Tooth Development Following Mandibular Distraction Osteogenesis in Neonates With Pierre Robin Sequence

Background: Mandibular distraction osteogenesis is a widely utilized surgical procedure in the pediatric population for the treatment of mandibular retrognathia. Patients with congenital abnormalities may display severe mandibular hypoplasia and associated functional problems. Distraction osteogenesis is effective in alleviating airway obstruction for these patients and is performed early in life, often during the neonatal period and during infancy. However, problems in tooth development may arise as a surgical complication. Evidence Review: A systematic search was conducted in PubMed and EMBASE to identify retrospective studies describing long term outcomes of mandibular distraction osteogenesis on tooth development. Each article was reviewed and relevant data were extracted, collected, and examined according to the type of dental injury, specific tooth effected, and frequency of occurrence. Results: Tooth injuries include positional change (35%), shape alteration/fracture (24%), missing tooth (15%), root injury/malformation (14%), follicle/bud perforation (9%), delayed eruption (2%), and dentigerous cyst (1%). The most commonly affected tooth is the permanent first molar, followed by the primary second molar. The least common tooth affected is the third molar. Conclusions: Although tooth injuries exist following mandibular distraction osteogenesis in the pediatric population, the risk of pathology and major complications remain relatively low. Technological advancements in presurgical planning can be expected to continue reducing the risk of adverse effects to primary and permanent tooth development.