DOI:

10.37988/1811-153X_2019_1_40

Orthognatic surgery planning in complex treating obstructive sleep apnea. Part 1

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Authors

  • M.A. Mokhirev 1, PhD in Medical Sciences, researcher
  • D.A. Volchek 1, PhD in Medical Sciences, orthodontist, researcher
  • M.V. Tardov 2, PhD in Medical Sciences, neurologist, senior researcher
  • G.B. Ospanova 1, PhD in Medical Sciences, research adviser
  • G.R. Arutunov 1, resident doctor
  • A.E. Vydrina 1, resident doctor
  • 1 Central Research Institute of Dental and Maxillofacial Surgery, 119021, Moscow, Russia
  • 2 Research Clinical Institute of Otorhinolaryngology, 117152, Moscow, Russia

Abstract

Obstructive sleep apnea syndrome (OSA) is a potentially life-threatening respiratory disorder. Medium and severe forms of OSA lead to the development of excessive daytime sleepiness, hemodynamic disorders, metabolic disorders and instability of cardiac activity. The authors have improved the diagnosis and treatment planning of patients with skeletal malocclusion, complicated by moderate and severe OSA syndrome with the use of orthognathic surgery and maxillo-mandibular advancement (OSMMA). Planning of complex orthodontic and surgical treatment of patients with OSA using the method of OSMMA consists of the precision analysis of models of dentition and computed tomography of the patient‘s head with the reconstruction of the volume of the airways of the pharynx. The stages of orthodontic preparation for orthognathic surgery and postoperative management are determined. 3D computer modelling OSMMA is performed taking into account the increase in the volume of airways of the pharynx. The effectiveness of treatment is assessed on the basis of polysomnography or cardiorespiratory monitoring data.

Key words:

orthognathic surgery, obstructive sleep apnea syndrome, snoring, orthodontic treatment, skeletal malocclusion, underdevelopment of the jaw, osteotomy

For Citation

[1]
Mokhirev M.A., Volchek D.A., Tardov M.V., Ospanova G.B., Arutunov G.R., Vydrina A.E. Orthognatic surgery planning in complex treating obstructive sleep apnea. Part 1. Clinical Dentistry (Russia).  2019; 1 (89): 40—45. DOI: 10.37988/1811-153X_2019_1_40

