Soft tissue changes after maxillo-mandibular advancement in OSAS patients: A three-dimensional study

IntroductionMaxillo-mandibular advancement (MMA) is the most successful surgical treatment for OSAS. This study prospectively evaluated soft tissue changes in typical OSAS patient before and after MMA.Material and methodsTen patients with severe OSAS, who underwent MMA, were considered. Age, BMI, polysomnographic recordings and cephalometric data were examined. Facial surface data acquired using a 3D laser scanner before (T0) and 1 year (T1) after surgery were pooled by electronic surface averaging to obtain the mean T0 and T1 facial model. A virtual optimal face (V) was used as control group. Mean T0, T1 and V models were compared.ResultsThe mean AHI improved from 69.8 ± 35.2 to 17.3 ± 16.7. The mean maxillary advancement was 9.2 mm ± 1.2 and the mean mandibular advancement was 10.4 mm ± 2.2. The comparison between T0 and T1 showed an overall increase of the sagittal projection of the cheeks, lips and of the chin. The comparison between T1 and V showed a transversal increase of the cheeks at the cross section through ch (cheilon).ConclusionMMA is a highly effective treatment for OSAS. The evaluations of 3D laser scanning showed that surgery in OSAS patients didn't cause an impairment of the facial appearance.