Thin-plate spline analysis of craniofacial morphology in subjects with adenoid or tonsillar hypertrophy.

Department of Orthodontics, University of Rome Tor Vergata, Italy.
International journal of pediatric otorhinolaryngology (Impact Factor: 0.85). 02/2011; 75(4):518-22. DOI: 10.1016/j.ijporl.2011.01.010
Source: PubMed

ABSTRACT To compare the skeletal features of subjects with adenoid hypertrophy with those of children with tonsillar hypertrophy using thin-plate spline (TPS) analysis.
A group of 20 subjects (9 girls and 11 boys; mean age 8.4 ± 0.9 years) with adenoid hypertrophy (AG) was compared with a group of 20 subjects (10 girls and 10 boys; mean age 8.2 ± 1.1 years) with tonsillar hypertrophy (TG). Craniofacial morphology was analyzed on the lateral cephalograms of the subjects in both groups by means of TPS analysis. A cross-sectional comparison was performed on both size and shape differences between the two groups.
AG exhibited statistically significant shape and size differences in craniofacial configuration with respect to TG. Subjects with adenoid hypertrophy showed an upward dislocation of the anterior region of the maxilla, a more downward/backward position of the anterior region of the mandibular body and an upward/backward displacement of the condylar region. Conversely, subjects with tonsillar hypertrophy showed a downward dislocation of the anterior region of the maxilla, a more upward/forward position of the anterior region of the mandibular body and a downward/forward displacement of the condylar region.
Subjects with adenoid hypertrophy exhibited features suggesting a more retrognathic mandible while subjects with tonsillar hypertrophy showed features suggesting a more prognathic mandible.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the present study was to evaluate whether or not there are any differences in the dentition between children with enlarged tonsils and those with normal tonsils. A sample of 73 children (33 boys and 40 girls) with enlarged tonsils and with a mean age of 10.1 years was compared with a normal control group, matched for age and sex. Eighteen dentition variables and thirty-two variables in anamnestic, clinical, pharyngeal and postural findings were recorded. Measurements were obtained from lateral skull radiographs and dental casts. Group means were compared. Relationships between variables were studied using simple correlations and multiple stepwise regression analyses. It was found that children with enlarged tonsils had more retroclined lower incisors, more anteriorly positioned upper incisors, smaller overbite, larger overjet, shorter lower dental arches, narrower upper dental arches and an increased frequency of lateral crossbite. Functional and/or morphological disorders, causing an open posture of the mouth, a lowered anterior posture of the tongue and a low position of the hyoid bone are thought to be associated with the differences in the dentition between the two groups. Obstruction of the oropharynx by enlarged tonsils, might be one factor responsible for these dysfunctions.
    The European Journal of Orthodontics 12/1989; 11(4):416-29. · 1.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There are a number of studies in the literature, that associate nasopharyngeal airway obstruction, as a result of adenoid enlargement, to the development of skeletal and dental abnormalities. However, the etiologic role of hypertrophied adenoids and tonsils in developing an aberrant dentofacial growth is not clear, yet. The present investigation attempted to study the incidence of maxillary posterior crossbite and oral habits, in a sample of 120 children, that displayed hypertrophied adenoids with or without enlarged tonsils, and underwent adenoidectomy. An attempt was also made to relate the presence of crossbite to the severity of upper respiratory airway obstruction. The severity of airway obstruction was assessed using radiographic and surgical criteria. A lateral cephalometric radiograph was obtained and studied for each patient. Results indicated, that 47% of the children examined, had developed a posterior crossbite. The presence of crossbite was high in children with severe airway obstruction, particularly in those with hypertrophied adenoids and tonsils. On the contrary, most of the children with a posterior crossbite did not have a history of pacifier or finger sucking. It was also concluded, that the study of a lateral cephalometric radiograph can be a valuable diagnostic method in the evaluation of children with upper airway obstruction.
    The Journal of clinical pediatric dentistry 02/1994; 18(3):197-201. · 0.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: At the present time, it is generally accepted that chronic mouth breathing influences craniofacial growth and development. The objective of this study was to determine the position of the jaw, its growth direction and morphology, and the facial proportions of children with two different etiological factors of mouth breathing, at different age groups. Four groups of mouth breathing children were analyzed by cephalometry. Two groups, ages ranging from 3 to 6 and 7 to 10 years, with respiratory obstruction due to isolated adenoid hypertrophy (AH), and two groups, ages ranging from 3 to 6 and 7 to 10 years, due to adenotonsillar hypertrophy (ATH). No significant differences were observed between mouth breathing children caused either by AH or by ATH in any of the age groups. Only the linear Ar-Go measurement was significantly larger in children with ATH with 7 years or more. The results suggest that the influence of mouth breathing on mandibular growth is poorly related to the etiological factors analyzed. The single difference observed was the lower posterior facial height in children of 7 years of age or more, which was higher in those with ATH than in those with AH.
    International Journal of Pediatric Otorhinolaryngology 04/2005; 69(3):311-7. · 1.35 Impact Factor


Available from
May 15, 2014