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Case Reports
. 2015 Jan-Feb;20(1):97-107.
doi: 10.1590/2176-9451.20.1.097-107.oar.

Alternative treatment for open bite Class III malocclusion in a child with Williams-Beuren syndrome

Giovanni Modesto Vieira  1 , Eduardo Jacomino Franco  1 , Denise Falcão Pinheiro da Rocha  2 , Laudimar Alves de Oliveira  3 , Rivadávio Fernandes Batista Amorim  4
Affiliations
Case Reports

Alternative treatment for open bite Class III malocclusion in a child with Williams-Beuren syndrome

Giovanni Modesto Vieira et al. Dental Press J Orthod. 2015 Jan-Feb.

Abstract
in English, Portuguese

Williams-Beuren syndrome (WBS) is a rare genetic condition that affects approximately 1 in every 20,000 - 50,000 live births. WBS children have specific skeletal deformities, dental malformations and rare lingual muscle dysfunction. The need for orthodontic and orthognathic therapy has arisen and has been considered a real clinical challenge even for experienced professionals, once it requires a complex and individualized treatment plan. This study reports a case of orthopedic expansion of the maxilla, in which a modified facial mask was used for protraction of the maxillary complex associated with clockwise rotation of the maxilla. In addition, special considerations about treatment time and orthopedic outcomes are discussed.

A síndrome de Williams-Beuren (WBS) é uma doença genética rara, acometendo, aproximadamente, de 1:20.000 a 1:50.000 crianças nascidas. As crianças com WBS têm deformidades esqueléticas específicas, má formações dentárias e, algumas vezes, disfunção muscular da língua. As necessidades ortodônticas e ortognáticas têm sido consideradas um verdadeiro desafio clínico, até mesmo para aqueles profissionais com vasta experiência, uma vez que requerem um plano de tratamento individualizado e complexo. Esse relato de caso aborda uma expansão ortopédica da maxila, em que foi utilizada uma máscara facial modificada para protração do complexo maxilar, acompanhada de uma rotação horária da maxila. Além disso, considerações especiais sobre o tempo de tratamento e resultados ortopédicos são discutidas.

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Figures

Figure 1 -
Figure 1 -. Photographs before treatment.
Figure 2 -
Figure 2 -. Photographs of dental casts before treatment.
Figure 3 -
Figure 3 -. Panoramic radiograph and lateral cephalogram before treatment.
Figure 4 -
Figure 4 -. Completion of interceptive treatment with Frankel III before the use of facial mask. Note improvements in lip competence and muscle tone. Panoramic radiograph and lateral cephalogram after interceptive treatment.
Figure 5 -
Figure 5 -. Nanda-modified facial mask with force application at the center of resistance in the maxillary complex. Lateral cephalogram after treatment with facial mask.
Figure 6 -
Figure 6 -. Patient at the age of 17 with extrusion maxillary arch in 0.019 x 0.025-in stainless steel arch wires.
Figure 7 -
Figure 7 -. Photographs after treatment.
Figure 8 -
Figure 8 -. Dental casts after treatment.
Figure 9 -
Figure 9 -. Panoramic radiograph and lateral cephalogram after treatment.
Figure 10 -
Figure 10 -. A) Cephalometric superimposition before and after treatment. B) Maxillary and mandibular superimposition.
See this image and copyright information in PMC

References

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