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The assessment and treatment by rapid maxillary expansion of 516 cases referred by medical practitioners for the treatment of poor nasal airway is reported. The technique is simple and most suitable for the correction of crossbite and Class III malocclusion and for establishing a nasal airway in habitual mouth breathers with a history of ENT problems.

A group of 15 cases with a history of allergic rhinitis and nasopharyngeal obstruction was selected in order to compare it with another group of equal size without pathological background, to determine, among both groups, the difference of the effects due to nasopharyngeal obstruction on the facial growth. The allergic patients characteristics were a high palate vault, retroinclinable maxillary incisors, increasement of total anterior facial elevation as well as the low third of facial elevation in addition to an augmented maxillary plane. Statistically, only the evaluation of the facial axis yielded a significant result. From a radiologic point of view, the measurement of the nasopharyngeal extent showed no difference although clinically and cephalometrically presented a typical facial growth deviation. Both groups measurements proved no difference mainly due to the fact of having observed but the lateral view x-rays, nontridimensionally. Allergic rhinitis, facial growth, malocclusion.

There is a renewed interest in the relationship between breathing patterns, tongue positions, and orthodontic management of patients with malocclusion. The authors address the effects of these factors on arch-form and occlusal contacts.

It is commonly assumed that nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. Specifically, it has been stated that chronic nasal obstruction leads to mouth breathing, which causes altered tongue and mandibular positions. If this occurs during a period of active growth, the outcome is development of the "adenoid facies" (dentofacial morphology). Such patients characteristically manifest a vertically long lower third facial height, narrow alar bases, lip incompetence, a long and narrow maxillary arch, and a greater than normal mandibular plane angle. These dentofacial traits have repeatedly been attributed to restricted nasorespiratory function. It is generally believed that environmental factors can exert subtle or dramatic effects upon dentofacial morphology, depending upon their magnitude, duration, and time of occurrence. The purpose of this article is to present a critical review of the literature concerning the effect of one such environmental factor, nasal airway function, upon dentofacial morphogenesis. This review will critically examine the most frequently cited papers reporting a relationship between nasorespiratory function and dentofacial morphology. In summary, this critical review fails to support a consistent relationship between obstructed nasorespiratory function and the adenoid facies or long-face syndrome. Additional objective evaluations of this relation are encouraged.

By training, the orthodontist is uniquely qualified to be the primary monitor of facial growth. He should assess the mode of respiration at approximately two years of age and confer with the pediatrician, allergist and otolaryngologist to institute appropriate medical management of any developing problems. He must educate his colleagues in medicine and dentistry to recognize those conditions that can produce facial deformity. The primary care physician should appreciate that obstruction of the nasal airway is an important dysfunction. Medical and surgical intervention and, above all, good preventive management must be instituted to promote patency of the nasal airway. Allergy is a disease of modern man. It is possible that better prenatal care, breastfeeding, the avoidance of common allergens, and appropriate surgical and medical management to reduce the incidence of respiratory obstruction in growing children will result in fewer cases of cleft lip and palate and other craniofacial anomalies.

Recent research, stimulated by the growing awareness of the sleep apnea syndrome, has shown that nasal breathing plays a major role in the regulation of respiration in sleep. These observations are not new; they confirm century-old clinical findings on the importance of nasal breathing in sleep. The earliest account of the deleterious effects of mouth breathing in sleep was made by Lemnious Levinus towards the end of the sixteenth century. Two hundred years later, Catlin dedicated an entire book to the superiority of nasal breathing over mouth breathing in sleep; and in the late 1800's, Cline, Wells, Griffin and others showed that obstructed nasal breathing causes sleep disorders.

The authors refer about an epidemiological survey in 651 children in the school-age. The aim of study is to investigate about the frequency of the bad habits and the pathogenetic relations between these and the development of the dento-maxillo-facial deformities. They point out an incidence of these bad habits in the 35,48% with a predominance of mouth breathers (45,45%). After they discuss the necessity of an early detection of anomalous neuromuscular attitudes.