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Respiração oral e crescimento craniofacial : evidência atual sobre as estratégias de intervenção precoce
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A respiração oral é uma condição comum em idade pediátrica e está associada a diversas alterações morfológicas e funcionais do complexo craniofacial, como constrição transversal da maxila, mordida cruzada posterior, incompetência labial e postura baixa da língua. Estas alterações comprometem o equilíbrio orofacial e a respiração nasal fisiológica, influenciando negativamente a mastigação, a fonação, o crescimento facial e a estética. Além disso, a respiração oral prolongada tem sido relacionada com distúrbios do sono, défices de atenção e dificuldades cognitivas, afetando de forma significativa o desempenho escolar e a qualidade de vida da criança.
Neste contexto, torna-se essencial ao médico dentista compreender as estratégias atuais de intervenção precoce mais eficazes para cada caso clínico, de modo a melhorar a respiração nasal e orientar o crescimento craniofacial.
Três abordagens têm demonstrado resultados promissores: a expansão maxilar, o tratamento otorrinolaringológico (como a adenoidectomia e a amigdalectomia) e a terapia miofuncional orofacial, frequentemente indicada como complemento após a eliminação da obstrução respiratória.
Durante a infância, a plasticidade óssea e muscular permite corrigir eficazmente as disfunções respiratórias e esqueléticas, contudo, quando o diagnóstico é tardio, as intervenções tornam-se mais complexas e mais invasivas. Assim, o diagnóstico precoce deve ser priorizado, permitindo restabelecer a função respiratória nasal e prevenir deformações craniofaciais persistentes.
O objetivo desta revisão narrativa é analisar a evidência científica disponível sobre a relação entre a respiração oral e o crescimento craniofacial, de forma a compreender como as diferentes estratégias de intervenção precoce podem influenciar o desenvolvimento facial, a função respiratória e a qualidade de vida dos pacientes.
Mouth breathing is a prevalent condition in the pediatric population and is associated with various morphological and functional alterations of the craniofacial complex, such as transverse maxillary constriction, posterior crossbite, lip incompetence, and low resting tongue posture. These alterations compromise orofacial equilibrium and physiological nasal breathing, exerting a negative influence on mastication, phonation, facial growth, and aesthetics. Furthermore, prolonged mouth breathing has been linked to sleep disorders, attention deficits, and cognitive impairments, significantly affecting the child's academic performance and overall quality of life. In this context, it is essential for the dental practitioner to understand the most effective current early intervention strategies for each clinical case, aiming to improve nasal breathing and guide craniofacial growth. Three approaches have demonstrated promising results: maxillary expansion, otorhinolaryngological treatment (such as adenoidectomy and tonsillectomy), and orofacial myofunctional therapy, frequently prescribed as an adjunct following the resolution of airway obstruction. During childhood, skeletal and neuromuscular plasticity allows for the effective correction of respiratory and skeletal dysfunctions; however, when diagnosis is delayed, interventions become increasingly complex and invasive. Therefore, early diagnosis must be prioritized to facilitate the restoration of nasal respiratory function and prevent persistent craniofacial deformities. The objective of this narrative review is to analyze the available scientific evidence regarding the relationship between mouth breathing and craniofacial growth, to understand how different early intervention strategies can influence facial development, respiratory function, and the patients' quality of life.
Mouth breathing is a prevalent condition in the pediatric population and is associated with various morphological and functional alterations of the craniofacial complex, such as transverse maxillary constriction, posterior crossbite, lip incompetence, and low resting tongue posture. These alterations compromise orofacial equilibrium and physiological nasal breathing, exerting a negative influence on mastication, phonation, facial growth, and aesthetics. Furthermore, prolonged mouth breathing has been linked to sleep disorders, attention deficits, and cognitive impairments, significantly affecting the child's academic performance and overall quality of life. In this context, it is essential for the dental practitioner to understand the most effective current early intervention strategies for each clinical case, aiming to improve nasal breathing and guide craniofacial growth. Three approaches have demonstrated promising results: maxillary expansion, otorhinolaryngological treatment (such as adenoidectomy and tonsillectomy), and orofacial myofunctional therapy, frequently prescribed as an adjunct following the resolution of airway obstruction. During childhood, skeletal and neuromuscular plasticity allows for the effective correction of respiratory and skeletal dysfunctions; however, when diagnosis is delayed, interventions become increasingly complex and invasive. Therefore, early diagnosis must be prioritized to facilitate the restoration of nasal respiratory function and prevent persistent craniofacial deformities. The objective of this narrative review is to analyze the available scientific evidence regarding the relationship between mouth breathing and craniofacial growth, to understand how different early intervention strategies can influence facial development, respiratory function, and the patients' quality of life.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Respiração oral Crescimento craniofacial Intervenção precoce Ortodontia intercetiva