Atlanta Oral & Maxillofacial Surgery, P.C.

A Permanent Solution for Sleep Apnea

Sleep apnea is often thought of as a condition treated only with CPAP machines or oral appliances. However, for many patients, the true cause of obstructive sleep apnea (OSA) lies in the structure of the jaw and airway. In these cases, orthognathic (jaw) surgery can provide a life-changing, long-term solution.

This blog explains how orthognathic surgery treats sleep apnea, who may be a candidate, and why airway-focused jaw surgery is becoming one of the most effective treatments for moderate to severe OSA.

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What Is Obstructive Sleep Apnea?

Obstructive sleep apnea occurs when the airway repeatedly collapses during sleep, blocking airflow and reducing oxygen levels. This disruption can happen dozens – even hundreds – of times per night.

Common symptoms include:

• Loud snoring

• Daytime fatigue or brain fog

• Morning headaches

• Teeth grinding (bruxism)

• Poor sleep quality despite “enough” sleep

• Difficulty concentrating

Left untreated, sleep apnea increases the risk of:

• High blood pressure

• Heart disease and stroke

• Diabetes

• Anxiety and depression

• Accidents caused by fatigue

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How Jaw Position Affects the Airway

The upper jaw (maxilla) and lower jaw (mandible) play a major role in airway size and stability. When one or both jaws are positioned too far back, they can:

• Narrow the airway

• Push the tongue backward

• Increase airway collapse during sleep

Many sleep apnea patients have skeletal patterns such as:

• A retruded lower jaw (Class II bite)

• A narrow upper jaw

• Vertical facial growth patterns

• Constricted nasal and oral airways

These structural issues cannot be corrected with CPAP or oral appliances alone.

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What Is Orthognathic Surgery?

Orthognathic surgery is a corrective jaw surgery that repositions the upper jaw, lower jaw, or both to improve function, facial balance, and airway health.

When performed for sleep apnea, the most common procedure is Maxillomandibular Advancement (MMA).

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What Is Maxillomandibular Advancement (MMA)?

Maxillomandibular advancement surgery moves the upper and lower jaws forward together, which:

• Permanently enlarges the airway

• Reduces airway collapse

• Improves oxygen levels during sleep

MMA is considered the gold-standard surgical treatment for moderate to severe obstructive sleep apnea.

Why MMA Is So Effective

• Enlarges the airway in multiple dimensions

• Improves airflow at the nose, soft palate, tongue base, and throat

• Treats the root cause of obstruction, not just symptoms

• Has one of the highest success rates of any sleep apnea treatment

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Orthognathic Surgery vs. CPAP for Sleep Apnea

While CPAP can be effective, long-term compliance is often low. Jaw surgery offers a one-time intervention with lasting results for appropriate candidates.

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Who Is a Candidate for Jaw Surgery for Sleep Apnea?

You may be a candidate if you:

• Have moderate to severe obstructive sleep apnea

• Struggle with CPAP tolerance or compliance

• Have jaw or bite discrepancies

• Have a recessed chin or jaw profile

• Experience airway collapse on imaging

• Are young, healthy, and motivated for definitive treatment

Many patients are surprised to learn that they are candidates — especially young adults and otherwise healthy individuals.

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The Evaluation Process

Airway-focused orthognathic surgery requires advanced diagnostics and careful planning.

Typical evaluation includes:

• 3D CBCT airway imaging

• Facial and skeletal analysis

• Bite and occlusion evaluation

• Sleep history and symptoms

• Collaboration with orthodontists and sleep specialists

This multidisciplinary approach ensures both functional airway improvement and excellent facial balance.

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What to Expect from Orthognathic Surgery for Sleep Apnea

The Process

1. Comprehensive consultation and imaging

2. Digital surgical planning

3. Orthodontic preparation (in some cases)

4. Jaw surgery in our surgical center

5. Recovery and gradual return to normal activity

Recovery

• Swelling peaks around days 3–5

• Most patients return to work in 2 weeks

• Full healing continues over several months

Patients often report immediate improvement in breathing, even during early recovery.

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Success Rates of Jaw Surgery for Sleep Apnea

Studies consistently show:

• Significant reduction in AHI (Apnea-Hypopnea Index)

• Improved oxygen saturation

• Reduced or eliminated snoring

• Improved energy, focus, and sleep quality

For many patients, MMA surgery results in resolution of sleep apnea without the need for CPAP.

