{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T19:03:47Z","timestamp":1778699027353,"version":"3.51.4"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Mandibular distraction osteogenesis is effective for the correction of severe tongue-based airway obstruction in infants with Pierre Robin sequence. Involved osteotomies may damage developing tooth buds and\/or the inferior alveolar nerve. The authors evaluated the theoretical safety of various osteotomy techniques to better define infantile mandibular anatomy using computer-aided modeling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Seven mandibular osteotomy techniques (oblique, inverted-L, multiangular, walking stick, high oblique, vertical\/high inverted-L, and horizontal) were simulated using computed tomography studies from infants with Pierre Robin sequence and without other associated conditions. Software was used to manually segment the mandibular bone, inferior alveolar nerve, and tooth buds.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Sixty-five computed tomography scans were included, yielding 130 hemimandibles. The horizontal osteotomy pattern had significantly lower theoretical risk of tooth bud (<jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001) and inferior alveolar nerve involvement (<jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001) than all other patterns. Osteotomies with high vertical components (i.e., vertical, walking stick, and multiangular) had lower theoretical tooth bud involvement than the more proximal oblique and inverted-L osteotomies (<jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001). Average lingula location was measured at a point 65 percent of the mandibular width from anterior mandibular border and 63 percent of the mandibular height from the inferior mandibular border.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Surgical planning with computed tomography scans can help evaluate an infant\u2019s mandibular anatomy to select an osteotomy that reduces morbidity risks. Regardless of technique, tooth buds and the inferior alveolar nerve are often included in osteotomies. The lingula location in this study demonstrates a position more superior and posterior than that previously described.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Therapeutic, V.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/prs.0000000000009032","type":"journal-article","created":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T21:10:41Z","timestamp":1647292241000},"page":"1169-1177","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Safety of Mandibular Osteotomies in Infants with Pierre Robin Sequence: Computer-Aided Modeling to Characterize the Risks of Various Techniques"],"prefix":"10.1097","volume":"149","author":[{"given":"Robert C.","family":"Siska","sequence":"first","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamit S.","family":"Prabhu","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyfong S.","family":"Lor","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Emmerich","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic","family":"Massary","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian S.","family":"Pan","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto L.","family":"Flores","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Runyan","sequence":"additional","affiliation":[{"name":"From the Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health; Department of Plastic Surgery, Cincinnati Children\u2019s Hospital Medical Center; and Hansj\u00f6rg Wyss Department of Plastic Surgery, New York 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