Khan Sofia, Sutton Sarah R, Nguyen Shaun A, Rinn Andrea M, Capasso Robson, Lal Chitra, Rakha Abdelwahab, Huja Sarandeep S, Tremont Timothy J, Abdelwahab Mohamed
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA 94305, USA.
Br J Oral Maxillofac Surg. 2025 Feb;63(2):83-90. doi: 10.1016/j.bjoms.2024.10.241. Epub 2024 Nov 26.
The aim of this paper was to systematically review and compare the Apnoea-Hypopnoea Index (AHI), Lowest O Saturation (LSAT), Oxygen Desaturation Index (ODI), Epworth Sleep Scale (ESS), and Body Mass Index (BMI) between dentofacial (skeletal) classes I, II, and III before and after maxillomandibular advancement (MMA) for Obstructive Sleep Apnoea (OSA). The PubMed, Scopus, and CINAHL databases were searched from inception to 23 November 2022. Two reviewers screened for articles that reported occlusion/malocclusion class type as I, II, or III, and reported preoperative and postoperative AHI, LSAT, ODI, ESS, and/or BMI. Two reviewers independently screened title/abstracts and subsequently, full-text articles that met eligibility criteria. Preoperative ESS and ODI were significantly higher in Class II (13.77, 95% CI, 11.38% to 16.17% and 47.49, 95% CI, 33.04% to 61.95%) than in Class III (12.47, 95% CI, 9.95% to 14.99% and 32.47, 95% CI, -10.37% to 75.30%) (p < 0.0001). Postoperatively, class I showed the greatest percentage reduction of AHI, with a reduction of 89.61% (95% CI, 84.47% to 94.75%) compared with class II and III (p < 0.0001). Additionally, amongst all malocclusion classes and operative status, meta-regression showed positive correlations between ESS and AHI (r = 0.94, p < 0.001) and ESS and ODI (r = 0.90, p < 0.001). Class I subjects with no dentofacial discrepancy had the greatest improvement in AHI compared with Class II and III. Class II subjects may express more severe ODI and ESS preoperatively compared with Class III subjects. Additionally, subjective outcomes (ESS) may be a predictor for objective outcomes (AHI and ODI) for patients undergoing MMA.
本文旨在系统回顾和比较阻塞性睡眠呼吸暂停（OSA）患者在上下颌前徙术（MMA）前后，I类、II类和III类牙颌面（骨骼）畸形患者的呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSAT）、血氧饱和度下降指数（ODI）、爱泼华嗜睡量表（ESS）和体重指数（BMI）。检索了PubMed、Scopus和CINAHL数据库，检索时间从建库至2022年11月23日。两名评审员筛选报告了I类、II类或III类咬合/错牙合类型，并报告了术前和术后AHI、LSAT、ODI、ESS和/或BMI的文章。两名评审员独立筛选标题/摘要，随后筛选符合纳入标准的全文文章。II类患者术前的ESS和ODI显著高于III类患者（分别为13.77，95%CI，11.38%至16.17%和47.49，95%CI，33.04%至61.95%）（12.47，95%CI，9.95%至14.99%和32.47，95%CI，-10.37%至75.30%）（p<0.0001）。术后，I类患者AHI的降低百分比最大，与II类和III类患者相比降低了89.61%（95%CI，84.47%至94.75%）（p<0.0001）。此外，在所有错牙合类型和手术状态中，meta回归显示ESS与AHI（r=0.94，p<0.001）以及ESS与ODI（r=0.90，p<0.001）之间呈正相关。与II类和III类患者相比，无牙颌面差异的I类患者AHI改善最大。与III类患者相比，II类患者术前可能表现出更严重的ODI和ESS。此外，主观结果（ESS）可能是接受MMA治疗患者客观结果（AHI和ODI）的预测指标。
