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Jaw Surgery and Dental Implants in Singapore Blog

Maxillo-mandibular advancement surgery for Obstructive Sleep Apnea

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 This is NOT a post about mixed martial arts. MMA in this post refers to maxillo-mandibular advancement. This is a surgical procedure of bring the upper jaw (maxilla) and the lower jaw (mandible) into a more forward position so as to open up the airway for breathing. Just as cosmetic jaw surgery is known as orthognathic surgery, “ortho” referring to “straightening” and “gnathic” meaning “jaws”, MMA is sometimes referred to as telegnathic surgery, with “tele” meaning “advancing”. Obstructive sleep apnea is a condition whereby breathing is blocked during sleep due to some anatomical structures obstructing the flow of air from the nose or mouth into the lungs. So, how does MMA solve the problem of OSA.

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Jaw surgery and oral appliance therapy for  Obstructive Sleep Apnea.

bigstock-Attractive-asian-woman-awaking-92232875.jpgI spent my last weekend attending a Sleep Medicine meeting organized by the National University of Singapore. This meeting was to raise funds for the Edmund Tay Mai Hiong Endowment Fund, which seeks to educate dentists on Sleep Medicine and the role they play in management of sleep-related breathing disorders (SBD). This is a very good initiative as dentistry offers solutions to such conditions that are as effective as any branch of medicine. What are the dental treatments that can help patients with sleep-related breathing disorders?

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Planning for Corrective Jaw Surgery for Overbite in Singapore.

bigstock-Side-View-Of-Beautiful-Woman-W-88938653.jpgOverbite deformity, whereby the lower jaw is significantly shorter than the upper jaw is actually a lot more common in Singapore. However, it is not as commonly treated surgically. This may be due to the fact that the ideal jaw relation dictates that the upper jaw is more protruding than the lower jaw. As such overbite only becomes a dentofacial deformity when it exceeds the norm by a significant extent, at least to an extent that the patient is bothered enough by it to seek surgery. However, unlike an underbite deformity, an overbite deformity can cause severe functional problems such as obstructive sleep apnea. The planning for such a case is similar to the underbite, but the movement of the jaws are in the opposite direction.


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Underbite – upper jaw surgery or lower jaw surgery or both?


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A protruding lower jaw is a fairly common facial deformity in Singapore. While it may not be the most common, it is one which for which surgical correction is most sought after. Underbite, as it is commonly called by many patients, poses significant functional challenges, depending on the degree of deformity. When the lower jaw grows disproportionately more than the upper jaw, the lower teeth are brought forward and causing an open bite. This disproportionate growth also cause the facial profile to resemble what some people call the “shoe horn”. Many patients coming for consultation usually assume that the problem can be solved by surgery to set the lower jaw back. However, in reality, most patients actually need something else.

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Corrective jaw surgery for obstructive sleep apnea (OSA)

 

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Obstructive sleep apnea is defined by the American Academy of Sleep Medicine as a “sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe.” Put in a more comprehensible way, it basically means that it is a condition whereby your breathing gets obstructed during sleep. How does this happen? Whether we are asleep of awake, air goes in through either the nose or the mouth or both and enters the lung whereby oxygen is provided to the rest of the body. However, on the way in, air can be obstructed in the nose, by the soft palate, by the tongue, the tonsils, the soft tissue of around the throat or a combination of the above structures. The obstruction causes a reduction in the amount of air entering the lungs leading to a wide range of chronic illnesses. In Singapore, surgical management of OSA is mainly done by Ear Nose & Throat (ENT) specialists while non-surgical management is mainly by either the respiratory physicians or neurologists. Some of these specialists have formal sub-specialty training in Sleep Medicine. Oral and Maxillofacial Surgeons (OMS) and dentists can offer effective alternative treatments that are not used as often as they should.

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