{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:44:56Z","timestamp":1787010296469,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11]]},"abstract":"\n Background:<\/jats:title>\n One of the arguments against early intervention for micrognathia in Pierre Robin sequence is the concept that the growth of the mandible will eventually \u201ccatch up.\u201d Long-term growth of the mandible and occlusal relationships of conservatively managed Pierre Robin sequence patients remain unknown. In this study, the authors evaluated the orthognathic surgery requirements for Pierre Robin sequence patients at skeletal maturity.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Orthognathic surgical requirements of conservatively managed Pierre Robin sequence and isolated cleft patients (aged \u226513 years) at two institutions were reviewed and analyzed using\n t<\/jats:italic>\n test, chi-square test, and Fisher\u2019s exact test. Values of\n p<\/jats:italic>\n < 0.05 were considered statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of the Pierre Robin sequence patients (\n n<\/jats:italic>\n = 64; mean age \u00b1 SD, 17.9 \u00b1 2.9 years), 65.6 percent were syndromic (primarily Stickler and velocardiofacial syndrome), 96.9 percent had a cleft palate, and 39.1 percent required orthognathic surgery at skeletal maturity. Nonsyndromic and syndromic Pierre Robin sequence patients demonstrated no differences in occlusal relationships or mandibular surgery frequency. The majority of Pierre Robin sequence patients requiring mandibular advancement had a class II occlusion. Comparison of Pierre Robin sequence patients to isolated cleft palate patients (\n n<\/jats:italic>\n = 17) revealed a comparable frequency of orthognathic surgery between the two; however, Pierre Robin sequence patients did require mandibular advancement surgery at a greater frequency than cleft palate patients (\n p<\/jats:italic>\n = 0.006).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The present study found that 39.1 percent of conservatively managed Pierre Robin sequence patients required orthognathic surgery at skeletal maturity, of which the vast majority required mandibular advancement for class II malocclusion. These data suggest that mandibular micrognathia in conservatively managed Pierre Robin sequence patients may not resolve over time and may require surgical intervention.<\/jats:p>\n <\/jats:sec>\n \n CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n Risk, II.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/prs.0000000000007246","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T20:03:48Z","timestamp":1603397028000},"page":"599e-606e","source":"Crossref","is-referenced-by-count":17,"title":["Long-Term Orthognathic Considerations in the Pierre Robin Sequence Patient"],"prefix":"10.1097","volume":"146","author":[{"given":"Miles J.","family":"Pfaff","sequence":"first","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fransia","family":"De Leon","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Le","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Haveles","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Liu","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Berthiaume","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia R.","family":"Ayeroff","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libby F.","family":"Wilson","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine C.","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and the Cleft Palate Program, Orthopaedic Institute for Children."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,23]]},"reference":[{"key":"R1-20230801","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.cps.2013.12.007","article-title":"Surgical considerations in Pierre Robin sequence.","volume":"41","author":"Lee","year":"2014","journal-title":"Clin Plast Surg"},{"key":"R2-20230801","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/1055665618774025","article-title":"Mandibular catch-up growth in Pierre Robin sequence: A systematic review.","volume":"56","author":"Purnell","year":"2019","journal-title":"Cleft Palate Craniofac J"},{"key":"R3-20230801","first-page":"898","article-title":"Skeletal characteristics and treatment outcome of five patients with Robin sequence.","volume":"76","author":"Matsuda","year":"2006","journal-title":"Angle Orthod"},{"key":"R4-20230801","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1067\/mod.2001.115038","article-title":"The mandibular catch-up growth controversy in Pierre Robin sequence.","volume":"120","author":"Daskalogiannakis","year":"2001","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R5-20230801","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.ajodo.2008.07.020","article-title":"Craniofacial morphology and adolescent facial growth in Pierre Robin sequence.","volume":"137","author":"Suri","year":"2010","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R6-20230801","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1177\/0194599818807918","article-title":"Cleft palates and occlusal outcomes in Pierre Robin sequence.","volume":"160","author":"Do","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R7-20230801","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1016\/j.joms.2009.06.010","article-title":"Effect of a syndromic diagnosis on mandibular size and sagittal position in Robin sequence.","volume":"67","author":"Rogers","year":"2009","journal-title":"J Oral Maxillofac Surg"},{"key":"R8-20230801","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3109\/00016359709115421","article-title":"Craniofacial morphology in young adults with the Pierre Robin sequence and isolated cleft palate.","volume":"55","author":"Laitinen","year":"1997","journal-title":"Acta Odontol Scand"},{"key":"R9-20230801","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/ijos.2014.59","article-title":"The impact of cleft lip and palate repair on maxillofacial growth.","volume":"7","author":"Shi","year":"2015","journal-title":"Int J Oral Sci"},{"key":"R10-20230801","first-page":"5","article-title":"Treatment variables affecting facial growth in complete unilateral cleft lip and palate.","volume":"24","author":"Ross","year":"1987","journal-title":"Cleft Palate J"},{"key":"R11-20230801","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1597\/06-075.1","article-title":"Frequency of Le Fort I osteotomy after repaired cleft lip and palate or cleft palate.","volume":"44","author":"Good","year":"2007","journal-title":"Cleft Palate Craniofac J"},{"key":"R12-20230801","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1597\/06-053.1","article-title":"Morphologic and management characteristics of individuals with unilateral cleft lip and palate who required maxillary advancement.","volume":"45","author":"Oberoi","year":"2008","journal-title":"Cleft Palate Craniofac J"},{"key":"R13-20230801","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1097\/SCS.0b013e3182413f88","article-title":"Sagittal maxillary growth pattern in unilateral cleft lip and palate patients with unrepaired cleft palate.","volume":"23","author":"Chen","year":"2012","journal-title":"J Craniofac Surg"},{"key":"R14-20230801","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/01.prs.0000436857.63021.f0","article-title":"Maxillary hypoplasia in the cleft patient: Contribution of orthodontic dental space closure to orthognathic surgery.","volume":"133","author":"Lee","year":"2014","journal-title":"Plast Reconstr Surg"},{"key":"R15-20230801","doi-asserted-by":"crossref","first-page":"142e","DOI":"10.1097\/PRS.0000000000000779","article-title":"Lateral incisor agenesis predicts maxillary hypoplasia and Le Fort I advancement surgery in cleft patients.","volume":"135","author":"Lai","year":"2015","journal-title":"Plast Reconstr Surg"},{"key":"R16-20230801","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/0002-9416(85)90039-9","article-title":"Facial growth following pharyngeal flap surgery: Skeletal assessment on serial lateral cephalometric radiographs.","volume":"87","author":"Long","year":"1985","journal-title":"Am J Orthod"},{"key":"R17-20230801","doi-asserted-by":"crossref","first-page":"e676","DOI":"10.1097\/GOX.0000000000000656","article-title":"Orthognathic consequences of sphincter pharyngoplasty in cleft patients: A 2-institutional study.","volume":"4","author":"Yoshikane","year":"2016","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R18-20230801","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ijom.2012.09.022","article-title":"Influence of pharyngeal flap surgery on maxillary outgrowth in cleft patients.","volume":"42","author":"Voshol","year":"2013","journal-title":"Int J Oral Maxillofac Surg"}],"container-title":["Plastic & Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007246","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T19:16:41Z","timestamp":1690917401000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,23]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/prs.0000000000007246","relation":{},"ISSN":["0032-1052"],"issn-type":[{"value":"0032-1052","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10,23]]}}}