Three-dimensional changes to the upper airway after maxillomandibular advancement with counterclockwise rotation: a systematic review and meta-analysis. Issue 5 (May 2018)

• Record Type: Journal Article
• Authors: Louro, R.S.; Calasans-Maia, J.A.; Mattos, C.T.; Masterson, D.; Calasans-Maia, M.D.; Maia, L.C.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 47:Issue 5(2018:May)
• Page Start: 622
• Page End: 629
• Publication Date: 2018-05
• Subjects: upper airway -- orthognathic surgery -- systematic review -- meta-analysis; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2017.11.003
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: The aim of this study was to evaluate the effect of counterclockwise (CCW) rotation and maxillomandibular advancement (MMA) on the upper airway space using three-dimensional images. An electronic search was performed in the PubMed, Cochrane Library, Scopus, Virtual Health Library, Web of Science, and OpenGrey databases (end date July 2016); a hand-search of primary study reference lists was also conducted. The inclusion criteria encompassed computed tomography evaluations of the upper airway spaces of adult patients undergoing orthognathic surgery with CCW rotation and MMA. The articles were evaluated for risk of bias with a tool for before-and-after studies. A meta-analysis was performed with the mean differences using a random-effects model. Heterogeneity was assessed with the Q -test and the I 2 index. The meta-analysis revealed significant ( P < 0.001) increases in both the total airway volume (effect size of 6832 mm 3 and confidence interval of 5554–8109 mm 3 ) and the minimum axial area (effect size of 92 mm 2 and confidence interval of 70–113 mm 2 ). The heterogeneity was low in both comparisons ( I 2 = 38% and 7%, respectively). The technique of mandibular advancement with CCW rotation produced significant increases in the volumes and areas of the upper airway spaces.