Virtual Surgical Planning for Patients with Skeletal-Dental and Obstructive Sleep Apnea Syndrome

Abstract

The integration of virtual surgical planning (VSP) for the treatment of skeletal, dental, and facial abnormalities and obstructive sleep apnea (OSA) with maxillofacial surgery has catapulted surgical planning. Although reported for treating skeletal-dental abnormalities and dental implant surgery, a paucity of knowledge existed reporting the feasibility and resultant outcome measures when VSP was employed for planning maxillary and mandibular surgery for OSA patients. The surgery-first approach is at the forefront of advancing maxillofacial surgery. Case series reporting success with the surgery-first approach for patients with skeletal-dental and sleep apnea patients have been reported. In sleep apnea patients, clinically significant reductions in apnea-hypopnea index and improvement of low oxyhemoglobin saturation have been achieved. More so, significant improvement in the posterior airway space at the occlusal and mandibular planes were achieved, while preserving aesthetic norms as measured by tooth to lip measurements. VSP is a feasible tool used for predicting surgical outcome measures in maxillomandibular advancement surgery for patients with skeletal, dental, facial, and OSA derangements.

Keywords

virtual surgical plan - surgery first - LeFort I - sagittal split osteotomy - obstructive sleep apnea

Publikationsverlauf

Accepted Manuscript online:
18. Mai 2023

Artikel online veröffentlicht:
12. Juni 2023

• References

• 1 Levine JP, Patel A, Saadeh PB, Hirsch DL. Computer-aided design and manufacturing in craniomaxillofacial surgery: the new state of the art. J Craniofac Surg 2012; 23 (01) 288-293
• 2 Zizelmann C, Hammer B, Gellrich NC, Schwestka-Polly R, Rana M, Bucher P. An evaluation of face-bow transfer for the planning of orthognathic surgery. J Oral Maxillofac Surg 2012; 70 (08) 1944-1950
• 3 Poirrier AL, Pire S, Raskin S, Limme M, Poirrier R. Contribution of postero-anterior cephalometry in obstructive sleep apnea. Laryngoscope 2012; 122 (10) 2350-2354
• 4 Pachêco-Pereira C, Abreu LG, Dick BD, De Luca Canto G, Paiva SM, Flores-Mir C. Patient satisfaction after orthodontic treatment combined with orthognathic surgery: a systematic review. Angle Orthod 2016; 86 (03) 495-508
• 5 Behrman SJ, Behrman DA. Oral surgeons' considerations in surgical orthodontic treatment. Dent Clin North Am 1988; 32 (03) 481-507
• 6 Uribe FA, Farrell B. Surgery-first approach in the orthognathic patient. Oral Maxillofac Surg Clin North Am 2020; 32 (01) 89-103
• 7 Pelo S, Gasparini G, Garagiola U. et al. Surgery-first orthognathic approach vs traditional orthognathic approach: oral health-related quality of life assessed with 2 questionnaires. Am J Orthod Dentofacial Orthop 2017; 152 (02) 250-254
• 8 Zingler S, Hakim E, Finke D. et al. Surgery-first approach in orthognathic surgery: Psychological and biological aspects - a prospective cohort study. J Craniomaxillofac Surg 2017; 45 (08) 1293-1301
• 9 Zamboni R, de Moura FRR, Brew MC. et al. Impacts of orthognathic surgery on patient satisfaction, overall quality of life, and oral health-related quality of life: a systematic literature review. Int J Dent 2019; 2019: 2864216
• 10 Kwon TG, Han MD. Current status of surgery first approach (part II): precautions and complications. Maxillofac Plast Reconstr Surg 2019; 41 (01) 23
• 11 Peiró-Guijarro MA, Guijarro-Martínez R, Hernández-Alfaro F. Surgery first in orthognathic surgery: a systematic review of the literature. Am J Orthod Dentofacial Orthop 2016; 149 (04) 448-462
• 12 Yang L, Xiao YD, Liang YJ, Wang X, Li JY, Liao GQ. Does the surgery-first approach produce better outcomes in orthognathic surgery? A systematic review and meta-analysis. J Oral Maxillofac Surg 2017; 75 (11) 2422-2429
• 13 Mahmood HT, Ahmed M, Fida M, Kamal AT, Fatima F. Concepts, protocol, variations and current trends in surgery first orthognathic approach: a literature review. Dental Press J Orthod 2018; 23 (03) 36.e1-36.e6
• 14 Resnick CM, Inverso G, Wrzosek M, Padwa BL, Kaban LB, Peacock ZS. Is there a difference in cost between standard and virtual surgical planning for orthognathic surgery?. J Oral Maxillofac Surg 2016; 74 (09) 1827-1833
• 15 Steinhuber T, Brunold S, Gärtner C, Offermanns V, Ulmer H, Ploder O. Is virtual surgical planning in orthognathic surgery faster than conventional planning? A time and workflow analysis of an office-based workflow for single- and double-jaw surgery. J Oral Maxillofac Surg 2018; 76 (02) 397-407
• 16 Schneider D, Kämmerer PW, Hennig M, Schön G, Thiem DGE, Bschorer R. Customized virtual surgical planning in bimaxillary orthognathic surgery: a prospective randomized trial. Clin Oral Investig 2019; 23 (07) 3115-3122
• 17 Nilsson J, Hindocha N, Thor A. Time matters - Differences between computer-assisted surgery and conventional planning in cranio-maxillofacial surgery: a systematic review and meta-analysis. J Craniomaxillofac Surg 2020; 48 (02) 132-140
• 18 Lin HH, Lonic D, Lo LJ. 3D printing in orthognathic surgery - a literature review. J Formos Med Assoc 2018; 117 (07) 547-558
• 19 Barrera JE. Virtual surgical planning improves surgical outcome measures in obstructive sleep apnea surgery. Laryngoscope 2014; 124 (05) 1259-1266
• 20 Jandali D, Barrera JE. Recent advances in orthognathic surgery. Curr Opin Otolaryngol Head Neck Surg 2020; 28 (04) 246-250