Maxillo-mandibular Advancement (MMA) is a procedure where both the upper and lower jaws are surgically moved forward (Lefort 1 osteotomy of the maxilla & saggital split advancement of the mandible). Although this is one of the most aggressive surgical procedures for the treatment of sleep apnea, it is also the most successful.  Most studies show successful treatment of sleep apnea in greater than 90%. 

When the bones of the upper and lower jaw are surgically advanced,  the soft tissues of the tongue and palate are also moved forward which opens the upper airway.  Since the upper and lower teeth are moved the same amount, the bite would be similar before and after operation, however pre-operative orthodontic work may be required.

The MMA alters, and may enhance appearance.  It is not disfiguring and there are no external scars. The operation is accomplished through the mouth. The jaws may be briefly wired closed or kept closed using tiny elastic bands following the operation. The procedure is technically involved with the potential for complications, but most patients recover remarkably well from this surgery.  It is generally reserved for otherwise healthy patients.

For some individuals, the MMA is the only technique that can adequately create the necessary air passageway that can resolve sleep apnea.

The procedure is usually performed by maxillo-facial suurgeons.  This is a branch of dentistry where dentists have also received 5 years of medical and surgical training.  This allows them to be experts in dentition and occlusion as well as facial surgery.