Effects of functional on the respiratory tract: analysis of the Mallampati score

Objective: To evaluate the clinical validity of the Mallampati score as an indicator of upper airway function in pediatric patients with suspected sleep disorders undergoing orthodontic treatment with functional appliances. The aim is to assess its readability usefulness, practicality and role as a complementary tool in clinical management. Materials and methods: Patients aged between 7 and 14 years attending the orthodontic clinic at Rho Hospital, with no previous orthodontic treatment and candidates for functional therapy, were included. The assessments were performed at three time points: T0 (start of treatment), T1 (12 months) and T” (15.20 months). The main parameter analyzed was the Mallampati score. Tonsillar grading and chin-hyoid distance were also recorded. At T0 and T2, orthopantomograms and lateral teleradiographs were performed for cephalometric analysis. Parents were given a questionnaire on the patients’ sleeping habits. Results: The study included 100 patients: 36% with skeletal Class I and 64 with Class II. At T0, 47% had Mallampati II, 38% Mallampati III, and 15% Mallampati IV, data consistent with sleep questionnaires. No significant differences emerged between T1 and T2. However, at the end of treatment, a reduction in the Mallampati score was observed in 76% of patients with Mallampati III and 47% of those with Mallampati II. In subjects with Mallampati IV, the improvement was limited to 30% frequently associated with macroglossia. Conclusions: The Mallampati score proved to be a valid and reliable tool for assessing the upper airways in pediatric patients undergoing functional orthodontic treatment. Its use, integrated with other clinical and radiological parameters, allows for a complete respiratory assessment without resorting to invasive investigations, making it safe, non-traumatic, and easily repeatable in daily clinical practice.