رویکردهای بین رشته‌ای در جراحی دهان و فک و صورت: پیامدهای درمان ارتوگناتیک بر آپنه انسدادی خواب، فشار خون بالا و نتیجه باروری: مرور روایتی

زمینه و هدف: جراحی ارتوگناتیک برای اصلاح ناهنجاری‌های دندانی-صورتی ضروری است و به دلیل تاثیر آن بر شرایط سیستمیک مانند آپنه انسدادی خواب (osa) و فشار خون بالا، به‌طور فزاینده‌ای شناخته شده است. این بهبودها همچنین ممکن است از طریق کاهش التهاب سیستمیک و استرس اکسیداتیو، بر نتایج باروری تاثیر مثبتی بگذارد. هدف این مطالعه بررسی رویکردهای بین‌رشته‌ای در جراحی دهان و فک و صورت، با تمرکز بر اثرات درمان ارتوگناتیک بر osa، فشار خون بالا و باروری است و در عین حال نقش مراقبت‌های مشترک و فناوری‌های دیجیتال نوظهور را برجسته می‌کند. روش کار: یک مرور جامع از ادبیات موجود، با تجزیه و تحلیل کارآزمایی‌های بالینی، مطالعات موردی و مرورهای سیستماتیک انجام شد که اثرات جراحی ارتوگناتیک بر osa، فشار خون بالا و نتایج باروری را بررسی می‌کند. تمرکز این مطالعه بر رویکردهای بین‌رشته‌ای درمان، فناوری‌های دیجیتال در برنامه‌ریزی جراحی، و نتایج بلندمدت سلامت قلبی-عروقی و باروری است. یافته‌ها: جراحی ارتوگناتیک، به‌ویژه mma، به‌طور قابل‌توجهی شدت osa را با بهبود باز شدن راه هوایی کاهش می‌دهد که به نوبه خود منجر به بهبود کنترل فشار خون و کاهش خطرات قلبی-عروقی مرتبط با فشار خون بالا می‌شود. مطالعات نشان می‌دهد که درمان osa و فشار خون بالا از طریق جراحی ارتوگناتیک می‌تواند با کاهش التهاب سیستمیک و استرس اکسیداتیو، تاثیر مثبتی بر نتایج باروری داشته باشد. علاوه بر این، بهبودهای روان‌شناختی و زیبایی‌شناختی پس از جراحی، رضایت بیمار و کیفیت کلی زندگی را افزایش می‌دهد که در سلامت کلی سیستمیک نیز نقش مهمی دارد.نتیجه‌گیری: جراحی ارتوگناتیک پیامدهای عمیقی فراتر از زیبایی‌شناسی صورت و اصلاح عملکردی دارد. با پرداختن به osa و فشار خون بالا، به سلامت قلبی-عروقی درازمدت کمک می‌کند و مزایای بالقوه‌ای برای بهبود نتایج باروری ارائه می‌دهد. همکاری بین‌رشته‌ای و پیشرفت‌های برنامه‌ریزی جراحی دیجیتال برای بهینه‌سازی این نتایج بسیار ضروری است. تحقیقات آینده باید بر مزایای بلندمدت سلامت سیستمیک جراحی ارتوگناتیک متمرکز باشد و نقش آن در بهبود سلامت باروری را بیشتر بررسی کند.

