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KMID : 0361920190490040265
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Korean Journal of Orthodontics
2019 Volume.49 No. 4 p.265 ~ p.276
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Maxillomandibular advancement surgery after long-term use of a mandibular advancement device in a post-adolescent patient with obstructive sleep apnea
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Lee Keun-Ha
Kim Kyung-A
Kwon Yong-Dae
Kim Sung-Wan
Kim Su-Jung
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Abstract
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Patients with obstructive sleep apnea (OSA) whose phenotype belongs to a craniofacial vulnerability are referred from sleep doctors to orthodontists. In adults, for osseo-pharyngeal reconstruction (OPR) treatment, permanent maxillomandibular advancement (MMA) surgery and use of a temporary mandibular advancement device (MAD) are applied. This case report demonstrates successful treatment of OSA through application of phased MAD and MMA in a 16-year-old male with craniofacial deformity and residual growth potential. This patient showed skeletal and dentoalveolar changes after 7-year MAD use throughout post-adolescence, which affected the design and timing of subsequent MMA surgery, as well as post-surgical orthodontic strategy. This case report suggests that OPR treatment can be useful for treatment of OSA in post-adolescent patients, from an orthodontic point of view, in close collaboration with sleep doctors for interdisciplinary diagnosis and treatment.
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KEYWORD
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Obstructive sleep apnea, Maxillomandibular advancement surgery, Mandibular advancement device, Surgery-firtst approach
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