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J Oral Maxillofac Surg. 2018 Jan;76(1):169-179. doi: 10.1016/j.joms.2017.06.032. Epub 2017 Jun 30.

Distraction Osteogenesis Normalizes Mandibular Body-Symphysis Morphology in Infants With Robin Sequence.

Author information

1
Assistant Professor, Divisions of Oral and Maxillofacial Surgery and Craniofacial and Plastic Surgery, Craniofacial Center, Seattle Children's Hospital, Seattle, WA. Electronic address: Srinivas.susarla@seattlechildrens.org.
2
Assistant Professor, Division of Craniofacial Medicine, Craniofacial Center, Seattle Children's Hospital, Seattle, WA.
3
Assistant Professor, Division of Craniofacial Orthodontics, Craniofacial Center, Seattle Children's Hospital, Seattle, WA.
4
Instructor, Division of Craniofacial Orthodontics, Craniofacial Center, Seattle Children's Hospital, Seattle, WA.
5
Associate Professor, Division of Oral and Maxillofacial Surgery, Craniofacial Center, Seattle Children's Hospital, Seattle, WA.
6
Professor and Chief, Division of Craniofacial and Plastic Surgery, Craniofacial Center, Seattle Children's Hospital, Seattle, WA.

Abstract

PURPOSE:

To evaluate changes in mandibular morphology in infants with Robin sequence (RS) after mandibular distraction osteogenesis (MDO) and compare the post-distraction morphology with that in infants without RS and infants with RS who had not undergone MDO.

MATERIALS AND METHODS:

Infants with RS treated with MDO were retrospectively evaluated over a 12-year period. All patients had pre-distraction and end-consolidation maxillofacial computed tomograms. Morphologic features of the mandible were divided into ramus and condyle, body and symphysis, and composite measurements. Post-distraction RS mandibular morphology was compared with pre-distraction morphology, as well as to age-matched infants without RS and age-matched infants with RS who had not undergone MDO. Comparisons were done using nonparametric paired-samples analyses.

RESULTS:

During the study period, 17 patients with RS treated with MDO met the inclusion criteria for the study. The mean ages at distraction and end-consolidation were 1.95 ± 3.24 and 8.46 ± 5.99 months, respectively. The post-MDO mandible was significantly different from the pre-MDO mandible with regard to the ramps-condyle unit and body-symphysis measurements, including development of a more parabolic mandibular arch form (P ≤ .001). Compared with age-matched non-RS infant mandibles, the post-distraction RS mandibles had similar morphologies. Compared with age-matched non-MDO RS mandibles, the post-distraction mandibles had significantly different morphologies anterior to the gonial angle, including a more parabolic arch form (P ≤ .006).

CONCLUSIONS:

MDO normalized mandibular morphology in infants with RS, with the greatest effect on measurements anterior to the gonial angle.

PMID:
28734994
DOI:
10.1016/j.joms.2017.06.032
[Indexed for MEDLINE]

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