ArticleFrontiers in oral health2025
Modified maxillomandibular advancement for Eastern Asian patients with moderate or severe OSA: an anatomic and aerodynamic assessment of the upper airway.
Article in Frontiers in oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background/purpose: Maxillomandibular advancement (MMA) is widely used for treating obstructive sleep apnea (OSA) patients. However, conventional MMA may not be suitable for Eastern Asian patients with moderate or severe OSA, as it can lead to unsatisfactory postoperative facial appearance. Hence, modified MMA was reported. Our study aims to evaluate the therapeutic effects of modified MMA on OSA and patient satisfaction with facial appearance. In addition, anatomic and aerodynamic changes in the upper airway were explored. Materials and methods: This retrospective study included 13 patients with moderate or severe OSA. Overnight polysomnography and the Epworth Sleepiness Scale (ESS) scores were recorded before operation and 6 months after operation to evaluate therapeutic outcomes. Spiral CT scans were performed for all patients to reconstruct 3D configurations of the bony structures and the upper airway. Computational fluid dynamics was performed to analyze aerodynamic characteristics. In addition, correlations between bone segment movements and improvement in airway parameters were examined. Results: Modified MMA achieved successful therapeutic and esthetic outcomes in all cases. The apnea-hypopnea index (36.05 ± 17.68 vs. 5.72 ± 4.76, Conclusion: Modified MMA is an excellent therapeutic method for Eastern Asian patients with skeletal class Ⅱ dentomaxillofacial deformity suffering from moderate to severe OSA; it achieves a balance between esthetic improvement and therapeutic efficacy for OSA both anatomically and aerodynamically.
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