Effects of maxillomandibular advancement on the upper airway and surrounding structures in patients with obstructive sleep apnoea: a systematic review

Hsieh, Yun-Huan; Liao, Yu‐Fang

doi:10.1016/j.bjoms.2012.11.010

Cited by 54 publications

(34 citation statements)

References 25 publications

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“…The surgical success of MMA for the treatment of OSA has a reported range of 65 to 100% when using the single success criterion of a postoperative AHI of less than 20. 12 Using the more rigorous definition 9,18,19,23,42 of a reduction in AHI of 50% or more in addition to a postoperative AHI of less than 20, the surgical success of the present study was 73%, consistent with the success rate in previous studies. 9 However, these definitions could still leave the patient with moderate OSA.…”

Section: Discussionsupporting

confidence: 90%

Linear and Volumetric Airway Changes After Maxillomandibular Advancement for Obstructive Sleep Apnea

Butterfield

Marks

McLean

et al. 2015

Journal of Oral and Maxillofacial Surgery

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Section: Discussionsupporting

confidence: 90%

Linear and Volumetric Airway Changes After Maxillomandibular Advancement for Obstructive Sleep Apnea

Butterfield

Marks

McLean

et al. 2015

Journal of Oral and Maxillofacial Surgery

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“…Two-jaw surgeries can also help prevent aggravating sleep apnea by advancing the maxilla, thus limiting the amount required to set back the mandible. [19][20][21] This study's predominance of two-jaw approaches for correction of skeletal Class III malocclusion may be due to the fact that this investigation was performed in an academic center. Referrals from general dentists play an important role in maintaining the number of orthognathic surgery patients.…”

Section: Discussionmentioning

confidence: 99%

Modern trends in Class III orthognathic treatment: A time series analysis

Lee¹,

Park²,

Lee

2016

The Angle Orthodontist

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Objective: To examine the current trends in surgical-orthodontic treatment for patients with Class III malocclusion using time-series analysis. Materials and Methods: The records of 2994 consecutive patients who underwent orthognathic surgery from January 1, 2004, through December 31, 2015, at Seoul National University Dental Hospital, Seoul, Korea, were reviewed. Clinical data from each surgical and orthodontic treatment record included patient's sex, age at the time of surgery, malocclusion classification, type of orthognathic surgical procedure, place where the orthodontic treatment was performed, orthodontic treatment modality, and time elapsed for pre-and postoperative orthodontic treatment. Results: Out of the orthognathic surgery patients, 86% had Class III malocclusion. Among them, two-jaw surgeries have become by far the most common orthognathic surgical treatment these days. The age at the time of surgery and the number of new patients had seasonal variations, which demonstrated opposing patterns. There was neither positive nor negative correlation between preand postoperative orthodontic treatment time. Elapsed orthodontic treatment time for both before and after Class III orthognathic surgeries has been decreasing over the years. Conclusion: Results of the time series analysis might provide clinicians with some insights into current surgical and orthodontic management. (Angle Orthod. 2017;87:269-278)

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“…The maxillary advancement procedure causes an enlargement of UA in the nasopharyngeal and retropalatal areas and a subsequent increase in the dimensions and volume of the airway space 12 . Although the repositioning is anteroposterior, the increase of the UA dimensions is mainly in the transverse direction 15,16 . Per Pereira-Filho et al's 1 study, the maxillary advancement procedure, when compared to the mandibular setback and bimaxillary surgery procedures, showed the highest stability in the anteroposterior increase of the UA due to the repositioning of the soft palate tissues and muscles.…”

Section: Discussionmentioning

confidence: 99%

“…Although this method is useful for analysis in the sagittal plane, it has limitations, including overlapping of images and difficult delimitation between the structures, and it does not capture the airway width 11,13,15 . Computed tomography is one of the best methods for evaluating 3D structures of the UA and facial skeleton [15][16][17] . Among its advantages is the evaluation of the regions in the coronal, axial, and sagittal planes; the visualization of soft and hard tissues; and the possibility of segmentation for volumetric analysis 8,[11][12][13] .…”

Section: Discussionmentioning

confidence: 99%

Volumetric and cephalometric evaluation of the upper airway of class III patients submitted to maxillary advancement

Santiago

Moura

Gabrielli

et al. 2016

Rev. odontol. UNESP

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ResumoIntrodução: A deficiência anteroposterior da maxila pode estar associada com a diminuição do volume da via aérea superior. O avanço de maxila por resultar em um aumento do espaço aéreo superior. Objetivo: Correlacionar mensurações cefalométricas (2D) e volumétricas (3D) da via aérea superior em pacientes classe III tratados por meio de avanço maxilar. Material e método: Este estudo retrospectivo transversal foi realizado em dez pacientes adultos submetidos ao avanço de maxila para correção de deficiência anteroposterior de maxila e deformidade classe III. Foram incluídos os dados de tomografias computadorizadas Cone beam em dois períodos: pré-operatório (T1) e pós-operatório de 6 a 8 meses (T2). Os arquivos DICOM foram importados e reconstruídos para avaliação volumétrica e cefalométrica da via aérea superior, dividida em nasofaringe, orofaringe e hipofaringe (Arnett & Gunson FAB Surgery). Resultado: A idade variou de 26 a 55 anos, com média de 36,3±9,2 anos. Não foram verificadas diferenças estatisticamente significantes para os parâmetros cefalométricos e volumétricos das três regiões da faringe entre os períodos T1 e T2. Este resultado ocorreu devido à pequena quantidade de avanço maxilar (4,7±1,89mm) necessário para a correção da deformidade na amostra. A correlação entre área e volume não foi estatisticamente significante apenas para as mensurações pré-operatórias da nasofaringe (r=0,30; p=0,40). Nas outras regiões e períodos a correlação foi estatisticamente significante (p<0,05). Conclusão: Avanços maxilares de pequenas dimensões não resultam em um aumento significativo das dimensões da via aérea superior.Descritores: Cirurgia ortognática; remodelação das vias aéreas; maxila. AbstractIntroduction: Anteroposterior maxillary deficiency can be associated with a decrease of upper airway volume. Maxillary advancement can improve the upper airway space. Aim: To correlate cephalometric (2D) and volumetric (3D) measurements of the upper airway in class III patients treated by maxillary advancement. Material and method: This retrospective transversal study was performed in ten adult patients submitted to maxillary advancement for correction of class III deformity secondary to maxillary anteroposterior deficiency. The Cone beam tomography files included in the medical records were used: (T1) pre-operative and (T2) 6 to 8 months postoperative. The DICOM files were imported and reconstructed for volumetric and cephalometric evaluation of the upper airway, as divided into nasopharynx, oropharynx and hypopharynx (Arnett & Gunson FAB Surgery). Result: Age ranged from 26 to 55 years with a mean of 36.3±9.2 years. There were no statistically significant differences for cephalometric and volumetric parameters of the three pharyngeal regions between T1 and T2 periods. This was due to the small amount of maxillary advancement necessary to correct the maxillary deformity in the studied patients (4.7±1.89mm). The correlation between area and volume was not statistically significant only for preoperative measurements of t...

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Effects of maxillomandibular advancement on the upper airway and surrounding structures in patients with obstructive sleep apnoea: a systematic review

Cited by 54 publications

References 25 publications

Linear and Volumetric Airway Changes After Maxillomandibular Advancement for Obstructive Sleep Apnea

Linear and Volumetric Airway Changes After Maxillomandibular Advancement for Obstructive Sleep Apnea

Modern trends in Class III orthognathic treatment: A time series analysis

Volumetric and cephalometric evaluation of the upper airway of class III patients submitted to maxillary advancement

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