Evaluate the Effect of Mouth Breathing on Growth and Development of Facial Bones and Malocclusion in Children: A Systematic Review and Meta-Analysis

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Pouya Asadi, Hooman Amiri, Fatemeh Aghaei, Morteza Rostami Baei


Background and aim:Mouth breathing changes the temporomandibular joint structure and periarticular muscle groups, resulting in regular mouth breathing. This causes malocclusion (often class II malocclusion) as well as changes in the maxillofacial soft and hard tissues, which in turn affects the maxillofacial appearance and development.The present study was performed to evaluate the effect of mouth breathing on growth and development of facial bones and malocclusion in children. 

Method:Databases of PubMed, Scopus, Web of Science, EBSCO and Embase were searched for systematic literature between 2011 to August 2021.  For Data extraction, two reviewers blind and independently extracted data from abstract and full text of studies that included.95% confidence interval for mean differences with fixed effect model and in-variance method were calculated. To deal with potential heterogeneity, random effects were used and I2 showed heterogeneity. Meta-analysis was performed using Stata/MP v.16 software (The fastest version of Stata).

Result:In the initial review, duplicate studies were eliminated and abstracts of 226 studies were reviewed, the full text of 31 studies was reviewed by two authors, finally, seven studies were selected. Mean differences ofANB between Mouth breathing and Nasal Breathingwas 1.34° (MD, 1.34° 95% CI 1.03°, 1.65°). Mean differences of SN-PP, SN-OP, PP-MP and SNGoGNbetween Mouth breathing and Nasal Breathing WERE0.1 (95% CI -1.49, 1.69), 2.72 (95% CI 1.75, 3.70), 4.5 (95% CI 2.16, 6.84), -2.09 (95% CI -2.85, -1.33), respectively.

Conclusion: The present Systematic Review and Meta-Analysis study showed vertical measurement changes were higher and all airway changes were lower in mouth-breathing individuals than in nasal-breathing individuals.

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