TY - JOUR
T1 - Long-Term Results of Mandibular Distraction Osteogenesis with a Resorbable Device in Infants with Robin Sequence
T2 - Effects on Developing Molars and Mandibular Growth
AU - Paes, Emma C
AU - Bittermann, Gerhard K P
AU - Bittermann, Dirk
AU - Muradin, Marvick M
AU - van Hogezand, Rose
AU - Etty, Erika
AU - Mink van der Molen, Aebele B
AU - Kon, Moshe
AU - Breugem, Corstiaan C
PY - 2016/2
Y1 - 2016/2
N2 - BACKGROUND: Mandibular distraction osteogenesis with a unidirectional resorbable device is an effective treatment option for severe upper airway obstruction in infants with Robin sequence. Long-term effects, especially with regard to tooth development and mandibular outgrowth, are not known.METHODS: Robin sequence infants with a follow-up of greater than or equal to 5 years were included. Baseline characteristics were extracted from medical records. Panoramic and lateral cephalometric radiographs were analyzed and patients were recalled for physical examination.RESULTS: Ten infants underwent mandibular distraction osteogenesis at a mean age of 3.7 months (median, 19 months; range, 11 days to 27 months). Mean length of follow-up was 6.8 years (range, 5.0 to 7.9 years). Ten Robin sequence infants without mandibular distraction osteogenesis (mean length of follow-up, 7.4 years; range, 6.7 to 8.9 years) were the controls. Shape anomalies, positional changes, and root malformations of molars were seen significantly more often than in the control group (p = 0.007, p = 0.009, and p = 0.043, respectively). Mandibular length was shorter (p = 0.030), but mandibular ramus height was comparable (p = 0.838) with that of the non-mandibular distraction osteogenesis group. Compared with healthy controls, all Robin sequence infants had a significantly shorter mandible.CONCLUSIONS: Mandibular distraction osteogenesis with a resorbable system reveals overall good short- and long-term results, but the effects on developing molars and mandibular outgrowth likely necessitate secondary procedures. This factor should be considered when deciding on treatment options and counseling of parents.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
AB - BACKGROUND: Mandibular distraction osteogenesis with a unidirectional resorbable device is an effective treatment option for severe upper airway obstruction in infants with Robin sequence. Long-term effects, especially with regard to tooth development and mandibular outgrowth, are not known.METHODS: Robin sequence infants with a follow-up of greater than or equal to 5 years were included. Baseline characteristics were extracted from medical records. Panoramic and lateral cephalometric radiographs were analyzed and patients were recalled for physical examination.RESULTS: Ten infants underwent mandibular distraction osteogenesis at a mean age of 3.7 months (median, 19 months; range, 11 days to 27 months). Mean length of follow-up was 6.8 years (range, 5.0 to 7.9 years). Ten Robin sequence infants without mandibular distraction osteogenesis (mean length of follow-up, 7.4 years; range, 6.7 to 8.9 years) were the controls. Shape anomalies, positional changes, and root malformations of molars were seen significantly more often than in the control group (p = 0.007, p = 0.009, and p = 0.043, respectively). Mandibular length was shorter (p = 0.030), but mandibular ramus height was comparable (p = 0.838) with that of the non-mandibular distraction osteogenesis group. Compared with healthy controls, all Robin sequence infants had a significantly shorter mandible.CONCLUSIONS: Mandibular distraction osteogenesis with a resorbable system reveals overall good short- and long-term results, but the effects on developing molars and mandibular outgrowth likely necessitate secondary procedures. This factor should be considered when deciding on treatment options and counseling of parents.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
KW - Absorbable Implants
KW - Child, Preschool
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Mandible/growth & development
KW - Molar/growth & development
KW - Osteogenesis, Distraction/instrumentation
KW - Pierre Robin Syndrome/surgery
KW - Retrospective Studies
KW - Time Factors
KW - Treatment Outcome
U2 - https://doi.org/10.1097/01.prs.0000475769.06773.86
DO - https://doi.org/10.1097/01.prs.0000475769.06773.86
M3 - Article
C2 - 26818328
SN - 0032-1052
VL - 137
SP - 375e-385e
JO - Plastic and Reconstructive Surgery
JF - Plastic and Reconstructive Surgery
IS - 2
ER -