Influence of respiratory function on craniofacial growth from the perspective of the functional matrix hypothesis: a narrative literature review

The craniofacial growth process results from the interaction among genetic, epigenetic, and environmental factors, with functional stimuli being fundamental to the development of the stomatognathic system. Among these stimuli, respiratory function exerts significant influence on craniofacial morphology and the establishment of normal occlusion. Functional alterations, especially chronic mouth breathing, can modify muscular balance, tongue posture, mandibular positioning, and facial growth patterns, contributing to the development of dentofacial anomalies and malocclusions. In this context, the Functional Matrix Hypothesis, proposed by Moss, provides a theoretical framework for understanding how functional demands influence craniofacial growth and remodeling. The present study aimed to analyze the influence of respiratory function on craniofacial growth from the perspective of the Functional Matrix Hypothesis, through a narrative literature review. A qualitative and descriptive review was conducted using scientific publications indexed in the PubMed, SciELO, and Google Scholar databases, including both classical and contemporary studies related to craniofacial growth, respiratory function, mouth breathing, mechanotransduction, and the Functional Matrix Hypothesis. The results indicate that nasal breathing contributes to harmonious craniofacial development, whereas persistent mouth breathing may lead to structural and functional adaptations associated with maxillary atresia, increased lower facial third height, posterior crossbite, open bite, and mandibular retrusion. Furthermore, the evidence reviewed highlights the importance of early diagnosis and an interdisciplinary approach to respiratory dysfunctions. Jaw Functional Orthopedics stands out as an important therapeutic alternative by promoting favorable functional conditions for craniofacial growth and development. It is concluded that respiratory function acts as a significant modulator of craniofacial growth, reinforcing the relevance of preventive and interceptive strategies aimed at restoring physiological functions and promoting balanced craniofacial development.