Obstructive sleep apnea (OSA) is a common sleep disorder syndrome, especially in the middle-aged, obese men population. Patients suffer from an interrupted sleep at night, which could be life-threatening. Treatment alternatives include continuous positive airway pressure, mandible advanced device, nasal surgery and maxillo-mandibular advancement surgery. This article presented a patient who came with chief complaints of lower jaw retrusion, poor sleep quality, unsatisfactory occlusion and old prosthesis. The patient had declined the surgical-orthodontics in 12 years ago, and went for another camouflage orthodontic treatment with extraction of teeth and multiple prosthesis. He presented with skeletal Class II with retrognathic mandible and uncoordinated upper dental midline with facial midline. Intraorally, he demonstrated deep overbite, splinted upper anterior prothesis, some missing teeth with space closure in previous camouflage treatment as well as 36, 37 implant prosthesis. Functionally, he had mild OSA with smaller airway dimension. He received two-jaw surgical-orthodontics and surgery-first approach, LeFort I osteotomy and bilateral sagittal split osteotomies for maxilla-mandible complex counter-clockwise rotation with advancement. Postsurgical full mouth orthodontic treatment was to improve dental alignment and space distribution. For the poor prognosis of anterior tooth, forced eruption was performed to maintain and induce alveolar bony height and width before tooth extraction. Previous implant prosthesis was used for a stationary landmark for dental occlusion correction. Through proper evaluation and good communication with the surgeon, prosthodontist and periodontist, this patient was well recovered from OSA with functional interdigitation, fair prosthodontic condition and esthetic appearance.
Chen, Si-Rong; Lin, Cheng-Hui; and Ko, Ellen Wen-Ching
"Multidisciplinary Retreatment of Skeletal Class II Malocclusion with Obstructive Sleep Apnea and Multiple Prosthesis,"
Taiwanese Journal of Orthodontics: Vol. 34:
4, Article 5.
https://doi.org/10.38209/2708-2636.1327 Available at: https://www.tjo.org.tw/tjo/vol34/iss4/5
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