"Impact of adenotonsillectomy or adenoidectomy on dentofacial development of children with obstructed sleep disordered breathing - Systematic review".

BACKGROUND

Adenotonsillar hypertrophy contributes to mouth breathing and sleep-disordered breathing in children and has been linked to altered dentofacial growth. Although adenoidectomy and adenotonsillectomy aim to restore nasal breathing, their impact on skeletal and dental development remains debated.

METHODS

A PRISMA-guided systematic review was conducted using PubMed, Scopus and Web of Science for studies published up to 2025 (PROSPERO: CRD420250511402). Longitudinal or prospective observational studies evaluating dentofacial, craniofacial or dental arch changes in growing children were included. Risk of bias was assessed with ROBINS-I.

RESULTS

Ten studies met the inclusion criteria. Adenotonsillectomy was associated with favourable dentoalveolar adaptations, including improved mandibular growth direction, incisor inclination and dental arch dimensions. Skeletal effects were more evident when surgery was performed before six years of age; however, complete craniofacial normalization was unpredicatble depending upon the timing of intervention as well as individuals.

CONCLUSION

Adenotonsillectomy supports dentofacial adaptation but does not reliably achieve full skeletal correction, and adjunctive orthodontic management is often required.