Effect of Orthognathic Surgery on the Posterior Airway Space in Patients Affected by Skeletal Class III Malocclusion.

Abstract

Dentofacial deformity refers to deviations from normal facial proportions and dental relationships that are severe enough to be handicapping. These anomalies involve many aspects of patient's life and are sometimes also associated with a reduction of pharyngeal air space. Through orthognathic surgery it is possible to treat dentofacial deformities: this kind of surgery has several effects on skeletal structures and it has changes, as it is demonstrated by many studies, also on the upper airways. The orthognathic surgeries commonly used to correct this deformity are the mandibular setback and the maxillary advancement procedures. This study aims to evaluate the effects of maxillary and mandibular surgery on pharyngeal airway dimensions in skeletal class III malocclusions. This study considers 76 patients, treated between 2007 and 2013 by maxillary advancement (11 patients), maxillary advancement and mandibular setback (39 patients), maxillary advancement, mandibular setback and genioplasty reduction (26 patients). Cranial latero-lateral radiography was used to compare oropharyngeal airway morphologies before and 1 year after surgery. The surgeon should consider bimaxillary surgery rather than mandibular setback surgery to correct a class III deformity to prevent the development of obstructive sleep apnea syndrome; in fact, bimaxillary surgery might have less effect on reduction of the pharyngeal airway than mandibular setback surgery only.