title: Sleep-disordered breathing following mandibular setback: a systematic review of the literature.
abstract: BACKGROUND
  A mandibular setback reduces space in the pharyngeal airway, and it has been suggested that it might induce sleep-disordered breathing.
  
  
  OBJECTIVE
  An evidence-based literature review was conducted to identify the effect of mandibular setback on the respiratory function during sleep.
  
  
  METHODS
  The authors performed a systematic review of pertinent literature published up to 2014. A structured search of literature was performed, with predefined criteria. A survey of the PubMed, ScienceDirect, and Cochrane database was performed. A manual search of oral and maxillofacial surgery-related journals was accomplished. Potentially relevant studies then had their full-text publication reviewed.
  
  
  RESULTS
  A total of 1,780 publications were evaluated, through which nine papers (seven case series and two case-control studies) were selected for the final review. No evidence of sleep disorder after six months was related in 223 patients. In one study, two patients developed obstructive sleep apnea syndrome after surgery, and in another two studies, seven patients presented an increase of obstructive apneas/hypopneas events and oxygen desaturation index. Most of the patients analyzed were young and thin.
  
  
  CONCLUSIONS
  There was no evidence of postoperative sleep apnea syndrome after a mandibular setback surgery. However, one should always consider a potential reduction of the upper airway space during the treatment plan. Obese patients and those submitted to large amounts of mandibular setbacks present a higher chance to develop obstructive sleep apnea syndrome.
authors.affiliation: Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil. drcanellas@icloud.com.
authors.forename: João Vitor dos Santos
authors.initials: JV
authors.lastname: Canellas
authors.affiliation: Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.
authors.forename: Hugo Leonardo Mendes
authors.initials: HL
authors.lastname: Barros
authors.affiliation: Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.
authors.forename: Paulo José D'Albuquerque
authors.initials: PJ
authors.lastname: Medeiros
authors.affiliation: Rio de Janeiro State University, Rua Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.
authors.forename: Fabio Gamboa
authors.initials: FG
authors.lastname: Ritto
mesh_terms: D000402:Airway Obstruction / Q000209:etiology; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D063175:Mandibular Reconstruction; D017286:Polysomnography; D011183:Postoperative Complications / Q000209:etiology*; D011378:Prognathism / Q000601:surgery*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000209:etiology*
keywords: Angle class III; Malocclusion; Obstructive; Oral; Oral surgical procedures; Orthognathic surgery; Prognathism; Sleep apnea; Surgery