No CrossRef data available.
Article contents
Outcome of orthodontic airway plate in improving airway among children with Pierre Robin Sequence: a systematic review
Published online by Cambridge University Press: 11 December 2025
Abstract
Background
Pierre Robin Sequence is characterised by a small lower jaw, tongue displacement and, often, a U-shaped cleft palate, leading to breathing and feeding problems. Orthodontic airway plates have been developed as a non-invasive treatment option. A systematic review was conducted to evaluate the outcomes of orthodontic airway plates in children with Pierre Robin Sequence.
Methods
Databases were searched for studies published up to December 2024, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results
Ten clinical studies with a total of 598 patients were included, among which 483 had isolated Pierre Robin Sequence, and 115 had syndromic Pierre Robin Sequence. Orthodontic airway plates improved airway obstruction and helped avoid tracheostomy in most patients. A small proportion of syndromic cases still required surgery. Feeding outcomes improved, with fewer children needing tube feeding. Speech development was good, though hypernasality persisted in some.
Conclusion
Orthodontic airway plates are a minimally invasive yet effective way to manage airway complications in Pierre Robin Sequence patients.
Information
- Type
- Systematic Review
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.
Footnotes
K Selvaraju and T C Shin These Authors have equal contribution
References
Müller-Hagedorn, S, Buchenau, W, Arand, J, Bacher, M, Poets, CF. Treatment of infants with syndromic Robin sequence with modified palatal plates: a minimally invasive treatment option. Head Face Med 2017;13:4CrossRefGoogle ScholarPubMed
Naros, A, Bartel, S, Bacher, M, Koos, B, Blumenstock, G, Wiechers, C et al. Speech development in cleft palate with and without Robin sequence. Plast Reconstr Surg 2022;149:443–52CrossRefGoogle ScholarPubMed
Choo, H, Khosla, RK, Meister, KD, Wan, DC, Lin, HF, Feczko, R et al. Nonsurgical orthodontic airway plate treatment for newborns with Robin sequence. Cleft Palate Craniofac J 2022;59:403–10CrossRefGoogle ScholarPubMed
Choo, H, Sidell, DR, Kim, JW, Ahn, HW, Day, HS, Sullivan, SS. Nonsurgical improvement of severe upper airway obstruction in infants with Robin sequence and cleft palate using Stanford orthodontic airway plate treatment. J Clin Sleep Med 2024;20:1807–17CrossRefGoogle ScholarPubMed
Ho, AC, Wong, RW, Cheung, T, Ng, DK, Siu, KK, Fung, SC. Orthodontic plate for management of obstructive sleep apnoea in infants with Pierre Robin sequence: experience and protocol in Hong Kong. J Orthod 2019;46:367–73CrossRefGoogle ScholarPubMed
Choo, H, Galera, RI, Balakrishnan, K, Lin, HF, Ahn, H, Lorenz, P et al. Disruptive therapy using a nonsurgical orthodontic airway plate for the management of neonatal Robin sequence: 1-year follow-up. Cleft Palate Craniofac J 2023;60:758–67CrossRefGoogle ScholarPubMed
Buchenau, W, Wenzel, S, Bacher, M, Müller-Hagedorn, S, Arand, J, Poets, CF. Functional treatment of airway obstruction and feeding problems in infants with Robin sequence. Arch Dis Child Fetal Neonatal Ed 2017;102:F142–6CrossRefGoogle ScholarPubMed
Naros, A, Steiner-Wilke, I, Kaiser, N, Bacher, M, Koos, B, Blumenstock, G et al. Neurocognitive development in isolated Robin sequence treated with the Tübingen palatal plate. Clin Oral Investig 2022;26:4817–23CrossRefGoogle ScholarPubMed
Marcus, KS, Scott, AR. Use of the preepiglottic baton plate for treatment of tongue-based obstruction in newborns with Robin sequence. Curr Opin Otolaryngol Head Neck Surg 2025;33:236–41CrossRefGoogle ScholarPubMed
Schmidt, G, Hirschfelder, A, Heiland, M, Matuschek, C. Customized pre-epiglottic baton plate – a practical guide for successful, patient-specific, noninvasive treatment of neonates with Robin sequence. Cleft Palate Craniofac J 2021;58:1063–9CrossRefGoogle Scholar
Wiechers, C, Buchenau, W, Arand, J, Oertel, AF, Peters, K, Müller-Hagedorn, S et al. Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate. Head Face Med 2019;15:17CrossRefGoogle ScholarPubMed
Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I, Hoffmann, TC, Mulrow, CD et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71CrossRefGoogle ScholarPubMed
Joanna Briggs Institute. Checklist for systematic reviews and research syntheses. 2017. Available from: https://joannabriggs.org/ebp/critical_appraisal_toolsGoogle Scholar
Poets, CF, Maas, C, Buchenau, W, Arand, J, Vierzig, A, Braumann, B et al. Multicenter study on the effectiveness of the pre-epiglottic baton plate for airway obstruction and feeding problems in Robin sequence. Orphanet J Rare Dis 2017;12:46CrossRefGoogle ScholarPubMed
Naros, A, Krimmel, M, Zengerle, F, Bacher, M, Koos, B, Mack, U et al. Perioperative complications in cleft palate repair with Robin sequence following Tübingen palatal plate treatment. J Craniomaxillofac Surg 2021;49:298–303CrossRefGoogle Scholar
Wiechers, C, Uhlig, S, Poets, A, Weise, C, Naros, A, Krimmel, M et al. Sleep and neurocognitive outcome in primary school children with Robin sequence. Sleep 2023;46:zsac317CrossRefGoogle ScholarPubMed
Haas, J, Yuen, K, Farrokhyar, F, Aminnejad, M, Williams, C, Choi, M. Non-operative interventions for Pierre-Robin sequence: a systematic review and meta-analysis. J Cranio-Maxillofac Surg 2024;52:1422–7CrossRefGoogle ScholarPubMed
Poets, CF, Koos, B, Reinert, S, Wiechers, C. The Tübingen palatal plate approach to Robin sequence: summary of current evidence. J Craniomaxillofac Surg 2019;47:1699–705CrossRefGoogle ScholarPubMed
Buchenau, W, Urschitz, MS, Sautermeister, J, Bacher, M, Herberts, T, Arand, J, Poets, CF. A randomized clinical trial of a new orthodontic appliance to improve upper airway obstruction in infants with Pierre Robin sequence. J Pediatr 2007;151:145–9.CrossRefGoogle ScholarPubMed
Resnick, CM, de Gijsel, J, Jindal, S, Quante, M, Poets, CF, Katz, E et al. Comparative effectiveness of preepiglottic baton plates and mandibular distraction in infants with Robin sequence. Plast Reconstr Surg 2021;147:10e–97eGoogle Scholar
Schmidt, G, Engeli, N, Matuschek, C, Hunn-Stohwasser, C, Bestendonk, C, Heiland, M et al. Speech outcomes in children with Robin sequence treated with a pre-epiglottic baton plate. Cleft Palate Craniofac J 2024;61:1055–66Google Scholar
Abbas, DB, Lavin, C, Fahy, EJ, Choo, H, Truong, MT, Bruckman, KC et al. A systematic review of mandibular distraction osteogenesis versus orthodontic airway plate for airway obstruction treatment in Pierre Robin sequence. Cleft Palate Craniofac J 2022;59:365–76CrossRefGoogle ScholarPubMed