Analysıng of the effects of adenoıd hypertrofy on maksıllofacıal development by objectıve fotographıc analysıs

The deformities in the dental arc and facial skeleton by adenoid hypertrofy due to cronic mouth breathing is a well-known process. Most of the related studies have been based on cephalometric analyses. Ninety-seven children having different degrees of adenoid age between 4-12 (48 boy,49 girl) and ninety cases age between 4-12 (54 boy,36 girl) having no adenoid tissue were studied by clinical history, physical examination including endoscopy and standardized clinical photographs. Sixteen distances and eight angles were measured on the anterior and lateral standardized clinical photographs for each cases.The assessment of the linear and angular measurements on the clinical photographs showed a statistically significant increase in the distances between nasion-tip, nasion-subnasale and the angles between tragion-angle of mandible and gnathion (upper goniac angle), nasion-angle of mandible and gnathion (lower goniac angle), frankfort horizontal line-gnathion and angle of mandible in the group having higher thickness of adenoids compared with controls. And a significant decrease in the angle beetween tragion-nasion and pogonion in the group having higher thickness of adenoids compared with controls. Results were paralel to the past cephalometric studies in literature. There was no difference in age and gender between groups.The children, we studied, were asked for snoring, sleep apnea, daytime sleepiness, school performance, mouth breathing during sleep, smoking in parents and restlessness during sleep to their parents. We compared two groups of children according to these complaints they have or not. There were statistically significant high ratio of snoring, sleep apnea, daytime sleepiness, restlessness during sleep smoking in parents and a lower school performance in the group having higher thickness of adenoids compared with controls.The aim of this study was to detect the presence of skeletal deformities on the soft tissue by analysing distances and angles on the photographs.In conclusion the analyses showed a significant increase in size of one third of middle face and increase in the anterior face height and decrease in the posterior face height and also increase in the craniomandibuler plane angle and a retropositioned and posterior rotated mandible due to higher thickness of adenoids.Key words: Adenoid hypertrophy, mouth breathing, cephalometry, photographic analyse, facial morphology, dental morphology