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KJO Korean Journal of Orthodontics

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pISSN 2234-7518
eISSN 2005-372X
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Korean J Orthod   

First Published Date June 29, 2022

Copyright © The Korean Association of Orthodontists.

Orthodontics treatment in a patient with Moebius syndrome : a case report

Sang-hee Leea and Cheol-Hyun Moonb

aPostgraduate Student, Department of Medicine , Gachon University Graduate School, Incheon, Korea
bProfessor, Department of Orthodontics, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea

Correspondence to:Dr. Cheol-Hyun Moon.
Professor and Department Chair, Department of Orthodontics, Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero 774, Namdong–gu, Incheon, 21565, South Korea
Tel +82324603881 e-mail orthodm@gilhospital.com

Received: January 17, 2022; Revised: June 14, 2022; Accepted: June 27, 2022

Abstract

Moebius syndrome (MBS) is congenital neurologic disorder that causes cranio-facial abnormalities. It is involved paralysis of the VI and VII cranial nerves and cause bilateral or unilateral facial paralysis, eye movement disorder, deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia.
This case report present a 7.1-year-old male patient who was a diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class Ⅱ malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during treatment to expand the arch width. After 30 months of phase Ⅱ treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable and a Class Ⅰ canine and molar relationship; and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, the important thing is to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long term retention follow-up.

Keywords: Dentofacial anomalies, Growth and development, Retention and stability, Moebius syndrome

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Korean J Orthod   

First Published Date June 29, 2022

Copyright © The Korean Association of Orthodontists.

Orthodontics treatment in a patient with Moebius syndrome : a case report

Sang-hee Leea and Cheol-Hyun Moonb

aPostgraduate Student, Department of Medicine , Gachon University Graduate School, Incheon, Korea
bProfessor, Department of Orthodontics, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea

Correspondence to:Dr. Cheol-Hyun Moon.
Professor and Department Chair, Department of Orthodontics, Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero 774, Namdong–gu, Incheon, 21565, South Korea
Tel +82324603881 e-mail orthodm@gilhospital.com

Received: January 17, 2022; Revised: June 14, 2022; Accepted: June 27, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Moebius syndrome (MBS) is congenital neurologic disorder that causes cranio-facial abnormalities. It is involved paralysis of the VI and VII cranial nerves and cause bilateral or unilateral facial paralysis, eye movement disorder, deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia.
This case report present a 7.1-year-old male patient who was a diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class Ⅱ malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during treatment to expand the arch width. After 30 months of phase Ⅱ treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable and a Class Ⅰ canine and molar relationship; and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, the important thing is to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long term retention follow-up.

Keywords: Dentofacial anomalies, Growth and development, Retention and stability, Moebius syndrome