scholarly journals Review the Impact of Mandibular Setback Surgery for the Correction of Class III Malocclusion on the Upper Airway Space

2021 ◽  
Vol 9 (F) ◽  
pp. 644-649
Author(s):  
Dareen Aljehani
Keyword(s):  
Upper Airway ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Eligibility Criteria ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Obstructive Sleep ◽  
Mandibular Setback Surgery ◽  
The Impact

AIM: This study aimed to review the scientific evidence related to the effect of mandibular setback surgery for the correction of Class III malocclusion on the changes in volume and anatomical structures’ positions of the upper airway within at least 1 year follow-up. METHODS: An electronic research was conducted on PubMed, Google scholar, and Elsevier up to April 20, 2021, the inclusion criteria were prospective or retrospective studies aiming to compare the changes in upper airway space following isolated mandibular setback through at least 1 year of follow-up. RESULTS: A total of 84 studies were retrieved, only 12 studies met the eligibility criteria. Their methods of measurement were using lateral cephalometry, CT, or Cone-beam computed tomography. Most of them showed narrowing in the Pharyngeal airway space, with some variability within the follow-up periods. Impact on the possibility of obstructive sleep apnea (OSA) was discussed in most of the included studies. CONCLUSION: Narrowing of upper airway volume is associated with isolated mandibular setback surgeries within 1 year of follow-up. However, OSA was not necessarily a consequence. Any predisposing factors for OSA should be considered before isolated mandibular setback surgery.

scholarly journals Impact of surgical maxillomandibular advancement upon pharyngeal airway volume and the apnoea–hypopnoea index in the treatment of obstructive sleep apnoea: systematic review and meta-analysis

2019 ◽  
Vol 6 (1) ◽  
pp. e000402 ◽  
Author(s):  
Maria Giralt-Hernando ◽  
Adaia Valls-Ontañón ◽  
Raquel Guijarro-Martínez ◽  
Jorge Masià-Gridilla ◽  
Federico Hernández-Alfaro
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Eligibility Criteria ◽  
Pharyngeal Airway ◽  
Maxillomandibular Advancement ◽  
Subsequent Decrease ◽  
Obstructive Sleep

BackgroundA systematic review was carried out on the effect of surgical maxillomandibular advancement (MMA) on pharyngeal airway (PA) dimensions and the apnoea–hypopnoea index (AHI) in the treatment of obstructive sleep apnoea (OSA), with the aim of determining whether increased PA in the context of MMA is the main factor conditioning the subsequent decrease in AHI.MethodsA search was made of the PubMed, Embase, Google Scholar and Cochrane databases. A total of 496 studies were identified. The inclusion criteria were a diagnosis of moderate to severe OSA, MMA success evaluated by polysomnography, reporting of the magnitude of MMA achieved, PA increase and a minimum follow-up of 6 months.ResultsFollowing application of the eligibility criteria, eight articles were included. Metaregression analysis showed MMA to significantly increase both pharyngeal airway volume (PAV) (mean 7.35 cm3 (range 5.35–9.34)) and pharyngeal airway space (mean 4.75 mm (range 3.15–6.35)) and ensure a final AHI score below the threshold of 20 (mean 12.9 events/hour).ConclusionsAlthough subgroup analysis showed MMA to be effective in treating OSA, more randomised trials are needed to individualise the required magnitude and direction of surgical movements in each patient, and to standardise the measurements of linear and nonlinear PAV parameters.

scholarly journals Computational fluid dynamics for the assessment of upper airway changes in skeletal Class III patients treated with mandibular setback surgery

2016 ◽  
Vol 86 (6) ◽  
pp. 976-982 ◽  
Author(s):  
Darshit H. Shah ◽  
Ki Beom Kim ◽  
Mark W. McQuilling ◽  
Reza Movahed ◽  
Ankit H. Shah ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Pressure Drop ◽  
Negative Correlation ◽  
Significant Negative Correlation ◽  
Class Iii ◽  
Time Points ◽  
Pharyngeal Airway ◽  
Mandibular Setback ◽  
Mandibular Setback Surgery

ABSTRACT Objective: To analyze and compare pharyngeal airflow characteristics pre- and post–mandibular setback surgery in patients with Class III skeletal dysplasia using cone beam computed tomography (CBCT) and computational fluid dynamics (CFD). Materials and Methods: Records of 29 patients who had received orthodontic treatment along with mandibular setback surgery were obtained. CBCT scans were obtained at three time points: T1 (before surgery), T2 (average of 6 months after surgery), and T3 (average of 1 year after surgery). Digitized pharyngeal airway models were generated from these scans. CFD was used to simulate and characterize pharyngeal airflow. Results: Mean airway volume was significantly reduced from 35,490.324 mm3 at T1 to 24,387.369 mm3 at T2 and 25,069.459 mm3 at T3. Significant increase in mean negative pressure was noted from 3.110 Pa at T1 to 6.116 Pa at T2 and 6.295 Pa at T3. There was a statistically significant negative correlation between the change in airway volume and the change in pressure drop at both the T2 and T3 time points. There was a statistically significant negative correlation between the amount of mandibular setback and change in pressure drop at the T2 time point. Conclusions: Following mandibular setback surgery, pharyngeal airway volume was decreased and relative mean negative pressure was increased, implying an increased effort required from a patient for maintaining constant pharyngeal airflow. Thus, high-risk patients undergoing a large amount of mandibular setback surgery should be evaluated for obstructive sleep apnea and the proposed treatment plan be revised based on the risk for potential airway compromise.

Effects of mandibular setback surgery on upper airway dimensions and their influence on obstructive sleep apnoea – A systematic review

2015 ◽  
Vol 43 (2) ◽  
pp. 248-253 ◽  
Author(s):  
Laura Fernández-Ferrer ◽  
José María Montiel-Company ◽  
Teresa Pinho ◽  
José Manuel Almerich-Silla ◽  
Carlos Bellot-Arcís
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Mandibular Setback ◽  
Obstructive Sleep ◽  
Mandibular Setback Surgery ◽  
Airway Dimensions

scholarly journals Changes in smile morphometric indices following maxillary advancement and mandibular setback surgery in skeletal Class III patients

2019 ◽  
Vol 18 (2) ◽  
pp. 216-221
Author(s):  
Fahimeh Farzanegan ◽  
Farzin Hearvi ◽  
Mandana Karrari ◽  
Hooman Shafaee ◽  
Touraj Vaezi ◽  
...  
Keyword(s):  
Medical Science ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Lower Incisor ◽  
Skeletal Class ◽  
Mandibular Setback ◽  
Post Surgery ◽  
Maxillary Advancement ◽  
Significant Difference ◽  
Mandibular Setback Surgery

Objectives: The aim of this study was to evaluate the changes in smile morphometric indices following maxillary advancement and mandibular setback surgery in patients with skeletal class III malocclusion. Materials and Methods: Smile morphometric indices were measured on frontal rest and smile photographs of 15 female patients with skeletal Class III malocclusions before and three months after maxillary advancement and mandibular setback surgery. Pre- and post-surgery measurements were compared. Results: The amount of left and right commissural height, philtrum height, and maximum upper incisor show at rest did not change significantly three months after surgery (p>0.05). The amount of maximum upper and lower incisor show, interlabial gap, smile width and index, buccal corridor ratio, gingival display, and smile arc on the frontal smile photographs didn’t showstatistically significant difference before and after surgery (P>0.05). Conclusion: Orthognathic surgery in patients with skeletal Class III malocclusion had no significant effect on rest and smile parameters from the frontal view. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.216-221

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