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. 2020 Oct;158(4):527-534.
doi: 10.1016/j.ajodo.2019.09.016. Epub 2020 Aug 14.

Follow-up observation of patients with obstructive sleep apnea treated by maxillomandibular advancement

Ghaddy AlSaty  1 , Jun Xiang  2 , Mary Burns  3 , Manhal Eliliwi  4 , Juan Martin Palomo  4 , Chris Martin  1 , Bryan Weaver  5 , Peter Ngan  6
Affiliations

Follow-up observation of patients with obstructive sleep apnea treated by maxillomandibular advancement

Ghaddy AlSaty et al. Am J Orthod Dentofacial Orthop. 2020 Oct.

Abstract

Introduction: This study aimed to evaluate the follow-up observation of patients with obstructive sleep apnea treated with maxillomandibular advancement (MMA) procedure with or without genial tubercle advancement (GTA).

Methods: A total of 25 patients (mean age 37.1 ± 17.3 years) were included in the study. Cone-beam computed tomography scans were taken before treatment; after presurgical orthodontic treatment; immediately after MMA procedure; and follow-up visit. All Digital Imaging and Communications in Medicine files were analyzed using the Dolphin 3D Imaging software program (Dolphin Imaging and Management Solutions, Chatsworth, Calif) to determine the total airway volume (TAV), airway area (AA), and minimal cross-sectional area (MCA). Dolphin 3D voxel-based superimposition was used to determine the amount of skeletal advancement with MMA and changes after surgery.

Results: Significant increase in TAV, AA, and MCA was found with MMA treatment (40.6%, 28.8%, and 56.4%, respectively, P <0.0001). Smaller but significant decrease in TAV, AA, and MCA was found during a follow-up visit (20.0%, 9.7%, and 26.8%, respectively, P <0.0001) giving a net increase of TAV, AA and MCA (35.8%, 27.1%, and 45.9%, respectively). No significant differences were found in any of the airway measurements with or without the GTA procedure. The average forward movements of the maxilla, mandible, and chin were 6.6 mm, 8.2 mm, and 11.4 mm, respectively. A relapse of less than 1 mm was found in each of the variables during the follow-up period. No correlation was found between the magnitudes of skeletal advancement and the change in oropharyngeal airway space (OPAS).

Conclusions: Significant increase in OPAS can be expected with MMA surgery with or without GTA procedure in patients diagnosed with obstructive sleep apnea. A partial loss in OPAS was found during the follow-up visit. The surgical movements were found to be stable, with less than 1 mm of relapse during the follow-up period, which was not clinically significant.

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Comment in

  • Authors' response.
    AlSaty G, Xiang J, Burns M, Eliliwi M, Palomo JM, Martin C, Weaver B, Ngan P. AlSaty G, et al. Am J Orthod Dentofacial Orthop. 2021 Apr;159(4):407-408. doi: 10.1016/j.ajodo.2020.12.005. Am J Orthod Dentofacial Orthop. 2021. PMID: 33795082 No abstract available.
  • Maxillomandibular advancement for treatment of obstructive sleep apnea.
    Thirumoorthy SN. Thirumoorthy SN. Am J Orthod Dentofacial Orthop. 2021 Apr;159(4):407. doi: 10.1016/j.ajodo.2020.11.023. Am J Orthod Dentofacial Orthop. 2021. PMID: 33795083 No abstract available.

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