An anti-glossoptosis orthodontic appliance with a contoured palatal surface and an intra-cleft extension for the management of newborns with Pierre Robin sequence

Relevance. Despite extensive investigation of Pierre Robin sequence (PRS), significant challenges remain in the treatment and rehabilitation of infants with congenital cleft lip and palate, including alveolar and palatal clefts affecting craniofacial development across the transverse, vertical, and sagittal planes. The coexistence of cleft palate and Pierre Robin sequence substantially complicates orthodontic management at different stages of neonatal care. In PRS, cleft palate associated with glossoptosis and micrognathia frequently results in acute airway obstruction and feeding difficulties, necessitating urgent specialized orthodontic care within the first 24 hours after birth.

Materials and methods. To achieve the study objectives, a novel orthodontic appliance was developed (patent application No. 2025101519, January 25, 2025). The appliance was used as an emergency intervention in five newborns with mild to moderate Pierre Robin sequence during the first days of life. Clinical use was carried out at the Perinatal Center (Neonatal Pathology Unit) and the Dental Department of the Clinical Diagnostic Center of Republican Hospital No. 1 – National Center of Medicine named after M. E. Nikolaev (Yakutsk, Russian Federation).

Results. Newborns adapted to the appliance within the first three days, with restoration of airway patency and sucking function, allowing independent oral feeding and subsequent removal of the nasogastric tube when clinically indicated. The appliance was worn continuously and cleaned once daily using infant soap. Replacement of the appliance was planned after 1.5–2 months, based on the infant’s growth and weight gain and following endoscopic reassessment.

Conclusion. Use of an anti-glossoptosis orthodontic appliance with a contoured palatal surface and a targeted intra-cleft extension enables effective early management of acute respiratory compromise and feeding difficulties in newborns with Pierre Robin sequence during the first days of life.

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