Review the Impact of Mandibular Setback Surgery for the Correction of Class III Malocclusion on the Upper Airway Space

Dareen Aljehani

doi:10.3889/oamjms.2021.7298

Authors

Dareen Aljehani Department of Basic and Preventive Sciences, Dentistry Program, Batterjee Medical College, Jeddah, Saudi Arabia

DOI:

https://doi.org/10.3889/oamjms.2021.7298

Keywords:

Mandibular setback, Obstructive sleep apnea, Pharyngeal airway space, Class III malocclusion, Orthognathic surgery, Skeletal Class III

Abstract

AIM: This study aimed to review the scientific evidence related to the effect of mandibular setback surgery for the correction of Class III malocclusion on the changes in volume and anatomical structures’ positions of the upper airway within at least 1 year follow-up.

METHODS: An electronic research was conducted on PubMed, Google scholar, and Elsevier up to April 20, 2021, the inclusion criteria were prospective or retrospective studies aiming to compare the changes in upper airway space following isolated mandibular setback through at least 1 year of follow-up.

RESULTS: A total of 84 studies were retrieved, only 12 studies met the eligibility criteria. Their methods of measurement were using lateral cephalometry, CT, or Cone-beam computed tomography. Most of them showed narrowing in the Pharyngeal airway space, with some variability within the follow-up periods. Impact on the possibility of obstructive sleep apnea (OSA) was discussed in most of the included studies.

CONCLUSION: Narrowing of upper airway volume is associated with isolated mandibular setback surgeries within 1 year of follow-up. However, OSA was not necessarily a consequence. Any predisposing factors for OSA should be considered before isolated mandibular setback surgery.

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References

Joss CU, Joss-Vassalli IM, Bergé SJ, Kuijpers-Jagtman AM. Soft tissue profile changes after bilateral sagittal split osteotomy for mandibular setback: A systematic review. J Oral Maxillofac Surg. 2010;68(11):2792-801. https://doi.org/10.1016/j.joms.2010.04.020 PMid:20708321 DOI: https://doi.org/10.1016/j.joms.2010.04.020

Ronchi P, Cinquini V, Ambrosoli A, Caprioglio A. Maxillomandibular advancement in obstructive sleep apnea syndrome patients: A restrospective study on the sagittal cephalometric variables. J Oral Maxillofac Res. 2013;4(2):e5. https://doi.org10.5037/jomr.2013.4205 PMid:24422033 DOI: https://doi.org/10.5037/jomr.2013.4205

Tselnik M, Pogrel MA. Assessment of the pharyngeal airway space after mandibular setback surgery. J Oral Maxillofac Surg. 2000;58(3):282-7. http://doi.org/10.1016/s0278-2391(00)90053-3 PMid:10716109 DOI: https://doi.org/10.1016/S0278-2391(00)90053-3

Chen CM, Lai S, Chen KK, Lee HE. Correlation between the pharyngeal airway space and head posture after surgery for mandibular prognathism. Biomed Res Int. 2015;2015:251021. https://doi.org/10.1155/2015/251021 PMid:25977919 DOI: https://doi.org/10.1155/2015/251021

Chen F, Terada K, Hua Y, Saito I. Effects of bimaxillary surgery and mandibular setback surgery on pharyngeal airway measurements in patients with Class III skeletal deformities. Am J Orthod Dentofac Orthop. 2007;131(3):372-7. https://doi.org/10.1016/j.ajodo.2005.06.028 PMid:17346593 DOI: https://doi.org/10.1016/j.ajodo.2005.06.028

Saitoh K. Long-term changes in pharyngeal airway morphology after mandibular setback surgery. Am J Orthod Dentofac Orthop. 2004;125(5):556-61. https://doi.org/10.1016/j.ajodo.2003.04.017 PMid:15127024 DOI: https://doi.org/10.1016/j.ajodo.2003.04.017

Haas OLJ, Becker OE, de Oliveira RB. Computer-aided planning in orthognathic surgery-systematic review. Int J Oral Maxillofac Surg. 2014;S0901-5027(14):430-5. https://doi.org/10.1016/j.ijom.2014.10.025 PMid:25432508 DOI: https://doi.org/10.1016/j.ijom.2014.10.025

Irani SK, Oliver DR, Movahed R, Kim YI, Thiesen G, Kim KB. Pharyngeal airway evaluation after isolated mandibular setback surgery using cone-beam computed tomography. Am J Orthod Dentofac Orthop. 2018;153(1):46-53. https://doi.org/10.1016/j.ajodo.2017.05.031 PMid:29287649 DOI: https://doi.org/10.1016/j.ajodo.2017.05.031

Cho HW, Kim IK, Cho HY, Seo JH, Lee DH, Park SH. Retrospective study of changes in pharyngeal airway space and position of hyoid bone after mandibular setback surgery by cephalometric analysis. Maxillofac Plast Reconstr Surg. 2015;37(1):38. https://doi.org/10.1186/s40902-015-0039-8 PMid:26523276 DOI: https://doi.org/10.1186/s40902-015-0039-8