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Benefits Beyond Sleep Apnea

In addition to airway improvement, orthognathic surgery can:

• Improve facial balance and profile

• Correct bite and jaw alignment

• Reduce teeth grinding

• Improve nasal breathing

• Enhance quality of life and confidence

Patients often describe the outcome as life-changing.

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Frequently Asked Questions

Is jaw surgery painful?

Discomfort is well managed with medication, and most patients report less pain than expected.

Will it change how I look?

Yes — typically in a positive, balanced way. Surgical planning prioritizes both airway function and facial aesthetics.

How long do results last?

Results are permanent. The airway expansion achieved through surgery does not regress.

Is this surgery only for severe sleep apnea?

While often used for moderate to severe cases, some patients with mild apnea but significant jaw restriction may benefit.

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Why Choose an Airway-Focused Oral & Maxillofacial Surgeon?

Jaw surgery for sleep apnea requires specialized expertise in:

• Facial skeletal surgery

• Airway anatomy

• Digital surgical planning

• Multidisciplinary collaboration

Choosing a surgeon experienced in airway-driven orthognathic surgery is critical for optimal results.

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Take the Next Step Toward Better Sleep

If you or a loved one struggles with sleep apnea and CPAP intolerance, orthognathic surgery may offer a permanent, life-changing solution.

A comprehensive airway evaluation can determine whether jaw surgery is right for you — and open the door to healthier sleep, better breathing, and improved quality of life.

Ridge Augmentation Techniques: Ramus Block Graft, Titanium Mesh & BMP. 

Not all ridge augmentation techniques are created equal, and there are pros and cons to all of them! During this episode, we welcome back Dr. Andy Loetscher for a conversation in which we delve into the details of the Ramus Block Graft, Titanium Mesh, and BMP techniques. From recovery time to cost implications to the best tools to use, Andy covers it all. So, if you are interested in learning how to ensure a successful, aesthetically-pleasing, long-lasting ridge reconstruction, this episode will provide you with a fantastic foundation.

Key Points From This Episode:

Key principles for a successful Ramus Block Graft.The length of time it takes for a Ramus Block Graft to mature.Andy’s approach to taking screws out. The downsides of a Ramus Block Graft.Cases in which Andy uses the Ramus Block Graft technique.Andy describes his technique for using titanium mesh.How Andy limits the chances of a dehiscence. The cost of a Ramus Block Graft. Other types of ridge augmentation techniques. An overview of Andy’s sinus lift technique.The pros and cons of BMP.Advantages of putting in the implants and the graft simultaneously.How Andy gets bone around an entire implant.Additional advice for ensuring a successful ridge reconstruction. How Andy learned how to do tissue grafts, and he thinks it is an important skill for every oral surgeon to learn.

Key Points From This Episode:

• Key principles for a successful Ramus Block Graft.
• The length of time it takes for a Ramus Block Graft to mature.
• Andy’s approach to taking screws out.
• The downsides of a Ramus Block Graft.
• Cases in which Andy uses the Ramus Block Graft technique.
• Andy describes his technique for using titanium mesh.
• How Andy limits the chances of a dehiscence.
• The cost of a Ramus Block Graft.
• Other types of ridge augmentation techniques.
• An overview of Andy’s sinus lift technique.
• The pros and cons of BMP.
• Advantages of putting in the implants and the graft simultaneously.
• How Andy gets bone around an entire implant.
• Additional advice for ensuring a successful ridge reconstruction.
• How Andy learned how to do tissue grafts, and he thinks it is an important skill for every oral surgeon to learn.

https://podcasts.apple.com/us/podcast/everyday-oral-surgery/id1535284898?i=1000603948351https://podcasts.apple.com/us/podcast/everyday-oral-surgery/id1535284898?i=1000603948351

Dr. Loetscher was featured on the “Everyday Oral Surgery” podcast with Dr. Grant  Stucki, a fellow oral surgeon practicing in Denver, CO.

“Recent technological advancements have led to incredible innovations in oral surgery, and today’s guest, Dr. Andy Loetscher, DDS, MS, is using them to full effect at his Atlanta Oral and Maxillofacial Surgery and Dental Implant Center. After taking us through his full arch rehabilitation surgery process, Dr. Andy explains what Face Hunter is and how he uses it at his practice. We then learn why payment options are better when discussed upfront, why practices have different prices, and how Dr. Andy decides on a course of treatment for his patients. What sets Dr. Andy apart from the rest are the techniques that he uses during surgery, and he educates us on how he inserts implants while accounting for varying bone densities, why osseodensification burs don’t excite him, the mechanics behind his use of prosthesis, and a rundown of his practice’s digital workflow. We end with our guest explaining some of the challenges he faces at work, why prosthesis hygiene is vital, why you’d do well to develop a digital workflow for your practice, and some of Dr. Andy’s life-changing reads from the past.”

