X, Wang L, Hu X, Zhao H, Diao Z, Peng F. Alveolar bone density reduction in rats caused by unilateral nasal obstruction. Balkan Med J. 2019;36(6):311.PubMedPubMedCentral Wang X, Cao Y, Liu Z, Wang Z, Chu X, Wang L, Hu X, Zhao H, Diao Z, Peng F. Alveolar bone density reduction in rats caused by unilateral nasal obstruction. Balkan Med J. 2019;36(6):311.PubMedPubMedCentral
26.
go back to reference Hosomichi J, Kuma YI, Oishi S, Nagai H, Maeda H, Usumi-Fujita R, Shimizu Y, Kaneko S, Shitano C, Suzuki JI. Intermittent hypoxia causes mandibular growth retardation and macroglossia in growing rats. Am J Orthod Dentofacial Orthoped. 2017;151(2):363–71.CrossRef Hosomichi J, Kuma YI, Oishi S, Nagai H, Maeda H, Usumi-Fujita R, Shimizu Y, Kaneko S, Shitano C, Suzuki JI. Intermittent hypoxia causes mandibular growth retardation and macroglossia in growing rats. Am J Orthod Dentofacial Orthoped. 2017;151(2):363–71.CrossRef
27.
go back to reference Lekvijittada K, Hosomichi J, Maeda H, Hong H, Changsiripun C, Kuma YI, Oishi S, Suzuki JI, Yoshida KI, Ono T. Intermittent hypoxia inhibits mandibular cartilage growth with reduced TGF-β and SOX9 expressions in neonatal rats. Sci Rep. 2021;11(1):1140.CrossRefPubMedPubMedCentral Lekvijittada K, Hosomichi J, Maeda H, Hong H, Changsiripun C, Kuma YI, Oishi S, Suzuki JI, Yoshida KI, Ono T. Intermittent hypoxia inhibits mandibular cartilage growth with reduced TGF-β and SOX9 expressions in neonatal rats. Sci Rep. 2021;11(1):1140.CrossRefPubMedPubMedCentral
28.
go back to reference Wang X, Sun H, Zhu Y, Tang Y, Xue X, Nie P, Zhu M, Wang B. Bilateral intermittent nasal obstruction in adolescent rats leads to the growth defects of mandibular condyle. Arch Oral Biol. 2019;106:104473.CrossRefPubMed Wang X, Sun H, Zhu Y, Tang Y, Xue X, Nie P, Zhu M, Wang B. Bilateral intermittent nasal obstruction in adolescent rats leads to the growth defects of mandibular condyle. Arch Oral Biol. 2019;106:104473.CrossRefPubMed
29.
go back to reference Moss ML. The functional matrix hypothesis of mechanotransduction. 1997. Moss ML. The functional matrix hypothesis of mechanotransduction. 1997.
30.
go back to reference Zhao M, Han M, Habumugisha J, Mohamed AS, Bu W, Guo Y, Zou R, Wang F. Electromyographic activities of the jaw and facial muscles in subjects with different vertical skeletal patterns and breathing modes. J Oral Rehabil. 2023:50(5):351–9. Zhao M, Han M, Habumugisha J, Mohamed AS, Bu W, Guo Y, Zou R, Wang F. Electromyographic activities of the jaw and facial muscles in subjects with different vertical skeletal patterns and breathing modes. J Oral Rehabil. 2023:50(5):351–9.
31.
go back to reference Dastan F, Ghaffari H, Shishvan HH, Zareiyan M, Akhlaghian M, Shahab S. Correlation between the upper airway volume and the hyoid bone position, palatal depth, nasal septum deviation, and concha bullosa in different types of malocclusion: a retrospective cone-beam computed tomography study. Dent Med Probl. 2021;58(4):509–14.CrossRefPubMed Dastan F, Ghaffari H, Shishvan HH, Zareiyan M, Akhlaghian M, Shahab S. Correlation between the upper airway volume and the hyoid bone position, palatal depth, nasal septum deviation, and concha bullosa in different types of malocclusion: a retrospective cone-beam computed tomography study. Dent Med Probl. 2021;58(4):509–14.CrossRefPubMed
Metadata
Title
Effect of breathing patterns on mandibular cortical bone quality in children and establishment of a preliminary screening model
Authors
Gaoli Wang
Badr Sultan Saif
Bo Cheng
Hongfei Li
Yutong Li
Jiawen Liu
Xiaoyong Ren
Rui Zou
Fei Wang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03406-z

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