Splintless maxillomandibular advancement for edentulous sleep apnoea patients: surgical accuracy and efficacy

The primary aim of this study was to assess the accuracy and predictability of a splintless treatment protocol for edentulous patients with moderate to severe obstructive sleep apnoea (OSA) undergoing maxillomandibular advancement (MMA). Ten consecutive edentulous patients treated with MMA were enrolled in this retrospective study. All cases were virtually planned, followed by computer-aided design of individual osteotomy cutting guides and patient-specific implants. For the maxilla, the mean discrepancy between the planned and achieved right to left, posterior to anterior, and cranial to caudal translations was 0.3 ± 0.2 mm, 1.0 ± 0.6 mm, and 0.8 ± 0.6 mm, respectively. There was a mean discrepancy of 0.5° ± 0.5°, 2.5° ± 2.0°, and 0.3° ± 0.4° for roll, pitch, and yaw of the maxilla, respectively. The mean discrepancy of the mandible osteotomy gap was 1.2 ± 1.0 mm on the right side and 0.8 ± 0.5 mm on the left. Surgical success was achieved in nine patients, one of whom met the criteria for surgical cure. On average, the apnoea-hypopnea index was reduced by 72%. The results of this study indicate that the splintless treatment protocol for MMA applied in edentulous OSA patients is highly accurate, predictable, and effective in the treatment of OSA.