References

  1. Guilleminault C., Tilkian A., Dement W.C. The sleep apnea syndromes. - Annu Rev Med. - 1976; 27: 465-84.DOI: https://dx.doi.org/10.1146/annurev.me.27.020176.002341.
  2. Бузунов Р.В., Легейда И.В., Царева Е.В. Храп и синдром обструктивного апноэ сна у взрослых и детей. Практическое руководство для врачей. - М., 2013. - С. 10-11.
  3. Бузунов Р.В., Легейда И.В., Царева Е.В. Храп и синдром обструктивного апноэ сна у взрослых и детей. Практическое руководство для врачей. - М., 2013. - С. 6-7.
  4. Sullivan C.E., Issa F.G., Berthon-Jones M., Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. - Lancet. - 1981; 1 (8225): 862-5.
  5. Epstein L.J., Kristo D., Strollo P.J. Jr, Friedman N., Malhotra A., Patil S.P., Ramar K., Rogers R., Schwab R.J., Weaver E.M., Weinstein M.D. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. - J Clin Sleep Med. - 2009; 5 (3): 263-76.
  6. Weaver T.E., Grunstein R.R. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. - Proc Am Thorac Soc. - 2008; 5 (2): 173-8.
  7. Baratta F., Pastori D., Bucci T., Fabiani M., Fabiani V., Brunori M., Loffredo L., Lillo R., Pannitteri G., Angelico F., Del Ben M. Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea syndrome. - Sleep Med. - 2018; 43: 66-70.
  8. Ishman S.L., Ishii L.E., Gourin C.G. Temporal trends in sleep apnea surgery: 1993-2010. - Laryngoscope. - 2014; 124 (5): 1251-8.
  9. Powell N.B. Contemporary surgery for obstructive sleep apnea syndrome. - Clin Exp Otorhinolaryngol. - 2009; 2 (3): 107-14.
  10. Holty J.E., Guilleminault C. Maxillomandibular advancement for the treatment of obstructive sleep apnea: a systematic review and meta-analysis. - Sleep Med Rev. - 2010; 14 (5): 287-97.
  11. Zaghi S., Holty J.E., Certal V., Abdullatif J., Guilleminault C., Powell N.B., Riley R.W., Camacho M. Maxillomandibular advancement for treatment of obstructive sleep apnea: a meta-analysis. - JAMA Otolaryngol Head Neck Surg. - 2016; 142 (1): 58-66.
  12. Ruehland W.R., Rochford P.D., O’Donoghue F.J., Pierce R.J., Singh P., Thornton A.T. The new AASM criteria for scoring hypopneas: impact on the apnea hypopnea index. - Sleep. - 2009; 32 (2): 150-7.
  13. Бузунов Р.В., Легейда И.В., Царева Е.В. Храп и синдром обструктивного апноэ сна у взрослых и детей. Практическое руководство для врачей. - М., 2013. - С. 65-66.
  14. Moorrees C.F., Kean M.R. Natural head position: A basic consideration in the interpretation of cephalometric radiographs. - Am J Phys Anthropol. - 1958; 16: 213-34.
  15. Lundström F., Lundström A. Natural head position as a basis for cephalometric analysis. - Am J Orthod Dentofacial Orthop. - 1992; 101 (3): 244-7.
  16. Madsen D.P., Sampson W.J., Townsend G.C. Craniofacial reference plane variation and natural head position. - Eur J Orthod. - 2008; 30 (5): 532-40.
  17. Weber D.W., Fallis D.W., Packer M.D. Three-dimensional reproducibility of natural head position. - Am J Orthod Dentofacial Orthop. - 2013; 143 (5): 738-44.
  18. Bolton W. Disharmony in tooth size and its relation to the analysis and treatment of malocclusion. - Angle Orthod. - 1958; 28 (3): 113-30.
  19. Tomassetti J.J., Taloumis L.J., Denny J.M., Fischer J.R. Jr. A comparison of 3 computerized Bolton tooth-size analyses with a commonly used method. - Angle Orthod. - 2001; 71 (5): 351-7.
  20. Бушан М.Г. Патологическая стертость зубов и ее осложнения. - Кишинев, 1979. - С. 94-95.
  21. Kim J., Lagravére M.O. Accuracy of Bolton analysis measured in laser scanned digital models compared with plaster models (gold standard) and cone-beam computer tomography images. - Korean J Orthod. - 2016; 46 (1): 13-9.
  22. Arnett G.W., Bergman R.T. Facial keys to orthodontic diagnosis and treatment planning. Part I. - Am J Orthod Dentofacial Orthop. - 1993; 103 (4): 299-312.
  23. Arnett G.W., Bergman R.T. Facial keys to orthodontic diagnosis and treatment planning-Part II. - Am J Orthod Dentofacial Orthop. - 1993; 103 (5): 395-411.
  24. Arnett G.W., Jelic J.S., Kim J., Cummings D.R., Beress A., Worley C.M. Jr, Chung B., Bergman R. Soft tissue cephalometric analysis: diagnosis and treatment planning of dentofacial deformity. - Am J Orthod Dentofacial Orthop. - 1999; 116 (3): 239-53.
  25. Arnett G.W. Facial and dental planning for orthodontists and oral surgeons. - Mosby, 2004. - P. 151-173.
  26. Arnett G.W., Gunson M.J. Facial analysis: The key to successful dental treatment planning. - J Cosmet Dent. - 2005; 21 (3): 20-33.
  27. Фадеев Р.А., Зотова Н.Ю., Кузакова А.В. Метод обследования височно-нижнечелюстных суставов с использованием дентальной компьютерной томографии. - Институт стоматологии. - 2011; 4: 34-6.
  28. Ikeda K., Kawamura A. Assessment of optimal condylar position with limited cone-beam computed tomography. - Am J Orthod Dentofacial Orthop. - 2009; 135 (4): 495-501.
  29. Ikeda K., Kawamura A., Ikeda R. Assessment of optimal condylar position in the coronal and axial planes with limited cone-beam computed tomography. - J Prosthodont. - 2011; 20 (6): 432-8.

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Published on

March 1, 2019