Counterclockwise maxillomandibular advancement: a choice for Chinese patients with severe obstructive sleep apnea

Wei, Silong; Zhang, Yong; Guo, Xiaojing; Yu, Wenwen; Wang, Meng; Yao, Kun; Sun, Hao; Zhang, Hua; Lü, Xingcai

doi:10.1007/s11325-017-1484-7

Cited by 18 publications

(9 citation statements)

References 20 publications

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“…The maxillo-mandibular advancement values achieved by the patients studied are compatible with other studies in the literature 16,18 . In the cases in which only the mandibular advancement was performed, which was the greater part of the sample studied 19 , the mean value found for point B was lower compared to that of the maxillomandibular surgery group (4.81 mm, SD 3, 43mm), although both values are within those reported in the literature. This fact proves that the movements observed in the studied sample are comparable to the ones from studies already published, acting as a parameter for the evaluation of the modifications occurred in the oropharyngeal airspace.…”

Section: Discussionsupporting

confidence: 55%

“…Another movement capable of providing an increase in oropharyngeal airspace is the anticlockwise rotation of the occlusal plane, due to the lower and anterior positioning it provides to the soft tissues of the palate, promoting an increase in space for the tongue that is now more anterior 9,16,18,19 . Keeping the supra-hyoid muscles attached to the anterior region of the mandible promotes an anterior tension of the tongue and hyoid bone, pulling them forward, and consequently, significantly increasing the pharyngeal airspace.…”

Section: Discussionmentioning

confidence: 99%

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Changes in head posture, hyoid bone position and airway dimensions after orthognatic surgery

Azevedo¹,

Feitoza

Vargas

et al. 2018

Braz. J. Oral Sci.

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Mandibular/bimaxillary advancement surgery is described as a potential means of increasing the oropharyngeal airspace , provided a significant improvement in breathing capacity. Aim: To evaluate postural changes suffered in the positioning of the head and the hyoid bone, dentofacial deformity patients undergoing orthognathic surgery with consequent dimensional changes of oropharyngeal airspace. Methods: We evaluated the archived records of patients with postoperative 6 months minimum, being used as criteria for selecting individuals with dental class II malocclusion and facial Pattern II, jaw or maxilomandibular deficiency, patients undergoing orthodontic-surgical treatment through mandibular advancement or of both bony bases, associated or not to genioplastia. Twenty-eight patients were part of the sample and were evaluated by means of lateral radiographs in lateral standard digitized, in three distinct periods: pre-operative, immediate postoperative period and late postoperative period (minimum 6 months). 12 linear measures and two angular cephalometric analysis were used in this research. Results: With the surgery, there was an average of mandibular advancement 6, 76 mm, while remaining stable in the long-term follow-up period; the hyoid bone moved onward and upward, extending your movement in the post-operative. The cervical region presented minimal movement of the head extension in the immediate post operative with almost total returns the position of the head in the post-operative. The surgical movement of oropharyngeal air space was in the same direction of the mandibular movement, but to a lesser extent (1,88 -2,76 mm). In the post-operative period was a late partial reduction of the diameter of the air space between 34-56% of gain, representing an apparent accommodation of this anatomical region soft tissue. Conclusion: Orthognathic surgery of mandibular advancement or bimaxillary promotes significant changes in aesthetics, in the position of the hyoid bone and upper airway dimensions, getting better quality of life to these patients.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Changes in head posture, hyoid bone position and airway dimensions after orthognatic surgery

Azevedo¹,

Feitoza

Vargas

et al. 2018

Braz. J. Oral Sci.

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“…Convex deformity has always been a problem that concerns some Chinese adults a lot [41]. Adult patients, mainly aged from 18 to 40, have been gradually aware of their pro le esthetics and kept seeking effective therapeutic methods in recent years [42].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Piezocision in Accelerating Maxillary Anterior Teeth En-Masse Retraction: Study Protocol for a Randomized Controlled Trial

