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KJO Korean Journal of Orthodontics

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eISSN 2005-372X
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Korean J Orthod   

First Published Date September 8, 2022

Copyright © The Korean Association of Orthodontists.

Orthodontic treatment in a patient with Moebius syndrome: A case report

Sanghee Leea , Cheol-Hyun Moonb

aDepartment of Medicine, Gachon University Graduate School, Incheon, Korea
bDepartment of Orthodontics, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea

Correspondence to: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, Korea.
Tel +82-32-460-3881 e-mail orthodm@gilhospital.com

How to cite this article: Lee S, Moon CH. Orthodontic treatment in a patient with Moebius syndrome: A case report. Korean J Orthod. Published online September 8, 2022. https://doi.org/10.4041/kjod22.012

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

Abstract

Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and 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 presents a 7-year-old male patient who was 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 the 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 with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.

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

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Korean J Orthod   

First Published Date September 8, 2022

Copyright © The Korean Association of Orthodontists.

Orthodontic treatment in a patient with Moebius syndrome: A case report

Sanghee Leea , Cheol-Hyun Moonb

aDepartment of Medicine, Gachon University Graduate School, Incheon, Korea
bDepartment of Orthodontics, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea

Correspondence to: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, Korea.
Tel +82-32-460-3881 e-mail orthodm@gilhospital.com

How to cite this article: Lee S, Moon CH. Orthodontic treatment in a patient with Moebius syndrome: A case report. Korean J Orthod. Published online September 8, 2022. https://doi.org/10.4041/kjod22.012

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 a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and 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 presents a 7-year-old male patient who was 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 the 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 with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.

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