Correlation of malocclusion and mouth breathing rates from a novel monitor

OBJECTIVE: This study aimed to develop, validate, and implement a novel wearable monitor to detect mouth breathing rates and analyze their correlation with malocclusion severity using craniofacial measurements obtained from CBCT and 3D photographs. MATERIALS AND METHODS: The monitor was equipped with two sensors mounted in a 3D-printed holder for oral and nasal breathing detection respectively, which senses humidity changes by silk fibroin and interprets into capacitive values. After qualitatively and quantitatively validated by polysomnography and the infrared thermography, the monitor was employed to calculate mouth breathing rates. Malocclusion parameters were derived from CBCT and 3D photographs, and correlated to mouth breathing rates. RESULTS: The accuracy, precision and recall of this novel monitor were 101.07 ± 5.21%, 98.80 ± 3.70% and 99.85 ± 2.08% respectively. The temperature changes and normalised capacitance values showed strong negative correlation during both inhalation and exhalation, with the mean correlation coefficients K at -0.8985 and -0.9332 respectively in the same breathing process. Strong correlations were identified between mouth breathing rates and maxillary canine width, palatal operculum height, left and right mandibular angle, lower face height, lower lip protrusion, nasolabial angle, chin-lip angle and the volumes of adenoid, nose, total airway and nasopharynx airway. CONCLUSION: This novel wearable monitor can qualitatively and quantitatively monitor mouth and nasal breathing accurately and precisely, potentially establishing itself as gold standard for mouth breathing diagnose and severity assessment. The strong correlations observed between mouth breath rates and malocclusion emphasize the importance of early orthodontic intervention in addressing mouth breathing habits.