The influence of different tonsillar hypertrophy types on dentofacial and craniofacial development in children with mixed dentition.

Ciao-Syuan Cai, Huimin Li, Yanmei Huang, Baozhen Luo, Xuepeng Chen

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Article in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Ciao-Syuan Cai *Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China.

Huimin Li *Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China.

Yanmei HuangStomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China.

Baozhen Luo *Department of Otolaryngology-Head and Neck Surgery, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310022, P. R. China. baozhen.luo@shulan.com.

Xuepeng Chen *Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China. cxp1979@zju.edu.cn.

Funding

Fundamental Research Funds for the Central Universities 2023QZJH60Key Program of Zhejiang Provincial Natural Science Foundation LZ25H140001Research and Development Project of Stomatology Hospital Zhejiang University School of Medicine RD2022DLYB03

6 · The paper itself

Abstract

objectivesTo evaluate the effects of different subtypes of tonsillar hypertrophy on dentofacial and craniofacial development in children during the mixed dentition stage, and to preliminarily explore associated craniofacial growth trends.

methodsA total of 275 children in the mixed dentition stage were retrospectively recruited from two hospitals between August 2023 and July 2024. Tonsillar hypertrophy was assessed using the Brodsky and Baroni methods, and patients were categorized by airway obstruction type: mild (Group A), transverse (Group B), anteroposterior (Group C), or combined (Group D). Anterior occlusion, sagittal skeletal classification, and lateral cephalometric parameters (Jarabak analysis) were recorded and compared across groups.

resultsGroups C and D were found to have significantly higher rates of anterior crossbite (16.67% and 21.77%) and skeletal Class III malocclusion (30.95% and 34.01%) compared to Groups A (0.00%, 2.78%) and B (0.00%, 6.00%) (p < 0.05). Subgroup D2 (severe combined obstruction) demonstrated the most pronounced skeletal Class III features, as evidenced by a higher mean SNB angle (78.75° ± 3.92), a lower ANB angle (- 0.03° ± 3.65), and pronounced mandibular prognathism. Both dental and skeletal compensatory changes were most evident in the combined obstruction group, indicating a significant degree of craniofacial imbalance (p < 0.05).

conclusionsAnteroposterior tonsillar hypertrophy is strongly associated with anterior crossbite and skeletal Class III development, primarily through mandibular advancement and rotational growth adaptations. Transverse obstruction has minimal skeletal impact, whereas combined obstruction of multiple directions exacerbates dentoskeletal compensation. These findings highlight the directional influence of upper airway obstruction on craniofacial morphology in growing children and underscore the importance of early interdisciplinary evaluation.

Indexed as

Dentition, MixedMaxillofacial DevelopmentPalatine TonsilAirway ObstructionCephalometryChildFemaleHumansHypertrophyMaleMalocclusionMalocclusion, Angle Class IIIRetrospective StudiesAnterior crossbiteCephalometric analysisChild craniofacial growth and developmentMalocclusionTonsillar hypertrophy

Identifiers

PMID41316242

DOI10.1186/s12903-025-07350-y

PMCPMC12683797

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.