Indian Journal of Sleep Medicine

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VOLUME 2 , ISSUE 3 ( July-September, 2007 ) > List of Articles


Management of Obstructive Sleep Apnea and Non Apneic Snoring with Maxillo-Mandibular Distraction Osteogenesis

K Ravishankar, BNBM Prasad, B Jayan, SK Roy Chowdhury, PS Menon

Citation Information : Ravishankar K, Prasad B, Jayan B, Chowdhury SR, Menon P. Management of Obstructive Sleep Apnea and Non Apneic Snoring with Maxillo-Mandibular Distraction Osteogenesis. Indian Sleep Med 2007; 2 (3):101-108.

DOI: 10.5005/ijsm-2-3-101

License: CC BY-SA 4.0

Published Online: 01-07-2007

Copyright Statement:  Copyright © 2007; Jaypee Brothers Medical Publishers (P) Ltd.


Background: Recently Distraction Osteogenesis (DO) has been used successfully for advancing maxilla and mandible to treat sleep disordered breathing like Obstructive sleep apnea and non apneic snoring. Prime advantage of DO is slow stretching of soft tissues and bone formation allowing greater advancement and enhancement of airway volume. Patients and Methods: 10 cases with sleep disordered breathing due to maxillo-mandibular discrepancy of varying age groups were treated by various DO techniques.. All the cases showed gross improvement not only in facial and dental aesthetics but also respiratory symptoms. A mean increase of 5.14 mm and 1.85mm with respect to posterior airway space and retro palatal space was observed in mandibular corpus lengthening cases. All the cases showed improvement subjectively and objectively. Conclusion: DO has been found to be valuable and gives us the ability to both prevent and correct the development of sleep disordered breathing.

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  1. Cohen SR, Ross DA, Burstein FD et al. Skeletal expansion combined with soft tissue reduction in the treatment of Obstructive sleep apnea in children; physiological results. Oto laryngol Head Neck Surg. 1998. 119; 476-480.
  2. Diner PA, Tomat C, Sergent B, Martinez H, Vanquez MP. Mandibular lengthening using intra oral distracters. In Craniofacial distraction Osteogenesis. Samchukov ML, Cope JB, Cherkasi AM. eds. Elsievier.2000; 247-255.
  3. Smith K, Harmish M. Pediatric sleep apnea treated with distraction Osteogenesis. In Cranio facial distraction Osteogenesis. Samchukov ML, Cope JB, Cherkasi AM. eds. Elsievier.2000; 213-224.
  4. Cope JB, Samchukov ML, Cherkasin AM. Mandibular distraction Osteogenesis: A historical perspective and future directions. Am J Orthod Dento facial Orthop. 1999. 115; 448-460.
  5. Borowiecki DB, Kukwa A, Blanks RH. Cephalometric analysis for diagnosis and treatment of Obstructive sleep apnea. Laryngoscope.1998.98; 226-231.
  6. Menon S, Roy Chowdhury SK, Vasant MR: Distraction osteogenesis in management of obstructive sleep apnoea. Indian Journal of Oral & Maxillofacial Surgery, 2003 .18 (3); 25-29.
  7. Rachmiel A, Aizenbund D, Pillar G, Srouji S, Peled M. Bilateral mandibular distraction for patients with compromised airway analysed by 3D CT Scan. International journalof Oral and Maxillofacial surgery.2005.34(1); 9- 18.
  8. Jayan B, Roy Chowdhury SK, Kharbanda OP, Kotwal A. Orthodontics in intra oral bilateral sagittal mandibular distraction Osteogenesis. Journal of Dentistry Defence Section.2007. 2(2); 4-13.
  9. Jayan B, Roy Chowdhury SK, Karkun S, Kamat UR.Treatment of skeletal class2 div2 malcclusion with associated upper airway sleepdisorder. A Case report. Journal of Dentistry Defence Section. 2006. 1(1); 46-49.
  10. Mazinni C. Report on two international congress on distraction Osteogenesis. Paris and Stuttgart. 2005.
  11. Distraction Osteogenesis. A new frontier in correcting Dentofacial deformities. Orthodontic dialogue of AAO. Spring 2000. 12(2); 1-4.
  12. Hanson PR, Melugin MB. Orthodontic management of patients undergoing mandibular distraction Osteogenesis. Semin Orthod. 1999. 5(1). 25-29.
  13. Peltomaiki T, Grayson BH, Venditelli BL, Katzen T, Mc Carthy JG.Moulding of regenerate to control open bite during distraction Osteogenesis. The European Journal of Orthodontics. 2002. 24(6); 639-645.
  14. Drew SJ. Distraction Osteogenesis. sleep review; Journal for sleep specialists. May-Jun 2002.(
  15. Prinsell JR. Maxillomandibular advancement surgery in site specific treatment approach for obstructive sleep apnea in 50 consecutive patients. Chest. 1999.116; 1519- 1529.
  16. Waite PD, Shashidhar MS. Maxillo-mandibular advancement surgery : A cure for obstructive sleep apnea syndrome. Oral and Maxillofac surg clinicNorth Am. 1995. 7 ; 327-344.
  17. Li KK, Riley RW, Powel NB, et al. Maxillomandibular advancement for persistent obstructive sleep apnea after phase I surgery in patients without maxillomandibular deficiency. Laryngoscope. 2000. 110; 1684-1688.
  18. Johal A, Battagel JM. Current principles in the management of obstructive sleep apnea with mandibular advancement appliances. British Dental Journal. 2001.190(10) ; 532-536.
  19. American sleep disorders association standards of practice committee, practice parameters for treatment of snoring and obstructive sleep apnea with oral appliances. Sleep. 1995. 18; 511-513.
  20. Jayan B, Prasad BNBM, Rajput AK, Bhattacharya R, Dhiman RK. Management of obstructive sleep apnea with oral appliance: our experience. Indian J Sleep Med. 2006. 1(4). 204-207.
  21. Abramson DL, Marrinan EM, Mulliken JB. Robin sequence: Obstructive sleep apnea following pharyngeal flap. Cleft palate Cranio fac J. 1997. 34; 256.
  22. Friedman M. Palatal stiffening as a CPAP alternative. Sleep review; Journal for sleep specialists. Jun 2007. (
  23. Cistulli P, Palmisano RG, Poole MD. Treatment of obstructive sleep apnea syndrome by rapid maxillary expansion. Sleep. 1998. 21; 831-835.
  24. Hartgerink DU, Vig PS, Abbot DW. The effect of rapid maxillary expansion on nasal resistance. Am J Orthod Dentofacial Orthop. 1987.92(2). 381-389.
  25. Babacan H, Sukucu O, Doruk C, Sinan A. Rapid maxillary expansion and surgically assisted rapid maxillary expansion effects on nasal volume.The AngleOrthodontist.2006. 76(1). 66-71.
  26. Chin M, Toth BA: Distraction osteogenesis in maxillofacial surgery using internal devices : a review of five cases. Int J Oral Maxillofac Surg, 1996. 54; 45 - 53.
  27. Spier S, Rivlin J, Rowe RD, Egan T. Sleep in Pierre -Robin syndrome. Chest. 1986. 90; 711-715.
  28. Johnson C, Taussing LN, Koopman C et al. Obstructive sleep apnea in Treacher Collin syndrome. Cleft Palate Craniofac J. 1985. 18. 39-43.
  29. Steinbacher DM, Kaban LB, Troulis MJ. Mandibular advancement by distraction osteogenesis for tracheostomy children with severe micrognathia. J Oral Maxillofac Surg. 2005. 63 (8);1072-1079.
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