Major clinical results of orthognathic surgery and maxillomandibular advancement in obstructive sleep apnea syndrome

Abstract

Introduction: Obstructive sleep apnea involves obstruction or narrowing of an individual's airway during sleep and is associated with several comorbidities. Management can be surgical or nonsurgical, and Phase II of the Stanford Protocol for surgical management involves maxillomandibular advancement. Objective: It was to carry out a concise systematic review to present the main considerations and clinical results of orthognathic surgery in obstructive sleep apnea syndrome. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 270 articles were found, 47 articles were evaluated and 23 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies at high risk of bias and 125 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with I2 =95.9% >50%. Maxillomandibular advancement surgery is a successful treatment for obstructive sleep apnea, but there are still concerns about the aesthetic results due to the great advances involved. The bimaxillary advancement osteotomy significantly increases the oropharyngeal volume and constricted surface areas, which remains stable between 6 months to 1 year postoperatively.