Publication: Evaluation of airway changes after orthognathic surgery with maxillomandibular advancement or maxillary advancement and mandibular setback
No Thumbnail Available
Date
2021-06-26
Authors
ACAR, YASEMİN BAHAR
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction/Purpose: The relationship between craniofacial morphology and airway has
been well documented in the literature. Surgical changes in jaw positions create reorganization
in the surrounding tissues i.e. soft palate, tongue and pharynx; depending on the magnitude and
direction of correction. Therefore, oropharyngeal changes caused by orthognathic surgery can
affect the airway function. Aim of the present study was to evaluate upper airway changes in
two different orthognathic surgery modalities: 1) Bimaxillary Advancement, 2) Maxillary
Advancement+Mandibular Setback.
Method: Sample in this retrospective study was derived from clinical archive of Orthodontic
department in Marmara University. Preoperative (T1) and 6-12 months postoperative (T2)
lateral cephalometric radiographies of 24 adult subjects (mean age: 22,3 ± 1,8 years), who
underwent bimaxillary orthognathic surgery, were analyzed and superimposed. Direction and
amount of horizontal displacement of A-point and B-point were recorded to define surgical
movements. Patients were then divided into two groups: Group 1 (n=13) included maxillary
advancement+mandibular setback. Group 2 (n=11) included maxillomandibular advancement.
Pharyngeal airway changes were measured at posterior (PAS), superoposterior (SPAS), middle
(MAS), inferior (IAS) and epiglottic airway spaces (EAS). For intragroup changes Paired
sample t-test and Wilcoxon’s test; for intergroup changes Two independent samples t-test and
Mann-Whitney U-test were used. Pearson Correlation analysis was performed.
Findings: In both groups SNA, SNB,ANB, Wits-Appraisal, Nasion-perpendicular to A-point,
maxillary depth values changed significantly. In Group 1, pharyngeal airway changes were nonsignificant. In Group 2 PAS, SPAS, MAS increased significantly and mean pharyngeal airway
changes were significantly higher than Group 1. In Group 2, significant and powerful
correlation was found between SNB and IAS (r=0,800) and EAS (r=0,719).
Conclusion: Mandibular setback did not cause significant reduction in airway when applied in
combination with maxillary advancement. Maxillomandibular advancement significantly
increased the upper airway parameters and a powerful correlation was observed between SNB
and IAS, EAS in this group.
Description
Keywords
Craniofacial morphology, maxillary advancement, mandibular setback, ortognathic surgery
Citation
ACAR Y. B., \"Evaluation of airway changes after orthognathic surgery with maxillomandibular advancement or maxillary advancement and mandibular setback\", 1st International Turkish Japanese Dental Congress 2nd Ankara-Osaka Universities Dental Workshop, 24 - 26 Haziran 2021