Key Points From This Episode:

• A warm welcome to today’s guest, Dr. Andy Loetscher, DDS, MS.
• Looking at Dr. Andy’s process for when a patient comes in for full arch rehabilitation.
• Dr. Andy explains Face Hunter and how he uses it at his practice.
• Why discussing pricing options upfront makes the rest of the process easier.
• How varying prices across practices confuse patients and doctors alike.
• The way Dr. Andy decides on a course of treatment for his patients.
• How he inserts patient implants and how he accounts for different bone densities.
• Why he doesn’t use osseodensification burs anymore.
• Our guest explains the mechanics behind prosthetics on the day of surgery.
• Digital workflow: the different technologies and methods that he uses in his surgical process.
• How technological advancements make Dr. Andy’s work easier, but also more expensive.
• Exploring some of the challenges that he faces at work.
• The usual amount of grafting done during Dr. Andy’s full arch rehabilitations.
• How developing a digital workflow will do wonders for you and your patients.

Dr. Loetscher was featured on the “Everyday Oral Surgery” podcast with Dr. Grant  Stucki, a fellow oral surgeon practicing in Denver, CO.

Dr. Loetscher shares his wisdom on what it takes to build a thriving implant practice . Dr. Loetscher shares how he started, marketed, and streamlined his practice, as well as how he refined his implant technique. He shares advice for young surgeons looking to specialize in implant surgery, outlining the advantages and disadvantages of doing so. He gives an in-depth view of his extraction/ implant process, complete with his preferred equipment, implants, and replacement kits. Tune in to learn all about building an implant empire, from the marketing strategies to the CE courses recommended to thrive!

• Dr. Loetscher’s training history and current practice setup.
• Why he chose to build an implant practice and what he’s learned about implant surgery.
• Advice for young surgeons looking to specialize in implant surgery.
• The advantages and disadvantages of specializing in implant surgery.
• How Dr. Loetscher streamlines the implant process for himself, his staff, and his patients.
• The equipment he uses to perform implant surgery.
• Dr. Loetscher’s extraction/ implant process.
• The implants and replacement kits he uses and why.
• Dr. Loetscher’s internal and external marketing strategies and advice.
• Recommended post-residency CE courses for refining implant technique.

“Hey, my name’s Tyler Davenport. I’m a lab tech here at S2 Digital Dental Lab, where we use the latest dental technology to transform smiles. From the most advanced digital record taking to the final mill prosthesis, we strive to provide the best experience for the patient.

So we start with an accurate final impression. In doing so, we use the iCam 4D telegrametry scanner, which gives us amazing accurate results, as well as a passive fit when it comes time to screw down the frontal bridge.

We use the Zirkonzahn Face Hunter, which allows us to scan the patient and have a 3D rendering of their face, which gives us the ability to design the bridge with their face in mind, giving them a natural smile, giving them a final prosthesis that fits their face. Along with the Face Hunter, we also use the mill from Zirkonzahn, as well as their Prettau material, which is a very aesthetic and durable zirconia. This allows us to give you a durable but also beautiful bridge that will last you years to come.

We combine our skill sets and expertise within the lab to provide the patient with a unique and customized bridge that’s fit and made just for them. We feel like we provide a great service for our local doctors and patients, and we would love to do the same for you. Please check out our website for more information.”

“Hi there. I’m Dr. Andy Loetscher, maxillofacial surgeon, and I wanted to talk to you a little bit about a technique we utilize called the zygomatic implant. And basically, it’s an excellent and highly successful solution for people that have no bone in their upper jaw. There’s many people out there that basically had been told that they’re not a candidate for implants because there’s no bone in their upper jaw, which is basically not true.

The upper jaw bone is the maxilla and above it are these dense bones called the zygomas that your cheekbones is zygomatic complex. And in those bones, we can place extra long implants. It’s like a dental implant, just longer that we can put into these bones and we can place implants and you literally can get a new set of solid teeth screwed in your mouth in a day.

And it’s a great thing for us to offer our patients. This technique has been around for many years, in the 80s and 90s, it was developed, but really in the last few years, the instrumentation has evolved to be much better basically out of Italy. And so now it’s a process that we can put these in with a very high success rate.

