Abstract:

Objective·To systematically compare the effects of maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery and simple mandibular setback surgery on the upper airway of patients with skeletal class III malocclusion. Methods·Randomized controlled trials and clinical case-control trials about the comparison of effects of maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery and simple mandibular setback surgery on the upper airway of patients with skeletal class Ⅲ malocclusion were retrieved from Cochrane Library, EMBASE, PubMed, CNKI and Wanfang databases up to February 29, 2016. Included studies were evaluated and analyzed using Rev Man 5.3 software. Results·A total of 6 clinical case-control trial articles and 205 cases were included. The results of meta-analysis showed that the difference in cross-sectional area (CSA) changes on the posterior nasal spine plane and epiglottis plane between two procedures was statistically significant (P<0.05), but the difference in CSA changes on the velar plane was not statistically significant. The difference in nasopharynx volume and upper airway volume changes was statistically significant (P<0.05), but the difference in oropharynx volume and hypopharynx volume changes was not statistically significant. Conclusion·Compared with simple mandibular setback surgery, maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery has slighter effects on CSAs on nasopharynx plane and hypopharynx plane and volumes of nasopharynx volume and upper airway. The combined surgery is more suitable for the treatment of patients with skeletal class Ⅲ malocclusion, especially for those with potential breathing problems.

Key words: mandibular setback surgery, maxillary Lefort Ⅰ osteotomy advancement surgery , skeletal class Ⅲ malocclusion, upper airway, meta analysis