Correlations Between Skeletal Patterns, Lips, And Maxilla In Children

Mouth breathing is common in children with a multifactorial etiology. Repeated upper airway obstruction may cause pediatric obstructive sleep apnea. Altered vertical facial growth is linked to both obstructive and habitual mouth breathing, different etiologies may yield distinct skeletal patterns and soft tissue/maxillary changes. This study aimed to investigate correlations among skeletal pattern, lip and perioral soft tissues, and maxillary morphology in children. We retrospectively analyzed 256 pediatric patients’ pretreatment lateral cephalograms. Based on the ANB angle, subjects were classified as Class I (Group I), Class II (Group II), or Class III (Group III). Landmarks were measured using Dolphin Imaging software, and analyses employed one-way ANOVA with Bonferroni correction, Kruskal-Wallis, and chi-square tests. The sample included 124 males (48.4%) and 132 females (51.6%). Group III exhibited a significantly larger nasolabial angle and reduced upper lip length compared to Group I. Maxillary convexity varied among groups, with Group III lower and Group II higher than Group I. Additionally, Group III showed greater upper lip thickness, while Group II had a deeper upper lip sulcus and lower Li-B’-Ct measurement than Group I. Pediatric skeletal patterns are associated with specific changes in orofacial soft tissues and maxillary morphology. Class III is linked to increased upper lip thickness and decreased upper lip height, whereas Class II is associated with lower lip protrusion, possibly due to reduced orbicularis oris function. These findings suggest that distinct skeletal patterns may influence soft tissue and maxillary development, warranting further investigation.