title: Ventilatory disorders and facial growth: benefits of early genioplasty.
abstract: OBJECTIVE
  The purpose of this prospective study was to determine whether combined functional genioplasty and orthodontic treatment in patients with vertical mandibular growth can be beneficial not only in achieving an esthetic outcome and orthodontic stability but also for the multi-disciplinary management of oral ventilation.
  
  
  METHODS
  Twenty-five non-obese adolescents (mean age: 14.6 ± 1.4 years) with vertical excess of the lower third requiring genioplasty received surgery following orthodontic treatment. All were predominantly mouth-breathers despite ENT treatment and rehabilitation. The functional before-after impact of genioplasty was examined in a clinical setting using polysomnography.
  
  
  RESULTS
  Before genioplasty, 52% of the adolescents presented an upper airways resistance syndrome (UARS) with obstructive hypopnea and poor sleep quality. Three to 6 months after genioplasty, the mode of ventilation shifted from oral to nasal (p < 0.001). Lip seal was significantly restored with no contraction of the labio-mental muscles. All nighttime symptoms improved. The proportion of patients suffering from ronchopathy (pathological snoring), dry mouth and disturbed sleep dropped significantly (p = 0.08, p = 0.001, p = 0.0009, respectively). Respiratory events and sleep pattern became normal. Below, we present two clinical reports involving obstructive sleep apnea syndrome (OSAS).
  
  
  CONCLUSIONS
  Genioplasty performed during puberty promotes spontaneous lip closure and helps restore nasal ventilation. It improves the obstructive disorder and its manifestations during sleep.
authors.affiliation: Service d'ODF, Inserm U888, UFR odontologie, université Montpellier I, Montpellier cedex 5, France. laure.frapier@wanadoo.fr
authors.forename: Laure
authors.initials: L
authors.lastname: Frapier
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Picot
authors.forename: Jérémy
authors.initials: J
authors.lastname: Gonzales
authors.forename: Laurent
authors.initials: L
authors.lastname: Massif
authors.forename: Isabelle
authors.initials: I
authors.lastname: Breton
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
authors.forename: Patrick
authors.initials: P
authors.lastname: Goudot
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002680:Chin / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008445:Maxillofacial Development; D009058:Mouth Breathing / Q000473:pathology / Q000601:surgery*; D017286:Polysomnography; D011446:Prospective Studies; D011627:Puberty; D019651:Plastic Surgery Procedures; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014716:Vertical Dimension