iDentistry The Journal Volume 14 No 2 | Page 44

The Journal It was proposed (Birte Melson) that the influence of deviation in swallowing and respiratory pattern depends on interaction 35 between genetic and environmental factors . A study was done by Nancy Ung in 1990 to quantitatively assess respiratory patterns and their effects on dentofacial development in 49 subjects ranging from 10-16 yrs. Comparisons of measured breathing modes and dentofacial characteristics revealed a weak tendency among mouth breathers toward a Class II skeletal pattern and retroclination of maxillary 36 and mandibular incisors. A research (Luc Tourne; 1990) on long face syndrome and impairment of nasopharyngeal airway showed that the switch from a nasal to an oronasal breathing pattern induces functional adaptations that include an increase in total anterior face height and vertical development of the lower anterior face. It was also found that individual variations in response should be expected from the alteration of a long 37 face syndrome patient's breathing mode . Studies were done to assess the amount of maxillary and mandibular growth and the direction of maxillary growth after the adenoidectomy (Donald Woodside). No difference was detected in the direction of maxillary growth between the one who had undergone adenoidectomy and the controls. But the amount of mandibular and maxillary growth was significantly greater in 38 adenoidectomy group . Studies by Frcke et al (1993) tried to relate nasal airway, lip competence and craniofacial morphology and concluded that there was no relationship between open mouth posture and obstructed airways. It was shown that some patients show an open mouth posture even though the nasal airway adequacy was 39 normal . A study (Ceylan Oktay; 1996) was done on the pharyngeal size in different skeletal patterns. 43 Lateral cephalometric headfilms of subjects with different ANB angles were taken. It had been observed that two measurements, hy (most superior and anterior point on body of hyoid bone) - apw4 (anterior pharyngeal wall along line intersecting cv4ia and hy) and oropharynx area measurements, were affected by the change of ANB angle and two other measurement, t-ppw (t-Dorsal tongue surface intersecting occlusal plane, ppw. Posterior pharyngeal wall intersecting occlusal plane) and hy-apw2 (apw2: Anterior pharyngeal wall along line intersecting cv2ia and hy) measurements, by the sex; and that hy-apw4 measurement and oropharynx area became smaller with the increase of ANB angle 58 . Brilliant literature was given regarding the soft tissue growth of the oropharynx. In general, two periods of accelerated change (6-9 yrs and 12- 15 yrs) and two periods of quiescence (9-12 yrs and 15-18 yrs) were identified for pharyngeal 40 soft tissue (Taylor Nelson; 1996) . Various authors (Trotman, McNamara, Dibbets; 1997) studied the association of lip posture, sagittal airway size and tonsil size separately with facial morphology under selected cephalometric measures. They observed that open lip posture, reduced sagittal airway and large tonsils were each associated statistically with a characteristic but different skeletal configuration. This association was proportional. It was concluded that lip posture, sagittal airway size and tonsil size represent three different and unrelated phenomenons with respect to their effects on craniofacial growth and form 41 . A cephalometric study was done by Eung Kwon Pal, Ravindra Nanda in 1997 to establish relation between pharyngeal length and open bite. A cephalometric variable, vertical airway length (VAL) was used and it concluded that pharyngeal length may be a convenient indicator to diagnose open bite 42 . Vol. 14 No. 2 May-August 2018