Dental outcomes after neonatal mandibular distraction

Morris, Lisa

doi:10.1097/moo.0000000000000826

Cited by 2 publications

(1 citation statement)

References 31 publications

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“…While dental complications are a well-recognized risk of MDO, data on the incidence and severity of permanent mandibular molar injury is variably reported in the literature, ranging between 3.7% and 76% of patients 1,2,4–6,13,14 . Heterogeneity regarding the incidence of dental complications may be a factor of the varying surgical techniques and hardware options associated with MDO, as well as a lack of consistent long-term follow-up and inconsistent definitions of dental injuries 15 . Given that MDO can be performed on a wide age range of pediatric patients, including neonates, there is likely further heterogeneity in the incidence of reported dental complications as a result of children being at different stages of dental development at the time of their procedures.…”

Section: Introductionmentioning

confidence: 99%

Mandibulotomy Technique and Permanent Molar Injury After Mandibular Distraction Osteogenesis in Infants

Sprow,

Danis Ⅲ,

Zee

et al. 2024

Journal of Craniofacial Surgery

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Objective: The risk that mandibular distraction osteogenesis (MDO) poses to the developing mandibular dentition is well-known; however, less is understood about how the choice of instrumentation used for mandibular osteotomy might affect the development of permanent molars. Methods: Retrospective chart review examining infants with micrognathia who underwent MDO from 2010 to 2018 at a single tertiary care children’s hospital using external, multivector devices. The first and second permanent mandibular molars were radiographically examined years after surgery to determine whether osteotomy cutting techniques affect the risk of injury to the permanent dentition. Results: Thirty-seven infants and children underwent MDO from 2010 to 2018. Follow-up dental radiographs were available for 17 patients; 6 patients were excluded based on the use of preoperative computed tomography, utilization of virtual surgical planning technology, use of buried internal distractors, or older age at the time of distraction surgery. This yielded a total of 11 patients who underwent MDO with external hardware without virtual surgical planning representing 22 osteotomies. Sixteen osteotomies were performed using a side-cutting burr and 6 with a piezoelectric saw. The median age at distraction surgery was 3 weeks. The rate of an abnormal permanent first or second mandibular molar finding per osteotomy was 88% (14/16) in the side-cutting group versus 17% (1/6) with the piezoelectric technique (P = 0.004). Conclusion: Mandibular distraction osteogenesis risks injury to the mandibular molars; however, this study suggests a significant risk reduction in molar injury if the piezoelectric device is utilized.

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Section: Introductionmentioning

confidence: 99%

Mandibulotomy Technique and Permanent Molar Injury After Mandibular Distraction Osteogenesis in Infants

Sprow,

Danis Ⅲ,

Zee

et al. 2024

Journal of Craniofacial Surgery

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Comprehensive Long-Term Outcomes Following Mandibular Distraction Osteogenesis

Kosyk,

Salinero,

Morales

et al. 2023

The Cleft Palate Craniofacial Journal

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Objective To describe long-term outcomes and complications following mandibular distraction osteogenesis (MDO) in a diverse patient cohort Design Cross-sectional study Setting Single tertiary-care pediatric center Patients Forty-eight patients previously undergoing MDO with minimum 4-year follow-up Main Outcome Measures Respiratory outcomes, feeding patterns, dental development, motor/sensory nerve function, temporo-mandibular joint function, and postsurgical scarring Results Forty-six patients with a median age of 7 years were evaluated. Of 20 nonsyndromic patients, none required additional airway procedures, none required continuous positive airway pressure (CPAP) during sleep, and 19 (95%) fed exclusively by mouth. Among 26 syndromic patients, 7 (27%) required CPAP and 8 (31%) were tube fed. Permanent first molar differences were seen in the majority of subjects; patterns of damage interfering with function were more common in syndromic (13/28, 46%) compared to nonsyndromic (5/24, 21%; P = .014) subjects. MDO prior to age two was associated with more frequent and worse dental damage ( P = .001). Inferior alveolar nerve and marginal mandibular nerve function were fully intact in 37 (80%) and 39 (85%) of patients, respectively. Three patients (6%), all with associated genetic syndromes, demonstrated severe nerve impairment. By the Vancouver scar scale, ≥ 80% of surgical scars were rated in the most favorable category for each quality assessed. Temporomandibular joint dysfunction was rare. Conclusions MDO shows highly favorable long-term respiratory, feeding, nerve, and scar outcomes in nonsyndromic patients, although permanent molar changes not precluding tooth viability are commonly seen. Patients with associated syndromes demonstrate respiratory and feeding benefits, but higher rates of dental and nerve abnormalities.

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Dental outcomes after neonatal mandibular distraction

Cited by 2 publications

References 31 publications

Mandibulotomy Technique and Permanent Molar Injury After Mandibular Distraction Osteogenesis in Infants

Mandibulotomy Technique and Permanent Molar Injury After Mandibular Distraction Osteogenesis in Infants

Comprehensive Long-Term Outcomes Following Mandibular Distraction Osteogenesis

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