Temporomandibular Joint Ankylosis Leading to Obstructive Sleep Apnea

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent partial or complete obstruction of the airways during sleep and is called OSAS syndrome when associated with day/night 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 (OC) can correct deformities of the maxillary and mandibular bones in OSAS. Objective: It was to develop the main approaches and clinical results of orthognathic surgery for the treatment of obstructive sleep apnea syndrome through a systematic review. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from November 2023 to February 2024 in the 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: 146 articles were found, 58 articles were evaluated and 26 were included in this systematic review. Considering the Cochrane tool for risk of bias, the global assessment resulted in 32 studies with a high risk of bias and 22 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2 =65.8%>50%. Maxillomandibular advancement surgery is a successful treatment for obstructive sleep apnea, but there are still concerns about cosmetic results due to the major advances involved. Bimaxillary advancement osteotomy significantly increases oropharyngeal volume and contracted superficial areas, which remain stable between 6 months and 1 year postoperatively.

Section: Major Clinical Resultsmentioning

confidence: 99%

Section: Vol 5 Suppl 2 Year 2024mentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Clinical results of orthognatic surgery in the treatment of obstructive sleep apnea syndrome: a systematic review

Ferreira,

Cavatão,

Magalhães

et al. 2024

“…Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible [1]. In this context, the facial deformity has a negative impact, resulting in social and psychological disadvantages [2,3].…”

Section: Introductionmentioning

confidence: 99%

Use of fat graft to correct facial asymmetries in patients undergoing Orthognathic Surgery: the systematic review

Bovo¹,

Santos²,

Magalhães³

et al. 2023

Introduction: Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible. In this scenario, fat grafting is a powerful tool for corrections and also for facial aesthetic improvement together or after OS. The benefits of fat grafting during orthognathic surgery; to maximize aesthetic results, minimize swelling and optimize wound healing. Objective: To analyze the main clinical studies on the benefits and risks of facial fat grafting in orthognathic surgery, to know the current state of the art. Methods: It followed a systematic literature review model on the main clinical findings of orthognathic surgery and fat grafting, according to the rules of PRISMA. The research was carried out from January 2021 to May 2021 and developed based on Google Scholar, Scopus, PubMed, Ovid, Scielo, and Cochrane Library. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: 123 studies were analyzed, with only 52 medium and high-quality studies selected, according to GRADE rules, and with risks of bias that do not compromise scientific development, based on the Cochrane instrument. Studies have shown that OS aims to establish harmonious facial esthetics, excellent functional occlusion, and improved airway conditions. As an important adjunct to OS, fat grafting is becoming more and more common due to its anti-inflammatory role and effects on facial swelling. High patient satisfaction with the results. Postoperative swelling resolved at week 12 in the fat graft group and persistent edema. The edema decrease over time, with almost complete resolution within 1 year, improvement in facial morphology, function, quality, and skin texture in most of their patients. The use of assisted lipo transfers containing mesenchymal stem cells derived from adipose tissue, enables improvement in skin quality, smoothing of wrinkles, pore size, and attenuation of pigmentation and resolution of scars. Furthermore, enrichment of the lipoaspirate with stem cells derived from adipose tissue increases graft retention. Conclusion: Most of the studies analyzed in this review study showed that fat grafting in orthognathic surgery is a safe and effective tool to improve wound healing, improve aesthetic results, present an anti-inflammatory effect and reduce edema.

“…Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible [1,2]. In this context, the facial deformity has a negative impact, resulting in social and psychological disadvantages [3][4][5][6]. The technique has undergone great evolution in the last two decades and has been growing continuously.…”

Section: Introductionmentioning

confidence: 99%

Orthognathic surgery and fat injection for corrective liposculpture: a systematic review

Lucchese¹,

Bisetto²,

Idalgo³

et al. 2022

Introduction: Orthognathic Surgery (OS) aims to correct deformities of the bones of the maxilla and mandible. In this scenario, fat grafting is a powerful tool for corrections and also for facial aesthetic improvement together or after OS. The benefits of fat grafting during orthognathic surgery; to maximize aesthetic results, minimize swelling and optimize wound healing. Objective: To analyze the main clinical studies on the benefits and risks of facial fat grafting in orthognathic surgery, to know the current state of the art. Methods: It followed a systematic literature review model on the main clinical findings of orthognathic surgery and fat grafting, according to the rules of PRISMA. The research was carried out from July to September 2022 and developed based on Google Scholar, Scopus, PubMed, Ovid, Scielo, and Cochrane Library, using scientific articles from 1986 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: 123 studies were analyzed, with only 32 medium and high-quality studies selected, according to GRADE rules, and with risks of bias that do not compromise scientific development, based on the Cochrane instrument. Studies have shown that OS aims to establish harmonious facial esthetics, excellent functional occlusion, and improved airway conditions. As an important adjunct to OS, fat grafting is becoming more and more common due to its antiinflammatory role and effects on facial swelling. High patient satisfaction with the results. Postoperative swelling resolved at week 12 in the fat graft group and persistent edema. The edema decrease over time, with almost complete resolution within 1 year, improvement in facial morphology, function, quality, and skin texture in most of their patients. The use of assisted lipo transfers containing mesenchymal stem cells derived from adipose tissue, enables improvement in skin quality, smoothing of wrinkles, pore size, and attenuation of pigmentation and resolution of scars. Furthermore, enrichment of the lipoaspirate with stem cells derived from adipose tissue increases graft retention. Conclusion: Most of the studies analyzed in this review study showed that fat grafting in orthognathic surgery is a safe and effective tool to improve wound healing, improve aesthetic results, present an anti-inflammatory effect and reduce edema.