Impact of orthognathic surgical procedure and surgical movement distance on obstructive sleep apnea in skeletal class III malocclusion
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Abstract
Objectives: To investigate the incidence of obstructive sleep apnea (OSA) in relation to the type of surgical procedure and the amount of mandibular setback.
Materials and Methods: The cohort study involved 20 participants (mean age: 25.1 ± 5.74) with skeletal Class III malocclusion. All participants had no prior history of sleep disorders and an apnea-hypopnea index (AHI) of fewer than 5 events/hour pre-surgery. They underwent either mandibular setback alone or two-jaw surgery (maxillary advancement and mandibular setback). OSA-related parameters were assessed at two time points: pre-surgery (T1) and six months post-surgery (T2), using a home sleep test device. The magnitude of surgical jaw movements was determined through data obtained from virtual surgical planning. The association between the type of surgical procedure, the categorized extent of mandibular setback, and the development of OSA was analyzed using Fisher’s exact test.
Results: Twenty- five percent of participants developed an AHI of ≥ 5 events/hour at 6 months post-surgery, regardless of the type of surgical procedure. Notably, 11.11% of patients with a mandibular setback of < 7 mm demonstrated an AHI of ≥ 5 events/hour post-surgery, whereas 36.36% of those with a setback of ≥ 7 mm exhibited similar AHI levels post-surgery. Participants who maintained an AHI of < 5 events/hour post-surgery, had greater maxillary advancement and less mandibular setback compared to those with higher AHI levels.
Conclusions: No statistically significant differences in the incidence of OSA were observed between one-jaw and two-jaw surgeries or between surgical distances using a 7 mm cutoff. However, greater maxillary advancement, combined with limiting mandibular setback to less than 7 mm, may be associated with a lower risk of developing OSA.
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