Abstract
Background. Many studies have demonstrated the effectiveness of mandibular distraction osteogenesis (MDO) in alleviating the micrognathia-associated upper airway obstruction but very few studies have focused on long-term dental outcomes. Objective. To report the effect of MDO on developing deciduous molars in the distraction area. Methods. A retrospective chart review was performed to identify patients with Pierre Robin sequence who underwent MDO with documented long-term dental assessments. Results. Ten children (mean age at surgery 69.8 days; 6 boys and 4 girls) were included for analysis. All patients underwent bilateral MDO with an inverted L-shaped osteotomy to avoid injuring tooth buds. The dental developmental stage was primary dentition in all children. Overall, 3 patients developed minor dental problems involving 4 molar teeth (2 root malformations and 2 shape anomalies) but they did not require any interventions. Conclusion. Significant primary molar developmental complications were not seen in our patients. The use of internal distractor device with an inverted L-shaped osteotomy seems to be a safe surgical approach in regards to dental outcomes.
Highlights
Upper airway obstruction secondary to micrognathia was first widely described by P
Newborns were considered to have severe airway obstruction requiring surgical intervention if they were intubated at birth and later failed extubation and/or presented with significant oxygen desaturations with signs of respiratory distress despite conservative measures, such as positioning
Pulseoximetry levels less than 90% for 30 seconds or greater as well as pCO2 greater than 50 mm Hg on blood gases were considered as preoperative indicators
Summary
Upper airway obstruction secondary to micrognathia was first widely described by P. Robin in 1934 [1] He described a constellation of findings, which included micrognathia, glossoptosis, and in some patients, cleft palate. These findings are commonly referred to as Pierre Robin sequence (PRS). Some craniofacial syndromes were later recognized to be associated with PRS Most notably they include Stickler syndrome, Treacher Collins syndrome, and Nager syndrome [2]. Many studies have demonstrated the effectiveness of mandibular distraction osteogenesis (MDO) in alleviating the micrognathia-associated upper airway obstruction but very few studies have focused on long-term dental outcomes. A retrospective chart review was performed to identify patients with Pierre Robin sequence who underwent MDO with documented long-term dental assessments. The use of internal distractor device with an inverted L-shaped osteotomy seems to be a safe surgical approach in regards to dental outcomes
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