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Case report, or case study

Vol. 23 No. 2 (2021)

Interdisciplinary stomatognathic and postural assessment in a pediatric mouth-breathing patient: A case report

DOI
https://doi.org/10.22267/rus.212302.229
Submitted
August 28, 2019
Published
2021-04-30

Abstract

Introduction: Oral respiration is associated with speech organs disorders, which are generally combined with facial deformities and dental occlusion problems. Objective: To conduct an interdisciplinary assessment of the physiology of the stomatognathic and postural system in a 11-year old mouth-breathing patient. Case presentation: The male subject underwent orofacial examination using myoscanography, dynamometry, electromyography, Payne technique, and Rosenthal test. Postural alignment, stability (Romberg index) and plantar pressures (baropodometry) were evaluated. Results: The subject displayed: class I malocclusion; hyperdivergent maxillary hypoplasia, and micrognathism in muscular activity; a 34% asymmetry index in masseters during mastication; the symmetry in temporals was 67% and 62% during protrusion; alteration of the static stability with a Romberg index of 1.22; and 42.2% and 57.8% plantar pressure distributions in the left and right feet, respectively. Conclusions: The subject showed a reduction in orofacial muscle strength activity, alterations in the alignment of the head, shoulders and pelvic region, an alteration of the static stability, and plantar pressures with a greater distribution on the bilateral hindfoot and right lower limb. 