Liu

et al. 2022

Preprint

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Background: Orthodontic treatment is commonly more time-consuming in adults than in teenagers, especially when it comes to the maxillary en-masse retraction, which may take 9 months or even longer. As to solve this concern, orthodontists have been striving to seek new methods for shortening orthodontic treatment time. Piezocision, as a popular alternative treatment, have been widely used in different types of tooth movement. However, its effect on en-masse retraction of maxillary anterior teeth remains unclear. This randomized controlled trial intends to figure out the role piezocision plays in accelerating en-masse retraction. Methods: This protocol is designed for a prospective, single-center, assessor-blinded and parallel-group randomized controlled trial. Twenty adult patients aged from 18 to 40 whose orthodontic treatment required bilateral maxillary first premolars extraction will be randomly assigned to the piezocision group and the control group at a ratio of 1:1. The piezocision group will undergo en-masse retraction immediately after the piezo surgery, while the control group will start en-masse retraction directly. Both groups will be followed up every two weeks to maintain the retraction force until the end of space closure. The space closing time is set as the primary endpoint. Meanwhile, the secondary endpoints include the change of root length, labial and palatal alveolar bone thickness, vertical bone height, probing depth of maxillary anterior teeth, cephalometric measurements, visual analogue scale, and postoperative satisfaction questionnaire.Discussion: This study will attempt to provide more convincing evidence to verify whether piezocision will shorten the time of en-masse retraction or not. Distinguished with previous studies, our study has made some innovations in orthodontic procedure and primary outcome measurement, aiming to clarify the efficacy and safety of piezocision-assisted en-masse retraction in Chinese population.Trial registration: Chinese Clinical Trial Registry ChiCTR 1900024297. Registered on 5 July 2019.

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“…Convex deformity has always been a problem that concerns some Chinese adults a lot [ 42 , 43 ]. Adult patients with convex deformity, mainly aged from 18 to 40, have high treatment expectations, demanding the most retraction to achieve a straight profile [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of piezocision in accelerating maxillary anterior teeth en-masse retraction: study protocol for a randomized controlled trial

Tong

et al. 2022

Trials

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Background Orthodontic treatment is commonly more time-consuming in adults than in teenagers, especially when it comes to the maxillary en-masse retraction, which may take 9 months or even longer. As to solve this concern, orthodontists have been striving to seek new methods for shortening orthodontic treatment time. Piezocision, as a popular alternative treatment, has been widely used in different types of tooth movement. However, its effect on en-masse retraction of maxillary anterior teeth remains unclear. This randomized controlled trial intends to figure out the role piezocision plays in accelerating en-masse retraction. Methods This protocol is designed for a prospective, single-center, assessor-blinded and parallel-group randomized controlled trial. Twenty adult patients aged from 18 to 40 whose orthodontic treatment required bilateral maxillary first premolars extraction will be randomly assigned to the piezocision group and the control group at a ratio of 1:1. The piezocision group will undergo en-masse retraction immediately after the piezo surgery, while the control group will start en-masse retraction directly. Both groups will be followed up every 2 weeks to maintain the retraction force until the end of space closure. The space closing time is set as the primary endpoint. Meanwhile, the secondary endpoints include the change of root length, labial and palatal alveolar bone thickness, vertical bone height, probing depth of maxillary anterior teeth, cephalometric measurements, visual analogue scale, and postoperative satisfaction questionnaire. Discussion This study will attempt to provide more convincing evidence to verify whether piezocision will shorten the time of en-masse retraction or not. Distinguished with previous studies, our study has made some innovations in orthodontic procedure and primary outcome measurement, aiming to clarify the efficacy and safety of piezocision-assisted en-masse retraction in Chinese population. Trial registration Chinese Clinical Trial Registry ChiCTR 1900024297. Registered on 5 July 2019

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Counterclockwise maxillomandibular advancement: a choice for Chinese patients with severe obstructive sleep apnea

Abstract: These findings indicate that CMMA is an effective way to achieve a balance between airway enlargement and facial appearance for Chinese patients with severe OSA.

Cited by 18 publications

References 20 publications

Changes in head posture, hyoid bone position and airway dimensions after orthognatic surgery

Changes in head posture, hyoid bone position and airway dimensions after orthognatic surgery

Efficacy and Safety of Piezocision in Accelerating Maxillary Anterior Teeth En-Masse Retraction: Study Protocol for a Randomized Controlled Trial

Efficacy and safety of piezocision in accelerating maxillary anterior teeth en-masse retraction: study protocol for a randomized controlled trial

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