Comparative Meta-Analysis of Complications of Maxillomandibular Advancement for OSA versus Orthognathic Surgeries for Dentofacial Deformities.

Abstract

Maxillomandibular advancement (MMA) surgeries for obstructive sleep apnea (OSA) and orthognathic surgeries for dentofacial deformities (DFDs) are both complex procedures with distinct indications. This meta-analysis and systematic review aimed to compare complications and recovery metrics between these surgeries. CINAHL, Cochrane Library, PubMed, and SCOPUS. Included studies focused on MMA for OSA or orthognathic surgeries for DFDs. Included were 18 bimaxillary studies (n = 1734), 10 single-jaw (n = 3847), and 17 MMA studies (n = 601). Outcomes analyzed included operative time, hospital stay, and complications such as neurosensory disturbance, infection, and hardware removal. MMA demonstrated a surgical success rate of 79.6% and a cure rate of 39%. Compared to bimaxillary surgery, MMA was associated with longer operative time (343.87 vs 326.95 min; P = .021) and postoperative hospital stay (4.22 vs 3.25 days; P < .0001). Neurosensory disturbance was comparable between MMA (40.44%) and bimaxillary surgeries (44.91%; P = .2189), but highest in single-jaw procedures (55.18%; P < .001). MMA had higher postoperative infection (16.34%) and hardware removal rates (21.99%) than bimaxillary surgery (3.55% and 4.21%, respectively; P < .0001). Postoperative OSA developed in 12.25% of bimaxillary cases for DFDs. Our findings underscore the need for tailored preoperative counseling and risk stratification when selecting orthognathic surgical interventions. MMA offers a high surgical success rate but is associated with longer operative time, increased hospital stay, and higher rates of infection and hardware removal compared to bimaxillary and single-jaw surgeries. These findings highlight the need to balance efficacy with complication risk when selecting surgical approaches for OSA or DFDs.