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

Autor: AlSaty G; Department of Orthodontics, West Virginia University, Morgantown, WVa., Xiang J; Department of Family Medicine, West Virginia University, Morgantown, WVa., Burns M; Private practice, New Hope, Pa., Eliliwi M; Department of Orthodontics, Case Western Reserve University, Cleveland, Ohio., Palomo JM; Department of Orthodontics, Case Western Reserve University, Cleveland, Ohio., Martin C; Department of Orthodontics, West Virginia University, Morgantown, WVa., Weaver B; Department of Oral and Maxillofacial Surgery, West Virginia University, Morgantown, WVa., Ngan P; Department of Orthodontics, West Virginia University, Morgantown, WVa. Electronic address: pngan@hsc.wvu.edu.
Jazyk: angličtina
Zdroj: American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics [Am J Orthod Dentofacial Orthop] 2020 Oct; Vol. 158 (4), pp. 527-534. Date of Electronic Publication: 2020 Aug 14.
DOI: 10.1016/j.ajodo.2019.09.016
Abstrakt: 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.
(Copyright © 2020. Published by Elsevier Inc.)
Databáze: MEDLINE
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