Orthognathic surgery in class II patients and the treatment of obstructive sleep apnea syndrome: a concise systematic review of the clinical studies

Abstract

Introduction: Obstructive sleep apnea (OSA) is characterized by intermittent partial or complete obstruction of the airways during sleep, being called OSA syndrome (OSA) when associated with daytime/nighttime symptoms and/or comorbidities, such as systemic arterial hypertension or diabetes mellitus. The prevalence reaches 32% in the general population, varies between 1% and 20% when associated with COPD (overlap syndrome), and is described as above 60% in populations with COPD and obesity, Orthognathic Surgery (OS) corrects the deformities of the bones of the maxilla and mandible. Objective: It was to highlight the main considerations and outcomes of clinical studies on the importance of orthognathic surgery in class II patients and the treatment of obstructive sleep apnea syndrome. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from October to December 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2005 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 420 articles were found, 157 articles were evaluated and 25 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 103 studies with a high risk of bias and 42 studies that did not meet GRADE. It was concluded that obstructive sleep apnea syndrome is related to comorbidities such as systemic arterial hypertension or diabetes mellitus. Orthognathic surgery treats patients with moderate and severe facial deformities, enabling the achievement of functional balance and harmony in facial aesthetics. Maxillomandibular advancement is an orthognathic surgery procedure that has been used to treat obstructive sleep apnea syndrome. However, maxillomandibular advancement often leads to unsatisfactory esthetic results. Proper early diagnosis and treatment can significantly improve a patient's quality of life, reduce sudden death, and prevent various complications. significantly increased compared to those before surgery, which can significantly improve the symptoms of obstructive sleep apnea syndrome and even achieve complete disappearance of symptoms.