Outpatient Notice | Feng Hua Joint Clinic Closed on 228 Memorial Day

This patient had undergone orthodontic treatment with tooth extraction before, but later she found that the problems and concerns she had far exceeded whether her teeth were straight. This time she was referred to our center by a sleep specialist dentist, mainly to solve her severe daytime sleepiness and snoring problems during sleep. After a sleep test, she was diagnosed with moderate sleep apnea (AHI=19.4). CT also showed that her airway stenosis was caused by severe retraction of the mandible, which compressed the posterior airway space. Taking into account her obvious symptoms of sleep apnea (sleepiness, snoring), the cause (narrow bones, lack of space), and her expectations for appearance and occlusion, we designed an orthognathic surgery (MMA: maxillo-mandibular advancement) for her, which would widen her airway and improve her appearance and occlusion. Postoperative orthodontic treatment was performed by the referring physician using Invisilign. The sleep test result six months after the operation was AHI=1.4, which has returned to normal. The symptoms of snoring and sleepiness have disappeared, and she also likes the way she looks after the operation more.

A 28-year-old man sought treatment for severe sleep apnea. The preoperative AHI index was 45 and the lowest blood oxygen concentration was 76%. After diagnosis, it was found that the upper and lower jaw bones were underdeveloped, resulting in airway compression. Through 3D customized orthognathic surgery, counterclockwise rotation and forward movement of both jaws were performed. After the operation, the AHI index dropped significantly to 0.4, and the lowest blood oxygen concentration increased to 92%. The patient's symptoms such as snoring, light sleep and daytime sleepiness have been significantly improved, the respiratory space has been effectively improved, and the treatment effect is excellent.

This 50-year-old woman suffered from severe sleep apnea (AHI = 40.5), with symptoms including severe daytime sleepiness (ESS = 17) and annoying snoring. Interestingly, a CT scan revealed that, in addition to the expected narrowing of her airways, she had undergone a Wassmund and Kole procedure in her youth. This procedure involves extracting one premolar from each side of her upper and lower jaws, then repositioning the upper and lower jaws through bone cutting to correct a protruding mouth.

Why might a receding chin cause breathing difficulties while sleeping? This article takes you inside the operating room, from pre- and post-operative images and 3D digital surgical planning to CT scans, to understand the relationship between a receding chin and airway narrowing, and how MMA orthognathic surgery increases airway space by moving the jawbone forward.

Orthognathic surgery was originally designed to improve the bite and appearance of the patient. However, in the field of treating obstructive sleep apnea, orthognathic surgery (maxillo-mandibular advancement/MMA) has become a means to tighten the collapsed (relaxed) muscles rather than an end. Improvement in appearance and bite has become an added value of maxillo-mandibular advancement.

A sleep apnea patient had to sleep in a separate room with his girlfriend due to severe snoring. After undergoing 3D customized orthognathic surgery and chin advancement surgery, I was most happy when I returned for a follow-up visit six months after the operation. The happiest thing was that my snoring had improved, my girlfriend no longer complained, and I could finally sleep in separate rooms. This case not only improved the patient's sleep quality, but also restored the couple's relationship, demonstrating the importance of sleep apnea treatment in improving the quality of life.