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Effect of a syndromic diagnosis on mandibular size and sagittal position in Robin sequence.
J Oral Maxillofac Surg. 2009 Nov; 67(11):2323-31.JO

Abstract

PURPOSE

Despite its pathogenic heterogeneity, it is often assumed that the small mandible in a neonate with Robin sequence will not grow normally. The purpose of this study was to determine mandibular length and position in patients with nonsyndromic versus syndromic Robin sequence.

PATIENTS AND METHODS

Lateral cephalograms of 51 children with Robin sequence were analyzed. Group I consisted of nonsyndromic (NS) subjects and group II consisted of subjects with the 4 most common syndromic (S) diagnoses. Cephalometric measurements included sella-nasion-A point (SNA), sella-nasion-B point (SNB), sella-nasion-pogonion (SNPg), articulare-gonion-pogonion (ArGoPg), temporomandibular joint-pogonion (TmPg), articulare-gonion (ArGo), and gonion-pogonion (GoPg). Differences between groups and subgroups were compared using t test.

RESULTS

There were 26 NS patients (mean age, 6.8 yrs) and 25 S patients (mean age, 8.7 yrs); mean age was statistically different between groups (P = .04); therefore, cephalometric measurements were compared with age-matched normal values. Syndromes included Stickler (n = 10), bilateral facial microsomia (n = 8), velocardiofacial (n = 4), and Treacher Collins (n = 3). SNA was statistically different from normal in both groups (NS, P = .017; S, P = .007); however, SNB was not different from normal for either group (NS, P = .175; S, P = .537). SNPg (0.007) was significantly greater than normal in NS (P = .007) but not in S (P = .702) patients. SNA, SNB, and SNPg were not significantly different between groups. In both groups, mandibular length was short (P = .00), especially in S patients (P = .049), mandibular body was small (NS, P = .00; S, P = .00), and the gonial angle more obtuse (NS, P = .006; S, P = .000) than normal. Ramus length was significantly shorter than normal only in S patients (P = .019). Mandibular length (TmPg) was smaller than normal in all S subgroups but with wide variability. There were statistically significant differences among S subgroups with respect to mandibular sagittal position (SNB, P = .00; SNPg, P = .00) and mandibular length (TmPg, P = .008). There were no differences in S subgroups with respect to age, SNA, ArGo, GoPg, and ArGoPg.

CONCLUSION

Mandibular morphology and position are variable in Robin sequence, based on the presence and type of associated syndromic diagnosis.

Authors+Show Affiliations

Department of Plastic and Oral Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19837298

Citation

Rogers, Gary F., et al. "Effect of a Syndromic Diagnosis On Mandibular Size and Sagittal Position in Robin Sequence." Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, vol. 67, no. 11, 2009, pp. 2323-31.
Rogers GF, Rogers G, Lim AA, et al. Effect of a syndromic diagnosis on mandibular size and sagittal position in Robin sequence. J Oral Maxillofac Surg. 2009;67(11):2323-31.
Rogers, G. F., Rogers, G., Lim, A. A., Mulliken, J. B., & Padwa, B. L. (2009). Effect of a syndromic diagnosis on mandibular size and sagittal position in Robin sequence. Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons, 67(11), 2323-31. https://doi.org/10.1016/j.joms.2009.06.010
Rogers GF, et al. Effect of a Syndromic Diagnosis On Mandibular Size and Sagittal Position in Robin Sequence. J Oral Maxillofac Surg. 2009;67(11):2323-31. PubMed PMID: 19837298.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of a syndromic diagnosis on mandibular size and sagittal position in Robin sequence. AU - Rogers,Gary F, AU - Rogers,Gary, AU - Lim,Asher A T, AU - Mulliken,John B, AU - Padwa,Bonnie L, PY - 2009/03/03/received PY - 2009/06/23/accepted PY - 2009/10/20/entrez PY - 2009/10/20/pubmed PY - 2009/11/5/medline SP - 2323 EP - 31 JF - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons JO - J Oral Maxillofac Surg VL - 67 IS - 11 N2 - PURPOSE: Despite its pathogenic heterogeneity, it is often assumed that the small mandible in a neonate with Robin sequence will not grow normally. The purpose of this study was to determine mandibular length and position in patients with nonsyndromic versus syndromic Robin sequence. PATIENTS AND METHODS: Lateral cephalograms of 51 children with Robin sequence were analyzed. Group I consisted of nonsyndromic (NS) subjects and group II consisted of subjects with the 4 most common syndromic (S) diagnoses. Cephalometric measurements included sella-nasion-A point (SNA), sella-nasion-B point (SNB), sella-nasion-pogonion (SNPg), articulare-gonion-pogonion (ArGoPg), temporomandibular joint-pogonion (TmPg), articulare-gonion (ArGo), and gonion-pogonion (GoPg). Differences between groups and subgroups were compared using t test. RESULTS: There were 26 NS patients (mean age, 6.8 yrs) and 25 S patients (mean age, 8.7 yrs); mean age was statistically different between groups (P = .04); therefore, cephalometric measurements were compared with age-matched normal values. Syndromes included Stickler (n = 10), bilateral facial microsomia (n = 8), velocardiofacial (n = 4), and Treacher Collins (n = 3). SNA was statistically different from normal in both groups (NS, P = .017; S, P = .007); however, SNB was not different from normal for either group (NS, P = .175; S, P = .537). SNPg (0.007) was significantly greater than normal in NS (P = .007) but not in S (P = .702) patients. SNA, SNB, and SNPg were not significantly different between groups. In both groups, mandibular length was short (P = .00), especially in S patients (P = .049), mandibular body was small (NS, P = .00; S, P = .00), and the gonial angle more obtuse (NS, P = .006; S, P = .000) than normal. Ramus length was significantly shorter than normal only in S patients (P = .019). Mandibular length (TmPg) was smaller than normal in all S subgroups but with wide variability. There were statistically significant differences among S subgroups with respect to mandibular sagittal position (SNB, P = .00; SNPg, P = .00) and mandibular length (TmPg, P = .008). There were no differences in S subgroups with respect to age, SNA, ArGo, GoPg, and ArGoPg. CONCLUSION: Mandibular morphology and position are variable in Robin sequence, based on the presence and type of associated syndromic diagnosis. SN - 1531-5053 UR - https://www.unboundmedicine.com/medline/citation/19837298/Effect_of_a_syndromic_diagnosis_on_mandibular_size_and_sagittal_position_in_Robin_sequence_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0278-2391(09)01330-5 DB - PRIME DP - Unbound Medicine ER -