4.

Temporomandibular disorders, specifically those that affect the joint anatomy and condylar morphology, can have a deleterious effect on patients with obstructive sleep apnea (OSA). There is a correlation that has emerged between OSA and temporomandibular joint (TMJ) diseases, whether the former influenced that latter or vice versa is of some debate. What is discussed, in this review, is that as the condyle resorbs it can have significant influence on the airway. More specifically, the volume and architecture of the upper airway can decrease in size and pose a threat to breathing. With a narrowed, or constricted airway, the propensity for airway collapse increases, thus leading to or developing into a sleep apnea. OSA as an entity unto itself can lead to significant cardiovascular and other systemic effects that can become morbid if not addressed. Given this, multiple treatments have been aimed at correcting the insult. It is also established that maxillomandibular advancement (MMA) surgery can greatly improve symptoms in patients with OSA, with safe, stable, and predictable results. This procedure achieves its goals by reconstructing the upper airway in such a manner that airflow is no longer just impeded but also aided. However, the traditional bimaxillary surgery alone may be insufficient especially in the setting of concomitant TMJ disease. This review will describe and discuss the indications wherein TMJ total joint replacement (TJR) surgery combined with MMA can also lead to similar predictive and stable results.

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