The airway implications in treatment planning two-jaw orthognathic surgery: The impact on minimum cross-sectional area

The impact of orthognathic surgery on the pharyngeal airway supported by cone-beam computed tomography (CBCT) technology has been the topic of many recent studies. The minimum cross-sectional area (MCA) has also been evaluated but not with respect to vertical position changes of the MCA with movement of the facial skeleton. Vertical position changes and shape changes of 71 patients after orthognathic treatment of Class II and Class III malocclusions were evaluated with CBCT images and Invivo5 software. The vertical changes were found not to be significant for Class II and Class III patients (5.0 mm and 0.2 mm respectively, p = 0.31). In addition, the vertical changes of the MCA with individual skeletal movement were also not significant. The shape changes were not consistent relative to individual Angle classification. Vertical changes of the MCA after orthognathic surgery could not be associated with Angle’s classification or skeletal movement while shape changes were not predictable. Orthognathic surgical planning is a complex process in which the patient’s occlusion, facial balance, and harmony are considered. The purpose of this article is to provide surgical insight into obtaining the best possible results when considering the multifactorial nature of orthognathic surgical treatment planning. Original research on the changes in MCA will be presented.