Maxillo-mandibular Advancement
Maxillomandibular advancement is a surgical procedure in which the upper (maxilla) and lower (mandible) jaws are moved forward, enlarging the airway as a whole. It generally provides the more predictable and robust improvement amongst all surgical procedures utilized for OSA however, because the recovery is more prolonged than other procedures and different set of potential risks, the procedure is generally performed in patients who have moderate or severe OSA who have not obtained sufficient improvement after other procedures. In some patients with jaw abnormalities it can be a first-line surgical treatment
All incisions are made inside the mouth, except for small incisions on the cheeks. The upper and lower jaws are mobilized with the use of thin saws and chisels, and they are advanced together, with placement of titanium plates and screws to hold the jaws in position. In some cases the surgery involves placement of large braces (arch bars) on the teeth that remain in place for 6 weeks; and rubber bands are placed to assist in maintaining a stable bite during the healing process.