title: Mid-Term Dental and Nerve-Related Complications of Infant Distraction for Robin Sequence.
abstract: BACKGROUND
  Mandibular distraction is effective for relieving airway obstruction in Robin sequence; however, mid-term dental and nerve-related complications have not been adequately studied.
  
  
  METHODS
  Records were reviewed for patients with a single distraction in infancy using internal devices. Follow-up was 5 years or longer. Craniofacial dysmorphic syndromes and those affecting facial nerve function were excluded. Part I involved a review of dental records, whereas Part II involved assessment of inferior alveolar and marginal mandibular nerve function in returning patients with the use of 1,1,1,2-tetrafluoroethane cold stimulation and photography, respectively.
  
  
  RESULTS
  Eighty-five patients met inclusion criteria. Dental records were complete in 44 patients (median follow-up, 7.3 years; range, 5.4 to 13.2 years). First permanent molar injury was seen in 42 of 88 half-mouths (48 percent); 32 of 42 (76 percent) were restorable. Primary second molar damage and ankylosis were observed in 12 of 88 (14 percent) and one of 88 half-mouths (1 percent), respectively. Mandibular second premolar absence was noted unilaterally in eight of 36 patients (22 percent) and bilaterally in six of 36 patients (17 percent). A mean 1.2 ± 0.95 operative rehabilitations were required. Nerve testing was completed in 20 patients (median follow-up, 8.7 years; range, 5.5 to 13.2 years). Complete absence of cold sensation was noted in one of 40 half-mouths (2.5 percent), whereas lower lip depressor weakness was seen in six of 40 half-mouths (15 percent).
  
  
  CONCLUSIONS
  Infant distraction is highly successful in averting tracheostomy; however, dental and nerve-related complications remain underreported. Regular follow-up with a pediatric dentist and early recognition of injury is essential. Although inferior alveolar nerve injury appears infrequent (2.5 percent), permanent lower lip depressor weakness is more common than previously reported (15 percent of sides).
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Atlanta, Ga.|From the Center for Craniofacial Disorders, Children's Healthcare of Atlanta at Scottish Rite.
authors.forename: Jordan P
authors.initials: JP
authors.lastname: Steinberg
authors.affiliation: Atlanta, Ga.|From the Center for Craniofacial Disorders, Children's Healthcare of Atlanta at Scottish Rite.
authors.forename: Colin M
authors.initials: CM
authors.lastname: Brady
authors.affiliation: Atlanta, Ga.|From the Center for Craniofacial Disorders, Children's Healthcare of Atlanta at Scottish Rite.
authors.forename: Brittany R
authors.initials: BR
authors.lastname: Waters
authors.affiliation: Atlanta, Ga.|From the Center for Craniofacial Disorders, Children's Healthcare of Atlanta at Scottish Rite.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Soldanska
authors.affiliation: Atlanta, Ga.|From the Center for Craniofacial Disorders, Children's Healthcare of Atlanta at Scottish Rite.
authors.forename: Fernando D
authors.initials: FD
authors.lastname: Burstein
authors.affiliation: Atlanta, Ga.|From the Center for Craniofacial Disorders, Children's Healthcare of Atlanta at Scottish Rite.
authors.forename: Jack E
authors.initials: JE
authors.lastname: Thomas
authors.affiliation: Atlanta, Ga.|From the Center for Craniofacial Disorders, Children's Healthcare of Atlanta at Scottish Rite.
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000009:adverse effects*; D010781:Photography; D010855:Pierre Robin Syndrome / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D014094:Tooth, Deciduous / Q000294:innervation*; D016896:Treatment Outcome; D014741:Video Recording