title: Distraction osteogenesis in a patient with juvenile arthritis.
abstract: We present a 26-year-old patient with juvenile-onset arthritis, Alagille's syndrome, micrognathia, and progressive sleep apnea. Despite the presence of significant temporomandibular joint pathology, mandibular distraction was indicated to correct life-threatening sleep apnea. Before distraction, the patient had only 10 mm of maximal interincisal opening and bilateral temporomandibular joint symptomatology. After distraction, the patient's sleep apnea resolved. There was slight improvement in her maximal incisal opening (12 mm) with neither exacerbation nor improvement of her temporomandibular joint symptomatology.
authors.affiliation: The Institute of Reconstructive Plastic Surgery, New York, New York.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Mackool
authors.forename: Pradip
authors.initials: P
authors.lastname: Shetye
authors.forename: Barry
authors.initials: B
authors.lastname: Grayson
authors.forename: Joseph G
authors.initials: JG
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D016738:Alagille Syndrome / Q000150:complications; D001171:Arthritis, Juvenile / Q000150:complications*; D002508:Cephalometry; D005260:Female; D006801:Humans; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement / Q000379:methods*; D008844:Micrognathism / Q000150:complications / Q000601:surgery*; D019857:Osteogenesis, Distraction; D016059:Range of Motion, Articular; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000150:complications*