Choi SK, Yoon JE, Cho JW, Kim JW, Kim SJ, Kim MR. Changes of the airway space and the position of hyoid bone after mandibular set back surgery using bilateral sagittal split ramus osteotomy technique. Maxillofac Plast Reconstr Surg. 2014;36(5):185-91. https://doi.org/10.14402/jkamprs.2014.36.5.185 PMid:27489832 DOI: https://doi.org/10.14402/jkamprs.2014.36.5.185

Park SB, Kim YI, Son WS, Hwang DS, Cho BH. Cone-beam computed tomography evaluation of short-and long-term airway change and stability after orthognathic surgery in patients with Class III skeletal deformities: Bimaxillary surgery and mandibular setback surgery. Int J Oral Maxillofac Surg. 2012;41(1):87-93. http://doi.org/10.1016/j.ijom.2011.09.008 PMid:22024138 DOI: https://doi.org/10.1016/j.ijom.2011.09.008

Abdelrahman TE, Takahashi K, Tamura K, Nakao K, Hassanein KM, Alsuity A, et al. Impact of different surgery modalities to correct class III jaw deformities on the pharyngeal airway space. J Craniofac Surg. 2011;22(5):1598-601. http://doi.org/10.1097/SCS.0b013e31822e5fc2 PMid:21959395 DOI: https://doi.org/10.1097/SCS.0b013e31822e5fc2

Pereira-Filho VA, Castro-Silva LM, de Moraes M, Gabrielli MF, Campos JA, Juergens P. Cephalometric evaluation of pharyngeal airway space changes in class III patients undergoing orthognathic surgery. J Oral Maxillofac Surg. 2011;69(11):e409-15. http://doi.org/10.1016/j.joms.2011.02.132 PMid:21757274 DOI: https://doi.org/10.1016/j.joms.2011.02.132

Gu G, Gu G, Nagata J, Suto M, Anraku Y, Nakamura K, et al. Hyoid position, pharyngeal airway and head posture in relation to relapse after the mandibular setback in skeletal Class III. Clin Orthod Res. 2000;3(2):67-77. PMid:11168287 DOI: https://doi.org/10.1034/j.1600-0544.2000.030203.x

Kawamata A, Fujishita M, Ariji Y, Ariji E. Three-dimensional computed tomographic evaluation of morphologic airway changes after mandibular setback osteotomy for prognathism. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(3):278-87. http://doi.org/10.1016/s1079-2104(00)70089-8 PMid:10710450 DOI: https://doi.org/10.1016/S1079-2104(00)70089-8

Fernández-Ferrer L, Montiel-Company JM, Pinho T, Almerich- Silla JM, Bellot-Arcís C. Effects of mandibular setback surgery on upper airway dimensions and their influence on obstructive sleep apnoea-a systematic review. J Craniomaxillofac Surg. 2015;43(2):248-53. http://doi.org/10.1016/j.jcms.2014.11.017 PMid:25547214 DOI: https://doi.org/10.1016/j.jcms.2014.11.017

Marşan G, Vasfi Kuvat S, Oztaş E, Cura N, Süsal Z, Emekli U. Oropharyngeal airway changes following bimaxillary surgery in Class III female adults. J Craniomaxillofac Surg. 2009;37(2):69-73. http://doi.org/10.1016/j.jcms.2008.11.001 PMid:19117765 DOI: https://doi.org/10.1016/j.jcms.2008.11.001

Samman N, Tang SS, Xia J. Cephalometric study of the upper airway in surgically corrected class III skeletal deformity. Int J Adult Orthodon Orthognath Surg. 2002;17(3):180-90. PMid:12353936

Muto T, Yamazaki A, Takeda S. A cephalometric evaluation of the pharyngeal airway space in patients with mandibular retrognathia and prognathia, and normal subjects. Int J Oral Maxillofac Surg. 2008;37(3):228-31. http://doi.org/10.1016/j.ijom.2007.06.020 PMid:18296029 DOI: https://doi.org/10.1016/j.ijom.2007.06.020

Lenza MG, de O Lenza MM, Dalstra M, Melsen B, Cattaneo PM. An analysis of different approaches to the assessment of upper airway morphology: A CBCT study. Orthod Craniofacial Res. 2010;13(2):96-105. http://doi.org/10.1111/j.1601-6343.2010.01482.x PMid:20477969 DOI: https://doi.org/10.1111/j.1601-6343.2010.01482.x

Hochban W, Schürmann R, Brandenburg U, Conradt R. Mandibular setback for surgical correction of mandibular hyperplasia--does it provoke sleep-related breathing disorders? Int J Oral Maxillofac Surg. 1996;25(5):333-8. http://doi.org/10.1016/s0901-5027(06)80024-x PMid:8961010 DOI: https://doi.org/10.1016/S0901-5027(06)80024-X