Comparing Outcomes of Airway Changes and Risk of Sleep Apnea after Bimaxillary Orthognathic Surgery and Mandibular Setback Surgery in Patients with Skeletal Class III Malocclusion: A Systematic Review and Meta-Analysis

Safi, Mehrnaz; Amiri, Ali; Nasrabadi, Navid; Khosravi, Setareh

doi:10.1590/pboci.2021.064

Pesqui. Bras. Odontopediatria Clín. Integr.

2021

DOI: 10.1590/pboci.2021.064

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Comparing Outcomes of Airway Changes and Risk of Sleep Apnea after Bimaxillary Orthognathic Surgery and Mandibular Setback Surgery in Patients with Skeletal Class III Malocclusion: A Systematic Review and Meta-Analysis

Mehrnaz Safi

Ali Amiri

Navid Nasrabadi

et al.

Abstract: How to cite: Safi M, Amiri A, Nasrabadi N, Khosravi S. Comparing outcomes of airway changes and risk of sleep apnea after bimaxillary orthognathic surgery and mandibular setback surgery in patients with skeletal class III malocclusion: a systematic review and meta-analysis.

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2024

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Cited by 2 publications

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Impacts of mandibular setback with or without maxillary advancement for class III skeletal correction on sleep‐related respiratory parameters: A systematic review and meta‐analysis

Honglertnapakul,

Peanchitlertkajorn,

Likitkulthanaporn

et al. 2024

Orthod Craniofacial Res

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A systematic review and meta‐analysis was conducted to evaluate the impacts of mandibular setback with or without maxillary advancement for class III skeletal correction on respiratory parameters measured by polysomnography (PSG) and to compare these respiratory parameters between these procedures for class III skeletal correction. Six electronic databases were searched up to June 2023. Studies comparing PSG parameters before and after orthognathic surgery for skeletal class III patients were selected for further analysis. The outcomes of interest were apnoea–hypopnea index (AHI), respiratory disturbance index (RDI), the lowest oxygen saturation (lowest SpO2), the average oxygen saturation (mean SpO2), and the 3% oxygen desaturation index (3% ODI). Data extraction, methodological quality assessment, risk of bias assessment, meta‐analysis, and subgroup analysis were performed. Sixteen studies with a total of 476 patients who underwent orthognathic surgery for class III skeletal correction were included for meta‐analysis. The risk of bias level was moderate for most studies. All PSG parameters before and after orthognathic surgery were not significantly different. The different surgical procedures also did not significantly affect post‐operative PSG parameters. 5.8% of patients developed post‐operative obstructive sleep apnoea (OSA). Most of them underwent a large distance of mandibular setback. There is a moderate level of evidence that mandibular setback with or without maxillary advancement for class III skeletal correction does not pre‐dispose young and healthy patients to obstructive sleep apnoea when evaluated in the short term after surgery. However, post‐operatively developed OSA was found in several isolated cases that underwent a large amount of mandibular setback with or without maxillary advancement.

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Impacts of mandibular setback with or without maxillary advancement for class III skeletal correction on sleep‐related respiratory parameters: A systematic review and meta‐analysis

Honglertnapakul,

Peanchitlertkajorn,

Likitkulthanaporn

et al. 2024

Orthod Craniofacial Res

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Estudo do impacto na via aérea superior de pacientes com síndrome da apneia obstrutiva do sono submetidos a cirurgia de avanços bimaxilares

Silveira,

Melo,

Ponte

et al. 2024

Cad. Pedagógico

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As deformidades dento-esqueléticas (DDE) são definidas como desproporções dentárias e faciais decorrentes de alterações de crescimento dos ossos da face. Podem levar à diminuição do espaço da via aérea superior (VAS), contribuindo para o desenvolvimento de distúrbios respiratórios graves, como a síndrome da apneia obstrutiva do sono (SAOS). Este estudo avalia mudanças no espaço aéreo faríngeo dos pacientes portadores da SAOS que foram submetidos a cirurgia de avanço bimaxilar para correção das DDE, a fim de detectar possível aumento da VAS como tratamento cirúrgico definitivo da SAOS. Para a avaliação do espaço aéreo utilizou-se um novo protocolo de delimitação da VAS, onde foram avaliadas tomografias computadorizadas (TC) no pré e pós-operatório da cirurgia ortognática de nove pacientes com perfil facial Classe II que apresentavam a SAOS associada, a fim de mensurar o diâmetro da VAS e o novo posicionamento do osso hioide. Uma vez coletados os valores mensurados, estes foram submetidos ao tratamento estatístico, através do programa SPSS (24.0). Aplicou-se o teste de normalidade de Shapiro-Wilk para averiguar a distribuição dos dados. E o teste t emparelhado para a comparação entre as mensurações no pré e pós-operatório. Observou-se um aumento estatisticamente significativo da VAS no corte sagital (média 0,35; p=0,001) e no corte axial (média 0,51; p=0,001). Já em relação às mudanças de posição do osso hióide, não houve diferenças estatisticamente significativas (p=0,551). A partir dos dados em análise, foi possível concluir que o manejo cirúrgico permitiu um aumento nos diâmetros da VAS e, consequente, redução no índice de apneia e hipopneia (IAH) para níveis próximos à normalidade. Entretanto novos estudos devem ser realizados para um acompanhamento longitudinal desses pacientes.

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Comparing Outcomes of Airway Changes and Risk of Sleep Apnea after Bimaxillary Orthognathic Surgery and Mandibular Setback Surgery in Patients with Skeletal Class III Malocclusion: A Systematic Review and Meta-Analysis

Abstract: How to cite: Safi M, Amiri A, Nasrabadi N, Khosravi S. Comparing outcomes of airway changes and risk of sleep apnea after bimaxillary orthognathic surgery and mandibular setback surgery in patients with skeletal class III malocclusion: a systematic review and meta-analysis.

Cited by 2 publications

References 37 publications

Impacts of mandibular setback with or without maxillary advancement for class III skeletal correction on sleep‐related respiratory parameters: A systematic review and meta‐analysis

Impacts of mandibular setback with or without maxillary advancement for class III skeletal correction on sleep‐related respiratory parameters: A systematic review and meta‐analysis

Estudo do impacto na via aérea superior de pacientes com síndrome da apneia obstrutiva do sono submetidos a cirurgia de avanços bimaxilares

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