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Maxillomandibular Advancement for OSA: A 25-year perspective
L' Orthodontie Francaise
|July 5, 2022
Summary
Surgical and non-surgical maxillary expansion for obstructive sleep apnea (OSA) showed poor results. Distraction osteogenesis maxillary expansion (DOME) caused significant dental issues, while non-surgical methods resulted in dental tipping and bone loss.
Area of Science:
- Orthodontics and Maxillofacial Surgery
- Sleep Medicine
Background:
- Maxillary expansion is used to treat obstructive sleep apnea (OSA).
- Various surgical and non-surgical techniques exist, but their outcomes require critical evaluation.
Purpose of the Study:
- To analyze the patterns and complications of surgical and non-surgical maxillary expansion in OSA patients seeking a second opinion.
Main Methods:
- Retrospective analysis of 28 patients (22 with complete records) who underwent maxillary expansion elsewhere.
- Evaluation included clinical examination, pre- and post-expansion cone beam computed tomography (CBCT), and photographs.
Main Results:
- Distraction osteogenesis maxillary expansion (DOME) in 6 patients showed anterior nasal spine (ANS) separation without posterior nasal spine (PNS) separation, large diastemas, and persistent bone defects.
- Non-surgical expansion in 16 patients (using AGGA, DNA, ALF, MARPE) resulted in dental and dentoalveolar expansion, not midpalatal suture separation.
- Complications included gingival recession, endodontic issues, and significant bone loss with anterior growth guidance appliance (AGGA) treatment.
Conclusions:
- Current maxillary expansion methods yield variable outcomes.
- A critical analysis of these techniques is necessary to ensure desired results and patient well-being.
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