Outpatient Notice | Fenghua Joint Clinic's Dragon Boat Festival Holiday Closure Dates

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.

This case shares the treatment experience of a patient with moderate sleep apnea (AHI 22.9). The patient had sleep problems due to mandibular and chin retraction, and was unable to adapt to CPAP treatment. Through 3D customized orthognathic surgery, using the treatment method of counterclockwise rotation and forward movement of the upper and lower jaw bones (CCW-MMA), the 6-month follow-up showed that the AHI dropped to 2.7, successfully improving the symptoms of sleep apnea, while improving the Appearance, the patient was quite satisfied with the surgical results.

A patient with severe sleep apnea (AHI=69.8) decided to seek treatment because of severe snoring that affected his family's quality of life, especially after the birth of his child, and daytime sleepiness. After trying non-surgical methods such as side sleeping, positive pressure respirators, and anti-snoring braces with limited results, I finally chose to undergo MMA orthognathic surgery. After the operation, the AHI dropped from 69.8 to 13, and the minimum blood oxygen concentration during sleep increased from 53% to 83%. This not only improved the mental and physical strength, but also made the family no longer need to wear earplugs to sleep.

Let me share the case of a 39-year-old male patient. Due to insufficient development of the upper and lower jaw bones, they were compressed backwards, resulting in airway stenosis, sleep apnea (AHI 22.5), and daytime sleepiness. The patient's airway space was successfully improved through orthognathic surgery on both jaws, nasal septum correction and lower nose clip plasty surgery. Three months after the operation, the AHI dropped to 5.1, the lowest blood oxygen concentration increased to 93%, and the patient's mental state and quality of life were significantly improved.

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.

This is a patient with extreme sleepiness. His Epworth Sleepiness Scale score is 17. If the score is over 10, it is considered to have reached the level of sleepiness that requires medical intervention. The sleep report he brought from the hospital showed that his AHI was as high as 64.5 (AHI>30 is severe sleep apnea) and his lowest blood oxygen level reached 60%. For patients with retruded mandible and severe sleep apnea, orthognathic surgery (Maxillo-Mandibular Advancement, MMA) should be one of the priority treatment options, especially since this patient is completely unable to accept having to wear a positive pressure ventilator for a long time. The CT scan after the operation showed that the narrow and blocked airway had been widened and supported through the reorganization of the upper and lower jaws. At the same time, the face shape, jaw line, tooth angle and bite state also benefited from the orthognathic surgery. Most importantly, the postoperative sleep report showed that the AHI had dropped to 4.3, which is the same as the normal standard, and the minimum blood oxygen level had increased to 83%. Subjectively, in addition to greatly reducing snoring, he felt much more energetic during the day and was not sleepy.