Orthod Craniofac Res. 2025 Nov 15. doi: 10.1111/ocr.70061. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aimed to evaluate the association between upper airway obstruction sites and the morphology of lip and perioral soft tissues in paediatric patients.
MATERIALS AND METHODS: Upper airway obstruction sites were classified into four categories using Fujioka and Baroni’s methodology: nasopharyngeal obstruction (NO), oropharyngeal obstruction (OO), combined nasopharyngeal-oropharyngeal obstruction (NO + OO) and a control group (CG). Primary outcomes focused on quantifying upper and lower lip thickness, while secondary outcomes evaluated perioral soft tissue morphology and maxillary skeletal parameters. Statistical comparisons were performed using one-way ANOVA, Kruskal-Wallis H test and chi-square tests. A multinomial logistic regression (reference = CG) examined adjusted associations, including ANB and SN-MP as covariates.
RESULTS: A total of 256 paediatric patients with pre-treatment lateral cephalograms were included, 64 in each group. Comparative analysis revealed the NO group demonstrated significantly greater upper lip thickness (p < 0.001) and eversion (p = 0.012) compared to the CG. Additionally, the NO group displayed a greater distance between the incisal edge of the lower anterior teeth and the uppermost point of the lower lip than the OO and CG groups. Regression analyses confirmed upper lip thickness was positively associated with all obstruction types, whereas upper lip length was inversely related to NO and NO + OO.
CONCLUSIONS: Nasopharyngeal obstruction was associated with upper lip thickening and eversion, while oropharyngeal obstruction corresponded to lower lip protrusion. These findings suggest that distinct obstruction sites are linked to specific perioral and maxillary morphological patterns, emphasising the importance of airway evaluation in orthodontic diagnosis and treatment planning.
PMID:41239851 | DOI:10.1111/ocr.70061
