Maxillomandibular advancement in edentulous patients as a treatment option for obstructive sleep apnea: report of two cases and a proposed treatment protocol

Obstructive sleep apnea (OSA) is a common disease that often causes debilitating symptoms. In its most severe form, OSA increases the risk of cardiovascular disease and mortality. OSA is characterized by repeated episodes of pharyngeal collapse leading to airway obstruction. The treatment options available in severe cases are limited to continuous positive airway pressure ventilation and maxillomandibular advancement (MMA). OSA is particularly difficult to treat successfully in edentulous patients. Two cases are presented here to illustrate use of MMA in edentulous patients with OSA. Our learning points based on these cases are shared, and a treatment and follow-up protocol is proposed for this specific patient group.

Experiencing your own orthognathic surgery: a personal case report

There has been much research on minimizing the side effects of orthognathic surgery. However, there are very few doctors and researchers who themselves have undergone this surgery. This case report describes the findings of a maxillofacial surgeon who underwent combined orthodontic and orthognathic treatment for correction of Class II malocclusion. In March 2012, the surgeon was referred to an orthodontist, and an orthodontic examination revealed a Class II, division 2, malocclusion with a traumatic palatal bite and attrition of the lower front teeth. The patient underwent alignment of the upper and lower arches, followed by a bilateral sagittal split osteotomy. During this treatment, he made many interesting observations and learned much as a patient, which can have implications in improving the outcomes and quality of care for patients receiving such treatment. Thus, this case report aims to provide a critical perspective of the surgical procedure and treatment from the viewpoint of a maxillofacial surgeon who himself experienced the surgery as a patient.