The Long-Term Effects of Mandibular Distraction Osteogenesis on Developing Deciduous Molar Teeth

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.

Long-Term Results of Mandibular Distraction Osteogenesis with a Resorbable Device in Infants with Robin Sequence

“…23 Hong et al revealed the results of an internal nonresorbable device applied for treatment of Robin sequence infants (mean age, 2.3 months; follow-up, 3 to 5 years). 24 Thirty percent of cases developed root malformations and positional changes of deciduous second molars, which is comparable to our findings when looking only at second deciduous molars. 24 However, in that study, the dental developmental stage was primary dentition: information on possible damage to permanent molars was lacking.…”

“…24 Thirty percent of cases developed root malformations and positional changes of deciduous second molars, which is comparable to our findings when looking only at second deciduous molars. 24 However, in that study, the dental developmental stage was primary dentition: information on possible damage to permanent molars was lacking. 24 In preventing damage to molar buds, the position of the osteotomy and screws must be considered.…”

“…24 However, in that study, the dental developmental stage was primary dentition: information on possible damage to permanent molars was lacking. 24 In preventing damage to molar buds, the position of the osteotomy and screws must be considered. In the present study, an oblique osteotomy was used (Fig.…”

“…Hong et al used an inverted L-shaped osteotomy, which might facilitate a position just cranial to the molar buds. 24 Whether the buds of permanent molars are safer using this osteotomy is unknown, as their positions are difficult to assess at birth. 13 Moreover, the chance of damaging the (pre)molar buds after screw placement remains.…”

“…In the study by Hong et al, all infants underwent computed tomography with three-dimensional reconstructions preoperatively, which aids planning of the exact location of the Plastic and Reconstructive Surgery • February 2016 osteotomy and might prevent damage to buds visible at radiography. 24 However, locating tooth buds in infant mandibles on computed tomography is difficult and requires training/expertise. 25 Monocortical placement of screws is associated with less damage to molar buds compared with bicortically fixed pins/screws.…”