Impact of adenotonsillectomy on the dentofacial development of obstructed children: a systematic review and meta-analysis.

Autor:	Becking BE; Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands.; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Division Clinical Methods and Public Health, University of Amsterdam, Faculty of Medicine (AMC), The Netherlands., Verweij JP; Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands., Kalf-Scholte SM; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Division Clinical Methods and Public Health, University of Amsterdam, Faculty of Medicine (AMC), The Netherlands.; Stichting Bijzondere Tandheelkunde, Amsterdam, The Netherlands., Valkenburg C; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Division Clinical Methods and Public Health, University of Amsterdam, Faculty of Medicine (AMC), The Netherlands., Bakker EWP; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Division Clinical Methods and Public Health, University of Amsterdam, Faculty of Medicine (AMC), The Netherlands., van Merkesteyn JPR; Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk:	angličtina
Zdroj:	European journal of orthodontics [Eur J Orthod] 2017 Oct 01; Vol. 39 (5), pp. 509-518.
DOI:	10.1093/ejo/cjx005
Abstrakt:	Background: Dentofacial deformities frequently require orthodontic treatment. Understanding of preventable risk factors is essential for reducing treatment need. Upper airway obstruction (for example due to hypertrophic adenoids and/or tonsils) has been hypothesized to be a risk factor. Objectives: This systematic review aimed to reflect the contemporary evidence on the risk of obstruction by hypertrophic adenoids and/or tonsils, by assessing the dentofacial changes after adeno- and/or tonsillectomy. Search Methods: A systematic search of electronic databases and manual searches of grey literature and reference lists of relevant studies was performed. Selection Criteria: No restrictions were placed on publication language. Experimental, cohort, and case-control studies were eligible for inclusion. Studies reporting associations between treatment of adenoid and/or tonsil hypertrophy and dentofacial deformities in children were included. Adenoidectomy and/or tonsillectomy were performed in all patients; outcomes were assessed before and after surgery. Data Collection and Analysis: Data were extracted by two independent reviewers in duplicate. The Cochrane Risk of Bias tool was used to assess the methodological quality of the included papers. Results: The initial search yielded 1196 papers, of which 16 articles could be included. All papers described controlled prospective cohort studies, reporting on a total of 461 patients and controls (mean age, 4.1-13.9 years). A descriptive and quantitative synthesis of dentofacial change postoperatively is presented. Consistent findings across studies were the normalisation towards labial inclination of the upper and lower incisors and towards a more horizontal mandibular growth pattern. No change in vertical or sagittal maxillary growth was reported after surgical treatment. Post-surgical increase in maxillary archwidth and decrease in lateral crossbite-frequency were consistently reported. Findings on overjet, overbite and angle from S to N to B (SNB-angle), mandibular arch width, and gonial angle were inconsistent. Conclusion: The available literature suggests that treatment of hypertrophic adenoids and/or tonsils affects dentofacial deformity. This could indicate a relationship between nasopharyngeal obstruction (i.e. upper airway obstruction) and the dentofacial growth pattern. However, the high risk of bias and considerable diversity between studies impedes a clear conclusion regarding this effect. Registration: None. (© The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com)
Databáze:	MEDLINE
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