Safety of Mandibular Osteotomies in Infants with Pierre Robin Sequence: Computer-Aided Modeling to Characterize the Risks of Various Techniques

Abstract

andibular distraction osteogenesis was made popular in the modern era by Joseph McCarthy in the 1990s. 1 The process consists of three components 1,2 : (1) performing a mandibular osteotomy to create a gap in the bone, (2) placement of hardware across the osteotomy that is attached to both the mesial and distal pieces of bone, and (3) the gradual activation

Dental outcomes after neonatal mandibular distraction

“…Siska et al [10 ▪ ] performed a simulated study evaluating seven osteotomy techniques manually drawn onto a cortical view of a mandibular computed tomography (CT) scan of multiple Robin sequence patients. The mandibular CT scan was then segmented to see if tooth bud or inferior alveolar nerve violation occurred.…”

“…The goals of MDO include correcting the airway obstruction caused by the tongue base, improving oral intake and avoidance of a tracheostomy [9 ▪ ]. The surgical technique for MDO involves bilateral mandibular osteotomies, application of distraction hardware to both sides of each osteotomy and gradual distraction of the bone segments away from each other resulting in lengthening of the bone [10 ▪ ]. Detailed description of the procedure has been well described [9 ▪ ,11].…”

“…The permanent molars do not have deciduous precursors and are termed nonsuccedaneous permanent teeth [10 ▪ ]. The first permanent molars begin to develop during the third to fourth month of gestation and are visible radiographically at the time of birth [10 ▪ ]. The second and third molars do not begin to develop until early childhood, arising from outpouchings of the dental laminae that lie within the mandibular mucosa [10 ▪ ].…”

“…The first permanent molars begin to develop during the third to fourth month of gestation and are visible radiographically at the time of birth [10 ▪ ]. The second and third molars do not begin to develop until early childhood, arising from outpouchings of the dental laminae that lie within the mandibular mucosa [10 ▪ ]. At the time of birth, the mental foramen is low and posterior, below the first molar tooth bud [10 ▪ ].…”

“…The second and third molars do not begin to develop until early childhood, arising from outpouchings of the dental laminae that lie within the mandibular mucosa [10 ▪ ]. At the time of birth, the mental foramen is low and posterior, below the first molar tooth bud [10 ▪ ]. If there is disruption in the formation or development of tooth buds, the tooth development halts [14].…”