Modification of Orthognathic Surgery for Skeletal Class III OSA Patients

Abstract

In general, mandibular setback surgery is performed for the correction of mandibular protrusion in patients with skeletal Class III malocclusion. A previous study suggested that mandibular retropositioning by more than 5 mm may significantly reduce the posterior airway space and cause mild-to-moderate OSA. Apart from the typical craniofacial phenotype of OSA, some OSA patients have skeletal Class III with prognathic mandible in relation to the obesity or other nonanatomical phenotypic causes. How can we treat the skeletal Class III patient with OSA, if he or she wants to opt for orthognathic surgery for esthetic improvement? Orthodontists should not miss the signs and symptoms of OSA or risk factors of OSA in the diagnosis of skeletal Class III patients who need orthognathic surgery. Moreover, surgical treatment objective needs to be modified to minimize airway narrowing after surgery in Class III patients with OSA.