Evaluation of Adenoid Hypertrophy Influence on Dentofacial Morphology Using Lateral Cephalograms and Photographs

Aims and objectives: To evaluate the influence of adenoid hypertrophy-induced airway obstruction on dentofacial morphology, correlate cephalometric and photographic measurements in mouth breathers and controls, and assess the reliability of photographs as a diagnostic tool for adenoid hypertrophy.Materials and methods: The study included 120 subjects aged from 12 to 20 years, divided into a control group (nasal breathers) and a test group (mouth breathers) based on a validated questionnaire.Exclusion criteria ensured elimination of other potential causes of mouth breathing.The test group was further divided into four subgroups based on the adenoid-nasopharyngeal ratio (ANR).Each subject underwent lateral cephalogram and standardized lateral profile photography.Linear and angular measurements were recorded on both records.Results: Cephalometric analysis showed significantly reduced Sella-Nasion to point B angle (SNB), Sella-Nasion to palatal plane angle (SNPP), and facial height index (FHi), and increased a point-Nasion-B point angle (ANB), Nasion-A point-pogonion angle (NAPog), Y-axis, Sella-Nasion to Gonion-Gnathion angle (SNGoGn), and anterior facial height index (AFHi) in mouth breathers compared to controls.Photographic analysis revealed significantly reduced nasolabial angle and increased gonial angle, alar length, and ramal height.Correlation analysis indicated that SNA, SNB, and facial height indices correlated with the nasofrontal angle; ANB correlated with the nasolabial angle; SNB, SNGoGn, and FHi correlated with TraNSn, Tra-N-Pog, and Tra-N-Gn; facial axis correlated with N-AnM-Gn.Conclusion: Mouth breathers exhibited posteriorly and downward rotated mandibles and a hyperdivergent growth pattern.Several cephalometric and photographic parameters showed significant correlations, supporting the use of clinical photographs as a reliable, noninvasive tool for assessing adenoid hypertrophy.