Systemic outcomes following maxillomandibular advancement for obstructive sleep apnea: systematic review and meta-analysis
In brief
Jaw-advancement surgery linked to 9 mmHg lower systolic pressure in sleep apnea
Across seven studies involving 271 patients with obstructive sleep apnea, jaw-advancement surgery was associated with systolic blood pressure about 9 mmHg lower and diastolic pressure about 5 mmHg lower; all studies also found improved apnea scores. The evidence comes from a small, varied set of studies, so randomized trials are needed to establish lasting systemic benefits.
- Journal
- International journal of oral and maxillofacial surgery (Q1)
- Published
- 16 October 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- C Holmes, A Namavarian, R Malinsky, M Abdelwahab, B Ibrahim
- PMID
- 42888121
- DOI
- 10.1016/j.ijom.2026.09.022
Why clinicians should know about it
- Picked for Otorhinolaryngology (paper of the day, 17 October 2026): MMA reduces AHI and lowers blood pressure
Abstract
Obstructive sleep apnea (OSA) is a common sleep disorder associated with an elevated risk of systemic comorbidities. Maxillomandibular advancement (MMA) surgery can reduce upper airway obstruction and improve sleep parameters, but its systemic health benefits remain less well characterized. This systematic review and meta-analysis was performed to synthesize evidence on the systemic health outcomes associated with MMA in patients with OSA. A comprehensive literature search was conducted in PubMed, Embase, Cochrane CENTRAL, Scopus, and Web of Science from inception through May 20, 2026. Inclusion criteria encompassed original research studies (case series, cohort studies, trials) reporting systemic health outcomes after MMA for OSA. Two reviewers independently screened and extracted data. Risk of bias was assessed using an NIH quality assessment tool. Seven studies (271 patients), with mean follow-up ranging from 5.2 months to 6.6 years, met the inclusion criteria . All studies reported significant reductions in apnea-hypopnea index postoperatively. Four studies included in a meta-analysis demonstrated statistically significant reductions in blood pressure: systolic, mean difference -8.6 mmHg (95% confidence interval -14.2 to -3.0); diastolic, mean difference -5.3 mmHg (95% confidence interval -8.5 to -2.0). MMA for OSA not only improves airway patency and sleep metrics, but is also associated with enduring systemic health benefits, including a blood pressure reduction. Limited evidence also suggests potential improvements in neurocognitive outcomes. Although the evidence suggests a positive impact, further high-quality randomized controlled trials employing rigorous outcome measures (e.g., ambulatory blood pressure monitoring) are needed to fully delineate the persistent systemic effects of maxillomandibular advancement.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.