Obstructive sleep apnea syndrome (OSAS) is defined by the occurrence of abnormally frequent episodes of upper airway obstruction during sleep. This syndrome, which affects about 3% of the adult population, is potentially lifethreatening, increasing cardiovascular problems or accidents due to sleepiness. After defining the therapeutic modalities for OSAS, such as continuous positive airway pressure and lifestyle changes, this thesis focuses on the three areas of mandibular advancement therapy: reversible mandibular advancement by oral appliance (OA), maxillomandibular advancement surgery (MMA), and finally orthopedic treatment of mandibular retrognathia as an interceptive treatment for children and adolescents. The results of original studies are presented: a pilot study to measure the forces generated by OAM in adults (1), the comparison of OA therapy and MMA on a sample of 25 successively treated patients (2), and evaluation of soft tissue profile changes following MMA to determine predictors of final esthetics (3) and specific orthodontic protocols derived from the experience of a 70 patients cohort study (4). Mandibular advancement therapies have many interactions with orthodontics and dento-facial orthopaedics, either in analyzing patient's architectural equilibrium, OA-induced occlusal side effects, or pre-surgical orthodontic preparation. Early treatment of maxillary transversal deficiencies and mandibular retrusion offers opportunities for certain groups of patients, especially when there is a family context of OSAS.
Mandibular advancement for Obstructive Sleep Apnea Syndrome treatment : interactions with dentofacial orthopaedies