References

  1. Barros J, Becker H, Pinto J. Evaluation of atopy among mouth-breathing pediatric patients referred for treatment to a tertiary care center. J Pediatr (Rio J). 2006;82(6):458–64. Disponible en: https://doi.org/10.2223/jped.1561
  2. Marques-Felcar J, Rafael-Bueno I, Silva-Massan AC, Pereira-Torezan R, Rosa-Cardozo J. Prevalence of mouth breathing in children from an elementary school. Cien Saude Colet. 2010;15(2):427–35. Disponible en: https://doi.org/10.1590/s1413-81232010000200020
  3. Korbmacher H, Eggers-Stroeder G, Koch L, Kahl-Nieke B. Correlation between anomalies of the dentition and pathologies of the locomotor system: a literature review. J Orofac Orthop. 2004;65(3):190-203. Disponible en: https://doi.org/10.1007/s00056-004-0305-3
  4. Arthur J, NowaK J, Christensen T, Mabry J, Twsend M. Oral Habits. Pediatr Dent. 2019;386–93.
  5. Chambi-Rocha A, Cabrera-Domínguez ME, Domínguez-Reyes A. Breathing mode influence on craniofacial development and head posture. J Pediatr (Rio J). 2018;94(2):123–30. Disponible en: https://doi.org/10.1016/j.jped.2017.05.007
  6. Leal R, Gomes M, Granville-García A, Goes P, de Menezes V. Impact of breathing patterns on the quality of life of 9- to 10-year-old schoolchildren. Am J Rhinol Allergy. 2016;30(5):147–52. Disponible en: https://doi.org/10.2500%2Fajra.2016.30.4363
  7. Sano M, Sano S, Oka N, Yoshino K, Kato T. Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study. Neuroreport. 2013;24(17):935–40. Disponible en: https://doi.org/10.1097/wnr.0000000000000008
  8. ASG (GESIDA) of the SS of ID, Microbiology C, the National AIDS Plan. Executive summary of the GESIDA/National AIDS Plan Consensus Document on Antiretroviral Therapy in Adults Infected by the Human Immunodeficiency Virus (Updated January 2017). Enferm Infecc Microbiol Clin. 2018;36(7):435–45. Disponible en: https://doi.org/10.1016/j.eimc.2017.04.001
  9. D´Onofrio L. Oral dysfunction as a cause of malocclusion. Orthod Craniofac Res. 2019;22(Suppl 1):43–8. Disponible en: https://doi.org/10.1111/ocr.12277
  10. Thomé-Pacheco MC, Santos-Fiorott B, Silveiia-Finck N, Martins de Araújo MT. Craniofacial changes and symptoms of sleep-disordered breathing in healthy children. Dent Press J Orthod. 2015;20(3):80–7. Disponible en: https://doi.org/10.1590/2176-9451.20.3.080-087.oar
  11. Franco L, Souki B, Cheib P, Abrão M, Pereira T, Becker H, et al. Are distinct etiologies of upper airway obstruction in mouth-breathing children associated with different cephalometric patterns? Int J Pediatr Otorhinolaryngol. 2015;79(2):223–8. Disponible en: https://doi.org/10.1016/j.ijporl.2014.12.013
  12. Lee S-Y, Guilleminault C, Chiu H-Y, Sullivan S. Mouth breathing, “nasal disuse,” and pediatric sleep-disordered breathing. Sleep Breath. 2015;19(4):1257–64. Disponible en: https://doi.org/10.1007/s11325-015-1154-6
  13. Trevisan ME, Bellinaso JH, de Bitencourt-Pacheco A, Barrios-Augé L, Toniolo da Silva AM, Rodrigues-Correa E. Respiratory mode, nasal patency and palatine dimensions. CoDAS. 2015;27(2):201–6. Disponible en: https://doi.org/10.1590/2317-1782/20152014177
  14. Milanesi J, Borin G, Rodrigues-Corrêa E, Toniolo da Silva AM, Bortoluzzi D, Souza J. Impact of the mouth breathing occurred during childhood in the adult age: biophotogrammetric postural analysis. Int J Pediatr Otorhinolaryngol. 2011;75(8):999–1004. Disponible en: https://doi.org/10.1016/j.ijporl.2011.04.018
  15. de Moura Milanesi J, Berwig LC, Marquezan M, Schuch LH, de Moraes A, Toniolo da Silva AM, et al. Variables associated with mouth breathing diagnosis in children based on a multidisciplinary assessment. Codas. 2018;30(4):e20170071. Disponible en: https://doi.org/10.1590/2317-1782/20182017071
  16. Abreau R, Rocha R, Lamounier J, Marques-Guerra AF. Etiology, clinical manifestations and concurrent findings in mouth breathing children. J Pediatr (Rio J). 2008;84(6):529–35. Disponible en: https://doi.org/10.2223/jped.1844
  17. Thomé-Pacheco MC, Ferreira-Casandrade C, Pacheco-Teixeira L, Finck N, Martins-de Araujo MT. Guidelines proposal for clinical recognition of mouth breathing children. Dent Press J Orthod. 2015;20(4):39–44. Disponible en: https://doi.org/10.1590/2176-9451.20.4.039-044.oar
  18. Wieler W, Barros A, Barros L, Camargo S, Ignacio S, Maruo H, et al. A combined protocol to aid diagnosis of breathing mode. Rev Clín Pesq Odontol. 2007;3(2):101–14. Disponible en: https://periodicos.pucpr.br/index.php/oralresearch/article/view/23107
