title: Cephalometric analysis and long-term outcomes of orthognathic surgical treatment for obstructive sleep apnoea.
abstract: The aim of this study was to describe skeletal and posterior airway changes after orthodontic treatment and surgical jaw advancement, and to evaluate whether there is a correlation between increasing advancement and a long-term reduction in obstructive sleep apnoea (OSA). Lateral cephalograms and polysomnography (apnoea-hypopnoea index, AHI) were collected from patients treated with bilateral sagittal split osteotomy (BSSO) or maxillomandibular advancement (MMA) in combination with orthodontics. Patients completed a questionnaire and the Epworth Sleepiness Scale (ESS) to assess long-term outcomes. Descriptive statistics for cephalometric measurements and linear regression were performed to find estimates of the final OSA (AHI and ESS) as a function of mandibular advancement. Forty-three patients with surgical advancement of the maxilla (5.2mm) and mandible (8.3mm) had a 4-mm increase in posterior airway. Thirty-three patients completed the long-term survey (6.3±2.6 years after treatment); 91% reported a reduction of OSA and were pleased with their facial appearance. The maxillomandibular and posterior airway increased. There was no evidence of a linear relationship between greater amounts of mandibular advancement and improvement of OSA. Patients with less than 10mm advancement had successful objective short-term and subjective long-term OSA reduction.
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Washington, Seattle, WA, USA.
authors.forename: E D
authors.initials: ED
authors.lastname: Ubaldo
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Washington, Seattle, WA, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Greenlee
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Washington, Seattle, WA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Moore
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Washington, Seattle, WA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Sommers
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Washington, Seattle, WA, USA. Electronic address: mine@uw.edu.
authors.forename: A-M
authors.initials: AM
authors.lastname: Bollen
mesh_terms: D000328:Adult; D002508:Cephalometry; D005260:Female; D006801:Humans; D008297:Male; D019186:Mandibular Advancement; D008875:Middle Aged; D009970:Orthodontics; D056948:Orthognathic Surgical Procedures; D059229:Osteotomy, Sagittal Split Ramus; D017286:Polysomnography; D011859:Radiography; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: cephalometry; obstructive sleep apnoea; orthodontics; surgical jaw advancement