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Patients who are predisposed to obstructive sleep apnea (OSA) often have upper airway obstruction in the nasopharynx or the oropharynx. Mandibular advancement and tongue-restraining devices are usually effective options for the management of OSA in selected patients. However, positive airway pressure therapy is considered the gold standard treatment for the management of OSA in adults. Maxillomandibular advancement surgery is an effective surgical technique for treatment of moderate to severe OSA. The role of the transverse maxillomandibular dimension (TMMD) in OSA is not fully understood, but recent reports appear to confirm that normalizing TMMD may assist in the treatment of OSA. With the help of two case reports, this manuscript reviews the mechanics used to change TMMD. These cases illustrate that patients may benefit from just increasing the TMMD alone, or both TMMD and anteroposterior measurements, if they experience snoring and OSA. TMMD followed by bimaxillary advancement, when indicated, might be more effective than maxillomandibular advancement alone.

journal of dental sleep medicine

Consideration of Maxillary Skeletal Expansion (MSE) and Mandibular Symphyseal Distraction Osteogenesis (MSDO) for the Treatment of Sleep Apnea and Snoring