It’s very cost-effective, and we can put these in most people. When I say high success rate, the long term, the research, 12, 15 years is 97, 98% fully functional. So it’s a great thing to offer our patients. The benefits to you are you can come in and in one day be put to sleep in our surgery center, get your implants placed, all computerized planning, and so forth, and you get a new solid set of teeth the next day. And these are teeth that will be designed to look beautiful, you’re gonna have a nice smile, you can chew on them, go to social functions, enjoy life, just like you did with your original teeth when you were 20 years old.

It’s not a very painful process. I’d say half our patients don’t use a narcotic afterwards. It’s a two to three-day recovery. Maybe you get a little boozing in your eyes, but in a week you’re done. And it’s very cost-effective.

For many years, people that didn’t have a lot of bone, we literally would take your teeth out, take bone from their hip, and would reconstruct their jaws. And this point that I did a couple hundred of those a year for many, many years. And we put these implants in with a bone graft from their hip or from elsewhere, let it sit for four to six months, and then put your teeth in. Now, we eliminate the bone grafting discomfort with it, place these implants immediately. So it’s a pretty awesome process.

Our candidates for this are people that have basically no bone in their upper jaw. There’s a lot of people that have what we call terminal dentition, meaning your teeth have had periodontal disease or broken down quite a bit, and it’s not worth the time and trouble and effort and money to rebuild your mouth for something that might fail in a few years, as we do in those patients.

Then sadly, there’s a lot of patients that have had implants placed poorly or wrongly, or prostheses made that are not cleansable, and so their implants are failing. So there’s a percentage of our patients that we treat, we have to basically rebuild their mouths.

When we do this, basically we have three goals. When we treat our patient. Wanna give you a beautiful set of teeth, we start with that. Number two, we wanna make these teeth cleansable and hygienic. I want these teeth to be put in so that you can keep them clean, they’re gonna last your lifetime. Whether you’re 35 years old, 50, 85 years old, we put them in all these age brackets, so that you can go home and you can spend two minutes in the morning, two minutes in the evening doing just traditional cleaning your teeth techniques, and they’ll last your lifetime. That’s actually a really big deal. You make the prosthesis clean that we deliver you, and that’s one of the advantages of our lab.

Number third, we make these retrievable. You may not appreciate this, but these prostheses need to be screwed into place. That’s why their saddles rock. We design them so the screw access openings come in from behind the teeth or on the top of the teeth in the back. So they’re easy to take in and out, like, in 10 minutes. So when you get done with these and two or three years later, if you move to a small town like Buke, Iowa, where I’m from, or you go to Naples, Florida, you go to east France, anywhere in the world, this is traditional dentistry. They can take these little filling plugs out unscrew them, clean underneath them, put them back in. And even though it’s not absolutely necessary, I’ve been doing these for 25 years, people’s bridges need to be removed on then, so their retrievability is a big factor.

Why come to us? I’m gonna toot my own horn, but I am basically one of the most reputable and experienced surgeons in the area, probably in the Southeast. It’s what we do. We offer for full-service implant dentistry, which is important to you because not everybody needs zygomatic implants. You may come in and, I’m an experienced treatment planner, we can decide what treatment is best for you. And so that actually is a big factor for people, just the experience in designing what needs to be done.

We’re very cost-effective where our prices are as competitive as anybody. And I truly believe that we deliver one of the best products anywhere in the U.S. I mean, it’s equal to anywhere. And part of that is we’re very proficient, we have an in-house lab that works here with us. It’s basically, I own it.

We’re experienced lab techs, I have a really experienced staff and basically, what we do here every day are dental implants. And another thing is you’ll find out we have a really friendly and polite staff. We take good care of you, we have a concierge service and so it’s a full-service, like, facility that provides good service to you.”

 

No bone? No problem!

If you have ever been told you don’t have enough bone for dental implants then our zygomatic implants may be the solution for you.

Patients who have undergone bone loss are not ideal candidates for traditional implants. Zygomatic implants have made dental implants available to even those with severe bone loss.

We utilize the Zygoma to place implants – 1 to 2 per side to facilitate support for your upper prosthesis. This can be done in conjunction with traditional implants or 2 zygomatic implants per side. Sometimes with a more posterior implant (Pterygoid Implant). This allows us to provide immediate implant supported teeth the day of your surgery.

Lynne: I’m Lynne Marks. And I run a company called London Image Institute, and I train trainers to teach corporate or individuals or both in appearance, behavior, and executive presence. And what our business, our industry is about is making other people beautiful and confident.

