Early Intervention for Mouth Breathing in Mixed Dentition Period using Ortho-Trainer: A Case Report

Sanka Sri Meghana; Kavitha Ramar1

1

Publication Date: 2024/06/22

Abstract: This case report presents the successful correction of mouth breathing and Class II malocclusion in a mixed dentition phase using an Ortho-Trainer. The treatment aimed at improving airway function, dental alignment, and overall facial aesthetics. This case report describes the successful treatment of an 8-year-old female patient with mouth breathing and Class II malocclusion using an Ortho-Trainer during the mixed dentition phase. The patient presented with chronic nasal congestion, increased lower facial height, lip incompetence, a Class II molar relationship, proclined upper incisors. Radiographic analysis confirmed a Class II skeletal pattern with a retrognathic mandible. The treatment plan involved addressing the nasal obstruction through an ENT referral and habit-breaking strategies to encourage nasal breathing, followed by fitting the patient with an Ortho-Trainer to correct dental malocclusion and improve jaw alignment. Over the course of a year, the patient showed significant improvement. Within the first three months, there was a noticeable reduction in overjet and improved nasal breathing. By six months, the patient predominantly exhibited nasal breathing, with a reduction in overjet to 3 mm and improved dental alignment. At the 12-month mark, the patient achieved a Class I molar relationship with an overjet of 2 mm, along with enhanced facial aesthetics and balanced facial proportions.

Keywords: No Keywords Available

DOI: https://doi.org/10.38124/ijisrt/IJISRT24JUN088

PDF: https://ijirst.demo4.arinfotech.co/assets/upload/files/IJISRT24JUN088.pdf

REFERENCES

  1. Dhull KS, Verma T, Dutta B. Prevalence of deleterious oral habits among 3- to 5-year-old preschool children in Bhubaneswar, Odisha, India. Int J Clin Pediatr Dent. (2018) 11:210–3. 10.5005/jp-journals-10005-1513
  2. Felcar JM, Bueno IR, Massan AC, Torezan RP, Cardoso JR. Prevalence of mouth breathing in children from an elementary school. Cien Saude Colet. (2010) 15:437–44. 10.1590/S1413-81232010000200020
  3. 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) 36:386–94. 10.14639/0392-100X-770 
  4. Galeotti A, Festa P, Viarani V, D'Anto V, Sitzia E, Piga S, et al.. Prevalence of malocclusion in children with obstructive sleep apnoea. Orthod Craniofac Res. (2018) 21:242–7. 10.1111/ocr.12242
  5. Pereira TC, Furlan R, Motta AR. Relationship between mouth breathing etiology and maximum tongue pressure. Codas. (2019) 31:e20180099. 10.1590/2317-1782/20182018099
  6. Azevedo ND, Lima JC, Furlan R, Motta AR. Tongue pressure measurement in children with mouth-breathing behaviour. J Oral Rehabil. (2018) 45:612–7. 10.1111/joor.12653
  7. Markkanen S, Niemi P, Rautiainen M, Saarenpaa-Heikkila O, Himanen SL, Satomaa AL, et al.. Craniofacial and occlusal development in 25-year-old children with obstructive sleep apnoea syndrome. Eur J Orthod. (2019) 41:316–21. 10.1093/ejo/cjz009
  8. Tang H, Liu Q, Lin JH, Zeng H. Three-dimensional morphological analysis of the palate of mouth-breathing children in mixed dentition. Hua Xi Kou Qiang Yi Xue Za Zhi. (2019) 37:389–93. 10.7518/hxkq.2019.04.009.
  9. Fraga WS, Seixas VM, Santos JC, Paranhos LR, Cesar CP. Mouth breathing in children and its impact in dental malocclusion: a systematic review of observational studies. Minerva Stomatol. (2018) 67:129–38. 10.23736/S0026-4970.18.04015-3
  10. Chung Leng Munoz I, Beltri Orta P. Comparison of cephalometric patterns in mouth breathing and nose breathing children. Int J Pediatr Otorhinolaryngol. (2014) 78:1167–72. 10.1016/j.ijporl.2014.04.046
  11. Freitas B, Freitas H, Dos Santos PC, et al. Correction of Angle Class II division 1 malocclusion with a mandibular protraction appliances and multiloop edgewise archwire technique. Korean J Orthod 2014; 44: 268–277. DOI: 10.4041/kjod.2014.44.5.268.
  12. Kalha AS. Early orthodontic treatment reduced incisal trauma in children with class II malocclusions. Evid Based Dent 2014; 15: 18–20. DOI: 10.1038/sj. ebd.6400986.
  13. Li X, Wang H, Li S, et al. Treatment of a Class II Division 1 malocclusion with the combination of a myofunctional trainer and fixed appliances. Am J Orthod Dentofacial Orthop 2019; 156: 545–554. DOI: 10.1016/j.ajodo.2018.04.032.
  14. Tallgren A, Christiansen RL, Ash M Jr, et al. Effects of a myofunctional appliance on orofacial muscle activity and structures. Angle Orthod 1998; 68: 249–258. DOI: 0.1043/0003-3219(1998)0682.3.Co;2.
  15. Usumez S, Uysal T, Sari Z, et al. The effects of early preorthodontic trainer treatment on Class II, division 1 patients. Angle Orthod 2004; 74: 605–609. DOI: 10.1043/0003-3219(2004)0742.0.Co;2.
  16. Uysal T, Yagci A, Kara S, et al. Influence of pre-orthodontic trainer treatment on the perioral and masticatory muscles in patients with Class II division 1 malocclusion. Eur J Orthod 2012; 34: 96–101. DOI: 10.1093/ejo/ cjq169.