International Journal of Oral & Maxillofacial Surgery
Volume 39, Issue 6 , Pages 541-547, June 2010

Effectiveness of maxillo-mandibular advancement in obstructive sleep apnea patients with and without skeletal anomalies

  • P. Ronchi

      Affiliations

    • Maxillo-Facial Surgery Unit, Sant’Anna Hospital, Como, Italy
  • ,
  • G. Novelli

      Affiliations

    • Maxillo-Facial Surgery Unit, Sant’Anna Hospital, Como, Italy
    • Corresponding Author InformationAddress: Giorgio Novelli, Viale Cesare Battisti 66, 20052 Monza, Milano, Italy. Tel.: +39 347 2746029.
  • ,
  • L. Colombo

      Affiliations

    • Maxillo-Facial Surgery Unit, Sant’Anna Hospital, Como, Italy
  • ,
  • S. Valsecchi

      Affiliations

    • Maxillo-Facial Surgery Unit, Sant’Anna Hospital, Como, Italy
  • ,
  • A. Oldani

      Affiliations

    • Centre for Sleep Medicine, San Raffaele Hospital, Milan, Italy
  • ,
  • M. Zucconi

      Affiliations

    • Centre for Sleep Medicine, San Raffaele Hospital, Milan, Italy
  • ,
  • A. Paddeu

      Affiliations

    • U.O. Cardiorespiratory Rehabilitation, Mariano Comense, Como, Italy

Accepted 16 March 2010. published online 30 April 2010.

Abstract 

This study evaluates the effectiveness of maxillo-mandibular advancement (MMA) in patients with obstructive sleep apnea syndrome (OSAS), even those without skeletal anomalies, indicating the possibility of extending this procedure to more patients. Two groups with different skeletal patterns were studied pre- and post-surgery. Group 1 (11 patients) had severe or moderate OSAS and maxillo-mandibular hypoplasia and/or mandibular deformities (SNA angle 78° or less or SNA angle>78° but with SNB<65° and severe skeletal class II malocclusion). Group 2 (11 patients) had severe or moderate OSAS without maxillo-mandibular hypoplasia or deformity (SNA angle>80°, dental class I occlusion). Analysis comprised: apnea hypopnea index (AHI), posterior airway space (PAS), SNA and SNB angles, Epworth sleepiness scale (ESS), body mass index (BMI), and a subjective standardized questionnaire about aesthetic appearance. All patients had increased PAS width and complete remission of objective and subjective OSAS symptoms evaluated by AHI and ESS. Results in both groups are comparable. Data were analysed using t-test; p<0.005 was statistically significant. All patients were satisfied with the functional and aesthetic results. MMA is effective in patients with severe or moderate OSAS, even in those without skeletal and/or occlusal anomalies and can be considered in more patients.

Keywords: OSAS, maxillo-mandibular advancement

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PII: S0901-5027(10)00099-8

doi:10.1016/j.ijom.2010.03.006

International Journal of Oral & Maxillofacial Surgery
Volume 39, Issue 6 , Pages 541-547, June 2010