So, that was why it was important for me to find somebody really, really good, A, in a dentist and, B, in an area of expertise that I needed. The actual moment when I realized I needed help very badly was back in 2020-21 when six of my teeth cracked within the space of six months.

And so, my wonderful dentist also introduced me to Dr. Loetscher.

Dr. Loetscher: Lynne came in looking for a permanent solution, and she has a relatively common history of people we see where they’ve had failing teeth throughout their life.

She’d spent a lot of time in the dental chair, and we came up with a nice plan. Six implants on the up, four in the lower. And we looked at her, got her x-rays and CT scans, and my lab technician and I made her teeth immediately.

In her case, we probably delivered them the next day. And the next step, we put her to sleep. And it was a real seamless process for her. It wasn’t just some set of teeth. It was a beautiful set of teeth, like fully functional and extremely cosmetic, and they’re beautiful.

Lynne: What impressed me so much was that I went home. There was no pain. I took no medication, not even a single aspirin. And the following morning, he had actually designed and…overnight, I think, to fit the new set in.

Afterwards, I had this beautiful set of gorgeous-looking teeth. And I really did. My smile got bigger, and this really matches what I’m trying to project. And so, now I don’t have any problems. You know, so that’s something I just forget about and just smile and have nice teeth.

 

Rebecca: I trust the whole process. I have faith and trust in the staff and Dr. Loetscher, or otherwise, I wouldn’t be here the seventh time.

Hi, I’m Rebecca Schaper, and I’ve been coming to Dr. Loetscher for a very long time. The first time I needed an implant was I went to my regular dentist, and the tooth was decaying. And part of it was the bone issue, bad teeth, getting older, and at that point, he recommended me to come to Dr. Loetscher.

Dr. Loetscher: Rebecca has been coming to us for years. And over the course of her many years, she’s been with us, we’ve put many implants in. She had a tooth towards the front of her mouth that broke off, and she had come in that day, have the tooth removed, an implant placed, and leave with a tooth that same day. And we’re pretty proud of that here because we as a team, myself and the whole staff, we work hard to take really good care of patients.

Rebecca: When I first came, my first visit here, I felt at ease. I felt very comfortable. They explained everything to me, and then when I went in to have my surgery, they were extremely detailed on what was going on, and that made me feel extremely comfortable. Everything went smoothly, and one of the reasons why I came to Dr. Loetscher because he’s so knowledgeable. His staff is extremely friendly, professional.

When I saw all the technology, I was blown away. I went, “Wow, I feel really safe.” It’s like a one-stop shop. Everything is wonderful. I would highly recommend anybody going to Dr. Loetscher.

 

Stefaney: Oh, you want me to hold the picture?

Stefaney: Okay. Just that girl was not happy. So, I don’t even know that person anymore. So, that’s why I said, “Life-changing.”

Hi, I’m Stefaney. I was a patient of Dr. Loetscher’s. So, I originally came in for cosmetic purposes to fix my smile.

I had gum recession. The gum recession was… They were receding down, and long story short, it was because my jaw wasn’t correctly placed. So, it was putting pressure on my teeth. And then, I learned my airway was occluded.

And so, then it, kind of, became all of them together. And then, I got referred to a dentist, then to an orthodontist, then to Dr. Loetscher.

Dr. Loetscher: Stefaney came in, and a lot of it was a cosmetic issue. You couldn’t see her full teeth when she smiled, her bite was off, and she was seeing an orthodontist. And we did a combined treatment with orthodontics to widen up her jaw, and to bring it forward. And it totally transformed her smile and her face.

Stefaney: So, the first one, I had a SARPE done. So, they did an expanding palate, and then they pushed the jaw back together. And then, he sutured it, and it just, kind of, settled. And then in about six weeks, I could finally open my mouth.

It changed my whole life. It fixed my smile, fixed my confidence. I did have sleep apnea before. I don’t have it anymore. Because I could breathe better, I started working out. I sleep so much better.

Dr. Loetscher: She’s got a great smile. She’s got a better bite, which is going to make her teeth last longer, a lot of self-confidence, but then she’s got this great airway that helps her whole general health.

Stefaney: He always answered my questions. He always took the time with me. Everyone was just super comforting. I never had a issue, like, worrying about being in his care. But if I could tell my younger self, I would have done this years…years and years, and years ahead. And, I mean, it’s an investment for yourself inside and outside. It was 100% worth it.