  19. Diouf J, Diallo B, Diop-Ba K, Badiane A, Ngom P, Sonko O, et al. Relationships between the obstructive character of the tonsils and the type of ventilation and lip posture. Int Orthod. 2018;16(2):349–60. Disponible en: https://doi.org/10.1016/j.ortho.2018.03.007
  20. Tiemi-Okuro R, Moreno-Morcillo A, Sakano E, Santos-Schivinski CI, Gonclaves-Oliveira MA, Ribeiro J. Exercise capacity, respiratory mechanics and posture in mouth breathers. Braz j otorhinolaryngol. 2011;77(5):656–62. Disponible en: https://doi.org/10.1590/s1808-86942011000500020
  21. Ikenaga N, Yamaguchi K, Daimon S. Effect of mouth breathing on masticatory muscle activity during chewing food. J Oral Rehabil. 2013;40(6):429-35. Disponible en: https://doi.org/10.1111/joor.12055
  22. Kawamura Y. Physiology of Mastication. Front Oral Biol Basel, Karger. 1974;1:121–58.
  23. Silvestrini-Biavati A, Salamone S, Silvestrini-Biavati F, Agostino P, Ugolini A. Anterior open-bite and sucking habits in Italian preschool children. Eur J Paediatr Dent. 2016;17(1):43–6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26949238/
  24. Fiala M. Open bite and interdental sigmatism. Stomatol DDR. 1989;39(4):238–52. Disponible en: https://pubmed.ncbi.nlm.nih.gov/2623721/
  25. Balaguer-García R. Valoración de un método de posturografía estática con pruebas dinámicas para evaluar funcionalmente pacientes vestibulares en edad laboral y su relación con el índice de discapacidad. Valencia; 2012. Universidad de Valencia. Disponible en: https://roderic.uv.es/bitstream/handle/10550/25455/TD%20RAMON%20BALAGUER%20GARCIA.pdf?sequence=1
  26. De-Moya P, Bertomeu B, Broseta V. Evaluacion y rehabilitacion del equilibrio mediante posturografia. Rehabilitación. 2005;39(6):315–23. Disponible en: https://doi.org/10.1016/S0048-7120(05)74365-6
  27. Huo F. Limits of stability and postural sway in young and older people; 1999. Ontario: University of Queens. Disponible en: https://www.collectionscanada.gc.ca/obj/s4/f2/dsk1/tape9/PQDD_0005/MQ42635.pdf
  28. Basmajian JV. Electromyography--dynamic gross anatomy: a review. Am J Anat. 1980;159(3):245-60. Disponible en: https://doi.org/10.1002/aja.1001590302
  29. Ferrario V, Sforza C, Miani A, D´Addona A, Barbini E. Electromyographic activity of human masticatory muscles in normal young people. Statistical evaluation of reference values for clinical applications. J Oral Rehabil. 1993;20(3):271–80. Disponible en: https://doi.org/10.1111/j.1365-2842.1993.tb01609.x
  30. Ortiz F, Rincón R, Mendoza J. Texto de medicina fisica y rehabilitacion. Bogota: Editorial Menual Moderno; 2016.
  31. Ono T, Ishiwata Y, Kuroda T. Inhibition of masseteric electromyographic activity during oral respiration. American Journal of Orthodontics and Dentofacial Orthopedics. 1998;113(5):518-25. Disponible en: http://www.duttondds.com/wp-content/uploads/2014/02/Ono-1998-AJODO-113-518-25.pdf
  32. Hsu H-Y, Yamaguchi K. Decreased chewing activity during mouth breathing. J Oral Rehabil. 2012;39(8):559–67. Disponible en: https://doi.org/10.1111/j.1365-2842.2012.02306.x
  33. Cuccia A, Lotti M, Caradonna D. Oral Breathing and head posture. Angle Orthod. 2008;78(1):77–82. Disponible en: https://doi.org/10.2319/011507-18.1
  34. da Silveira W, de Queiroz F, Silva F, Silveira SL. Postural alterations and pulmonary function of mouth breathing children. Braz J Otorhinolaryngol. 2010;76(6):683–6. Disponible en: https://doi.org/10.1590/S1808-86942010000600002
  35. Neiva P, Kirkwood R, Mendes P, Zabjek K, Becker H, Mathur S. Postural disorders in mouth breathing children: a systematic review. Braz J Phys Ther. 2018;22(1):7–19. Disponible en: https://doi.org/10.1016/j.bjpt.2017.06.011
  36. Yi L, Jardim J, Inoue D, PIgnatari S. The relationship between excursion of the diaphragm and curvatures of the spinal column in mouth breathing children. J Pediatr (Rio J). 2008;84(2):171–7. Disponible en: https://doi.org/10.2223/jped.1771
  37. Martínez-Nova A, Sanchez-Rodríguez, R. Cuevas-García J, Sanchez-Barrado E. Estudio baropodométrico de los valores de presión plantar en pies no patológicos. Rehabilitacion. 2007;41(4):155–60. Disponible en: https://medes.com/publication/36012
  38. Tafner BN. Analise estabilometrica da influencia da oclusao na postura ortostatica. Blumenau: Universidade Regional de Blumenau; 2010. Disponible en: https://bu.furb.br//docs/mo/2011/345311_1_1.pdf

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