Mandibular distraction osteogenesis in children with Pierre Robin Sequence: long-term analysis of teeth and jaw growth

Abstract

BackgroundTreatment of children with Pierre Robin Sequence (PRS) having a hypoplastic mandible and upper airway distress after birth may consist of external distraction devices. Shape anomalies of the permanent molars and positional changes due to the surgery have been documented. The aim of this study is to compare the long-term effects (>5 years) on the growth pattern of PRS-patients treated with an external mandibular distraction device with no-surgery cases and to investigate the dental development or damage. MethodsA retrospective cohort study was performed. PRS-patients with and without surgery were included. A digital cephalometric analysis was made to evaluate the growth pattern of the mandible between groups as well as with normal values. ResultsNine of 19 patients underwent an external mandibular distraction. All children were extubated after 4-5 days with no signs of respiratory distress. Screw and device loosening presented in 1 patient. The articular and sellar angle was significantly larger and smaller respectively in the surgery group. ConclusionsMandibular distraction surgery might result in a 'growth boost' compared to the no-surgery group. No significant difference in dental development was found. Mandibular distraction osteogenesis is an effective way of relieving severe upper airway obstruction.