For the Correction of Dentoskeletal Deformities and Obstructive Sleep Apnea
Traditionally, combining orthognathic surgery and orthodontic therapy has been used to correct moderate to severe dentoskeletal deformity, which is difficult to accomplish with an orthodontic treatment alone.
Orthognathic surgery is used for the following reasons:
- Management of a severe dentoskeletal discrepancy, which is out of the scope of treatment by orthodontic means alone. Dentofacial disharmony in which esthetic camouflage or dental compensation can produce a less desirable esthetic or unstable functional result.
- Improvement of a dentoskeletal discrepancy, recognized as an etiologic factor for the dysfunction of the masticatory system, TMJ and speech mechanism.
- Improvement of an oropharyngeal discrepancy, recognized as an etiologic factor for the dysfunction of an upper pharyngeal airway causing obstructive sleep apnea.
Ideally, the combination of orthognathic surgery and orthodontic therapy is directed toward maximizing the forward movement of the jaws for proper correction of the masticatory and airway function and for acquisition of optimal dentofacial esthetics and harmony. Surgical strategy and magnitude of the maxillary/mandibular or chin advancement is determined by the site or severity of oropharyngeal obstruction. Significant forward movement of the maxillary (10 mm) and mandibular/chin structures (10 mm to 20 mm) is usually the acceptable range of osteotomy for correction of moderate to severe OSA.