Does orthognathic surgery have an effect on the oropharyngeal airway

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Skeletal movements and changes in the position of the hyoid bone as a result of orthognathic surgery may have on the oropharyngeal airway.  The aim of this article was to report the results from a meta-analysis of the scientific literature concerned with changes in the airway in human clinical trials in adult subjects submitted to orthognathic surgery to correct sagittal skeletal deformities

The databases LILACS, IBECS, Medline, The Cochrane Library, SCIELO databases, Scirus, Ovid and the System for Information on Grey Literature in Europe (SIGLE) were searched.  In addition the reference lists of all included studies were searched and experts contacted to identify unpublished and ongoing studies.

49 articles met the inclusion criteria, Articles were independently assessed for quality and a meta-analysis was performed. Heterogeneity was assessed amongst the studies and results were presented in forest plots. Only studies with moderate or high methodological soundness were included.

They found:-

Moderate evidence  to support a significant decrease in the oropharyngeal airway in mandibular setback surgery, a milder decrease in bimaxillary surgery to correct Class III and an increase in maxillomandibular advancement surgery.

They concluded:-

Three-dimensional studies are important in the near future to confirm the results observed using two-dimensional tools, as evidence is lacking on the volume changes of the airway after orthognathic surgery.

Mattos CT, Vilani GN, Sant’anna EF, Ruellas AC, Maia LC. Effects of orthognathic surgery on oropharyngeal airway: a meta-analysis. Int J Oral Maxillofac Surg. 2011 Jul 20. [Epub ahead of print] PubMed PMID: 21782388.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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