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Obstructive Sleep Apnea (OSA)

OMS and Other Dental Specialists

Session: Oral Abstract Session Two

SA2 - Bone Grafting in Maxillomandibular Advancement Surgery in Obstructive Sleep Apnea: A Retrospective Cohort Study

Friday, October 2, 2026
1:35 PM - 1:45 PM PDT

    Oral Abstract Presenter(s)

  • kk

    karel kuik

    OMF surgeon
    Isala Zwolle
    Zwolle, Overijssel, Netherlands

    • Co-Author(s)

  • JT

    Jean-Pierre T.F. Ho, DDS, MD

    Oral Maxillofacial Surgeon
    Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
    Amsterdam, Noord-Holland, Netherlands

  • Jd

    Jan de Lange, DDS, MD, PhD

    Professor and head of the department of Oral and Maxillofacial surgery
    Amsterdam University Medical Center
    Amsterdam, Noord-Holland, Netherlands

Abstract: Objective: This retrospective study assessed the influence of different bone grafting techniques on complications and skeletal stability in patients undergoing bilateral sagittal split ramus osteotomy during maxillomandibular advancement surgery (MMA) for the treatment of obstructive sleep apnea (OSA).

Methods: The sagittal split osteotomy gap was grafted using either xenogeneic bone grafts (Bio-Oss collagen, n = 20) or autologous bone grafts harvested from the anterior iliac crest (AIC, n = 17) and compared with a non-grafted control group (n = 20). Data on surgical-site infection and need for removal of osteosyntheses material were extracted from medical records. Mandibular border defects were evaluated using panoramic radiographs. The degree of mandibular advancement and postoperative relapse was assessed on cephalometric radiographs.

Results: Use of xenogeneic bone grafts was associated with lower odds of having unilateral or bilateral mandibular border defects compared to the control group (OR: 0.068; 95% CI: 0.007-0.678; P = .022). In contrast, autologous bone grafts did not show a significant difference in odds of having unilateral or bilateral border defects in comparison with the control group (OR: 0.441; 95% CI: 0.107-1.828; P = .259). Patients in the AIC group exhibited significantly greater mandibular advancement compared to the control group (B: 3.122; 95% CI: 0.173-6.071; P = .038), while the mandibular advancement in Bio-Oss collagen group did not show a significant difference compared to the control group (B: 0.507; 95% CI: -1.427-2.441; P = .600). There was no significant association of grafting methods with the extent of postoperative skeletal relapse in millimeters (Bio-Oss collagen group vs control: B: 0.382; 95% CI: -0.829-1.594; P = .529; AIC group vs control: B: 0.019; 95% CI: -1.280-1.318; P = .976), occurrence of surgical-site infection (Bio-Oss collagen group vs control: OR: 3.029; 95% CI: 0.441-20.821; P = .260; AIC group vs control: OR: 2.507; 95% CI: 0.372-16.911; P = .345), and removal of osteosynthesis material (Bio-Oss collagen group vs control: OR: 0.452; 95% CI: 0.088-2.313; P = .341; AIC group vs control: OR: 1.162; 95% CI: 0.267-5.061; P = .842).

Conclusion: Xenogeneic grafting significantly reduced the odds of having unilateral or bilateral mandibular border defects compared with non-grafting. AIC grafting was associated with greater mandibular advancement compared with the non-grafting group.

Bone grafting did not significantly increase the magnitude of the postoperative skeletal relapse, the odds of occurrence of surgical-site infection or the removal of osteosynthesis material.