Short‐term pharyngeal airway space changes after mandibular advancement surgery in Class II patients—a two‐dimensional retrospective study

Abstract

Structured Abstract Introduction Planning successful treatment for the correction of anatomic abnormalities of the upper airways, by surgical advancement of the mandible, depends on extensive knowledge of the pharyngeal airway space (PAS). However, there is limited scientific evidence about changes in PAS after mandibular advancement surgery. Aim To evaluate the immediate changes in superior posterior airway space (SPAS) in Class II patients, after mandibular advancement surgery. Materials and Methods A cephalometric evaluation of 37 patients with skeletal Class II deformity was performed at 2 distinct time intervals: Pre‐operative (T0) and immediate post‐operative (T1), using Dolphin Image & Management Solutions, version 11.9, according to the method of Arnett/Gunson FAB Surgery. The differences due to the surgical intervention were assessed with Student's t test, and a Principal Component Analysis was used to evaluate the relationship between mandibular advancement and SPAS variables. Anticlockwise and clockwise rotation groups were also evaluated with Mann‐Whitney tests. The statistical analysis was conducted in SPSS and R assuming a 0.05 level of significance. Results As an effect of mandibular advancement, an anteroposterior statistically significant increase in SPAS (P < 0.001) was perceived at all points measured. Conclusion Our findings indicate that mandibular advancement surgery is a viable option to achieve widening of the SPAS in patients with Class II skeletal morphology.

Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis

“…Twenty papers were finally included in the SR 32‐51 . The data extracted from the included papers are reported in Table 2.…”

“…Seventeen studies evaluated the oropharyngeal anteroposterior linear changes: twelve studies [33][34][35][36][38][39][40][43][44][45]47,51 reported significant changes, four studies 37,41,48,50 observed non-significant findings and one study 32 revealed an increase in the linear oropharyngeal dimension (>2 mm), but not dedicated statistics was run. The MA of the short-term anteroposterior linear measurements of the oropharynx showed statistically significant increase at the level of the posterior border of the tongue (SMD: 0.52, CI: 0.21, 0.84, P = .001; I 2 : 60.5%), of the Gonion (SMD: 1.24, CI: 0.56, 1.91, P < .001; I 2 = 88.8%) and of the second cervical vertebra (SMD: 0.92, CI: 0.14, 1.70, P = .021; I 2 : 88.7%) (Figure 6).…”

Pharyngeal Airspace Alterations after Using the Mandibular Advancement Device in the Treatment of Obstructive Sleep Apnea Syndrome

“…The alternative to the method used for cephalometric assessment would be cone beam computed tomography. However, the potential benefits of diagnosis and treatment planning do not outweigh the potential risks of an increase in radiation dose [ 10 , 18 ]. Moreover, further studies should be carried out with larger samples and follow-up.…”

“…This device has six connectors of different lengths with the aim of inducing mandibular advancements of 65% to 75% in the maximum protrusion of each patient. This device also allows limited laterality and mouth opening movements [ 10 ] ( Figure 1 ).…”

“…The actual movement presented by each patient after the placement of the MAD was quantified at the Pogonion point (Pog), after the superimposition of the pre- and post-treatment radiographs of each patient. The superimposition method adopted was based on “The structural method” developed by Arne Björk [ 10 , 12 ].…”