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Impact of counterclockwise rotation of the occlusal plane on the mandibular advancement, pharynx morphology, and polysomnography results in maxillomandibular advancement surgery for the treatment of obstructive sleep apnea patients

  • Dentistry • Original Article
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Abstract

Purpose

Evaluate the impact of counterclockwise rotation of the occlusal plane (CCWROP) on pharynx morphology and polysomnography in maxillomandibular advancement (MMA) surgery to treat obstructive sleep apnea (OSA) patients.

Methods

Prospective clinical trial of patients with OSA treated by MMA. Computed tomography and polysomnography were performed pre- and postoperatively and the parameters were compared. The surgery classified the patients into two groups: with (R) and without (NR) CCWROP.

Results

The study sample comprised 38 individuals: R (n = 19) and NR (n = 19). An anterior mandible advancement of 0.71 mm was identified for each degree of CCWROP (p < 0.001). As for polysomnography, the apnea-hypopnea index was reduced by 80% and 62% in R and NR, showing final values of 6.8 and 13.0, respectively. The apnea index changed equally in both groups. Reduction of 68 and 26% in the hypopnea index was observed for R and NR, respectively, with no statistically significant difference. Total volume increased by 45% in R and 30% in NR. Retropalatal and retrolingual volumes increased by 49% and 4% in R and 43% and 15% in NR, respectively. The minimum axial area increased by 92% in the retropalatal region and 97% in the retrolingual region in R, whereas these increases were of 76% and 31% in NR, respectively.

Conclusion

Anterior mandibular advancement of 0.71 mm for each degree of CCWROP is of great importance for surgical planning. As a result of this resource, individuals in R presented better results than those in NR in all parameters assessed, especially regarding the retrolingual region.

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Funding

This study was funded by CAPES- Coordination of Superior Level Staff Improvement.

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Authors and Affiliations

  1. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av. Sumaré 752, sala 2, Ribeirão Preto, São Paulo, Brazil

    Mariana Christino, Pedro Pileggi Vinha, Ana Célia Faria, Denny Marcos Garcia & Francisco Veríssimo de Mello-Filho

Authors
  1. Mariana Christino
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  2. Pedro Pileggi Vinha
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  3. Ana Célia Faria
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  4. Denny Marcos Garcia
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  5. Francisco Veríssimo de Mello-Filho
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Corresponding author

Correspondence to Mariana Christino.

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Conflict of interest

Mariana Christino has received research grants from CAPES. Author Pedro Pileggi Vinha declares that he has no conflict of interest. Ana Célia Faria declares that she has no conflict of interest. Denny Marco Garcia declares that he has no conflict of interest. Author Francisco Veríssimo de Mello-Filho declares that he has no conflict of interest.

Ethical approval

The research protocol was approved by the Research Ethics Committee of the Hospital das Clínicas of the Ribeirão Preto Medical School of the University of São Paulo (HC-FMRP-USP), according to process HCRP no. 3135/2014, and registered with the National Research Ethics Commission under no. 21398514.5.0000.5440, and opinion no. 566.861.

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Informed consent was obtained from all individuals included in the study.

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Christino, M., Vinha, P.P., Faria, A.C. et al. Impact of counterclockwise rotation of the occlusal plane on the mandibular advancement, pharynx morphology, and polysomnography results in maxillomandibular advancement surgery for the treatment of obstructive sleep apnea patients. Sleep Breath 25, 2307–2313 (2021). https://doi.org/10.1007/s11325-020-02279-8

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  • DOI: https://doi.org/10.1007/s11325-020-02279-8

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