interdisciplinary approaches in oral and maxillofacial surgurery: implications of orthognathic treatment on obstructive sleep apnea, hypertention, and fertility outcome; narrative review

background & aims:  oral and maxillofacial surgery (omfs) is a surgical specialty that deals with many conditions affecting the mouth, jaw, face, and neck. it plays an important role in functional and aesthetic corrections, with different methods from simple tooth extraction to complex facial reconstructions. a key area in omfs is orthognathic surgery, a corrective jaw surgery that aims to realign the jaws to improve form and function. this method is often used for patients with malocclusion, facial asymmetry, and jaw deformities that cannot be treated only through orthodontics. orthognathic surgery not only addresses issues related to biting, chewing, and speech but also has important implications for systemic conditions, highlighting its importance beyond facial aesthetics. considering the complexity of cases that require orthognathic surgery, a multidisciplinary approach is necessary for successful treatment results. collaboration between oral and maxillofacial surgeons, orthodontists, anesthesiologists, sleep specialists, and cardiologists is often required to address a patient's condition's oral and facial health and systemic aspects. for example, orthodontists play a key role in preoperative tooth alignment, while sleep specialists may evaluate obstructive sleep apnea as part of the treatment planning process. this interdisciplinary collaboration ensures a comprehensive assessment and allows the optimization of functional and aesthetic outcomes while also addressing systemic conditions such as osa and hypertension. with the participation of several specialists, the treatment becomes more comprehensive reduces the risk of complications, and increases the long-term success of the surgery. therefore, we decided to investigate interdisciplinary approaches in oral and maxillofacial surgery in the present review, focusing on the effects of orthognathic treatment on osa, hypertension, and fertility.methods: this study was conducted with a comprehensive literature review of clinical trials, case studies, and systematic reviews published between 2015 and 2022. the main focus of this review has been on interdisciplinary approaches in orthognathic surgery and its effects on obstructive sleep apnea (osa), hypertension, and fertility outcomes. a literature search was conducted through pubmed, scopus, web of science, sciencedirect, megiran, and sid databases using a detailed search strategy and specific keywords. data were extracted from selected studies to evaluate the impact of orthognathic surgery on airway patency, blood pressure control, fertility outcomes, and patient-reported quality of life. the role of digital technologies in surgical planning and execution, including 3d imaging and computer-assisted surgery, was also analyzed. the final results were combined and categorized to examine the broader implications of orthognathic surgery in improving functional and systemic health, with a focus on interdisciplinary collaboration. these data were categorized and analyzed to evaluate the contribution of orthognathic surgery in improving cardiovascular health, fertility and increasing quality of life. a comprehensive review of literature was conducted, analyzing clinical trials, case studies, and systematic reviews that investigate the effects of orthognathic surgery on osa, hypertension, and fertility outcomes. emphasis was placed on interdisciplinary treatment approaches, digital technologies in surgical planning, and long-term cardiovascular and reproductive health outcomes.results:  orthognathic surgery, particularly maxillomandibular advancement (mma), was found to significantly reduce osa severity by improving airway patency, which in turn led to improved blood pressure control and reduced cardiovascular risks associated with hypertension. studies show that treating osa and hypertension through orthognathic surgery can positively impact fertility outcomes by mitigating systemic inflammation and oxidative stress. additionally, psychological and aesthetic improvements post-surgery contribute to enhanced patient satisfaction and quality of life, which also plays a role in overall systemic health.conclusion: orthognathic surgery, especially when performed through interdisciplinary collaboration, offers significant benefits beyond facial correction and significantly improves systemic conditions such as obstructive sleep apnea (osa) and hypertension. by increasing airway patency and reducing cardiovascular pressure, this surgery helps in long-term control of blood pressure and reduces cardiovascular risks. furthermore, improvement in these systemic conditions is associated with better reproductive outcomes, as it reduces inflammation and oxidative stress, which are critical factors in reproductive health. the psychological and aesthetic benefits of orthognathic surgery also help to increase patient satisfaction and overall quality of life. as digital technologies such as 3d imaging and computer-aided surgical planning continue to evolve, they simplify interdisciplinary collaboration and improve surgical precision. future research should focus on the long-term systemic health consequences of orthognathic surgery, particularly in terms of fertility and cardiovascular health, and explore innovative techniques to enhance treatment outcomes. by integrating technological advances and interdisciplinary strategies, oral and maxillofacial surgery can continue to expand its role in addressing functional and systemic health issues.