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Evaluation of pharyngeal airway space changes after bimaxillary orthognathic surgery with a 3-dimensional simulation and modeling program.
Am J Orthod Dentofacial Orthop. 2014 Oct; 146(4):477-92.AJ

Abstract

INTRODUCTION

The aims of this study were to use 3-dimensional simulation and modeling programs to evaluate the effects of bimaxillary orthognathic surgical correction of Class III malocclusions on pharyngeal airway space volume, and to compare them with the changes in obstructive sleep apnea measurements from polysomnography.

METHODS

Twenty-five male patients (mean age, 21.6 years) with mandibular prognathism were treated with bilateral sagittal split osteotomy and LeFort I advancement. Polysomnography and computed tomography were performed before surgery and 1.4 ± 0.2 years after surgery. All computed tomography data were transferred to a computer, and the pharyngeal airway space was segmented using SimPlant OMS (Materialise Medical, Leuven, Belgium) programs. The pretreatment and posttreatment pharyngeal airway space determinants in volumetric, linear distance, and cross-sectional measurements, and polysomnography changes were compared with the paired samples t test. Pearson correlation was used to analyze the association between the computed tomography and polysomnography measurements.

RESULTS

The results indicated that setback procedures produce anteroposterior narrowing of the pharyngeal airway space at the oropharyngeal and hypopharyngeal levels and the middle and inferior pharyngeal volumes (P <0.05). In contrast, advancement of the maxilla causes widening of the airway in the nasopharyngeal and retropalatal dimensions and increases the superior pharyngeal volume (P <0.05). Distinctively, bimaxillary orthognathic surgery induces significant increases in the total airway volume and the transverse dimensions of all airway areas (P <0.05). Significant correlations were found between the measurements on the computed tomography scans and crucial polysomnography parameters.

CONCLUSIONS

Bimaxillary orthognathic surgery for correction of Class III malocclusion caused an increase of the total airway volume and improvement of polysomnography parameters. A proposed treatment plan can be modified according to the risk of potential airway compromise or even to improve it with 3-dimensional imaging techniques and polysomnography.

Authors+Show Affiliations

Associate professor, Department of Orthodontics, Dental Sciences Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey. Electronic address: silagokce@yahoo.com.Associate professor, Department of Orthodontics, Dental Sciences Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.Associate professor, Medical Design and Manufacturing Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.Professor and chairman of Dental Sciences Center, Department of Orthodontics, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.Associate professor, Department of Orthodontics, Dental Sciences Center, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.Associate professor, Department of Radiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25263151

Citation

Gokce, Sila Mermut, et al. "Evaluation of Pharyngeal Airway Space Changes After Bimaxillary Orthognathic Surgery With a 3-dimensional Simulation and Modeling Program." American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics, vol. 146, no. 4, 2014, pp. 477-92.
Gokce SM, Gorgulu S, Gokce HS, et al. Evaluation of pharyngeal airway space changes after bimaxillary orthognathic surgery with a 3-dimensional simulation and modeling program. Am J Orthod Dentofacial Orthop. 2014;146(4):477-92.
Gokce, S. M., Gorgulu, S., Gokce, H. S., Bengi, A. O., Karacayli, U., & Ors, F. (2014). Evaluation of pharyngeal airway space changes after bimaxillary orthognathic surgery with a 3-dimensional simulation and modeling program. American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics, 146(4), 477-92. https://doi.org/10.1016/j.ajodo.2014.06.017
Gokce SM, et al. Evaluation of Pharyngeal Airway Space Changes After Bimaxillary Orthognathic Surgery With a 3-dimensional Simulation and Modeling Program. Am J Orthod Dentofacial Orthop. 2014;146(4):477-92. PubMed PMID: 25263151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of pharyngeal airway space changes after bimaxillary orthognathic surgery with a 3-dimensional simulation and modeling program. AU - Gokce,Sila Mermut, AU - Gorgulu,Serkan, AU - Gokce,Hasan Suat, AU - Bengi,Ali Osman, AU - Karacayli,Umit, AU - Ors,Fatih, PY - 2013/06/01/received PY - 2014/06/01/revised PY - 2014/06/01/accepted PY - 2014/9/30/entrez PY - 2014/9/30/pubmed PY - 2015/2/28/medline SP - 477 EP - 92 JF - American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics JO - Am J Orthod Dentofacial Orthop VL - 146 IS - 4 N2 - INTRODUCTION: The aims of this study were to use 3-dimensional simulation and modeling programs to evaluate the effects of bimaxillary orthognathic surgical correction of Class III malocclusions on pharyngeal airway space volume, and to compare them with the changes in obstructive sleep apnea measurements from polysomnography. METHODS: Twenty-five male patients (mean age, 21.6 years) with mandibular prognathism were treated with bilateral sagittal split osteotomy and LeFort I advancement. Polysomnography and computed tomography were performed before surgery and 1.4 ± 0.2 years after surgery. All computed tomography data were transferred to a computer, and the pharyngeal airway space was segmented using SimPlant OMS (Materialise Medical, Leuven, Belgium) programs. The pretreatment and posttreatment pharyngeal airway space determinants in volumetric, linear distance, and cross-sectional measurements, and polysomnography changes were compared with the paired samples t test. Pearson correlation was used to analyze the association between the computed tomography and polysomnography measurements. RESULTS: The results indicated that setback procedures produce anteroposterior narrowing of the pharyngeal airway space at the oropharyngeal and hypopharyngeal levels and the middle and inferior pharyngeal volumes (P <0.05). In contrast, advancement of the maxilla causes widening of the airway in the nasopharyngeal and retropalatal dimensions and increases the superior pharyngeal volume (P <0.05). Distinctively, bimaxillary orthognathic surgery induces significant increases in the total airway volume and the transverse dimensions of all airway areas (P <0.05). Significant correlations were found between the measurements on the computed tomography scans and crucial polysomnography parameters. CONCLUSIONS: Bimaxillary orthognathic surgery for correction of Class III malocclusion caused an increase of the total airway volume and improvement of polysomnography parameters. A proposed treatment plan can be modified according to the risk of potential airway compromise or even to improve it with 3-dimensional imaging techniques and polysomnography. SN - 1097-6752 UR - https://www.unboundmedicine.com/medline/citation/25263151/Evaluation_of_pharyngeal_airway_space_changes_after_bimaxillary_orthognathic_surgery_with_a_3_dimensional_simulation_and_modeling_program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0889-5406(14)00587-3 DB - PRIME DP - Unbound Medicine ER -