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Interdisciplinary Management of a Class III Anterior Open Bite Malocclusion in a Patient With Cerebral Palsy.

Michelogiannakis, Dimitrios; Vorrasi, John Stephen; Kotsailidi, Elli Anna; Rossouw, Paul Emile.
J Oral Maxillofac Surg; 76(12): 2648.e1-2648.e15, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30193117
Dentofacial disharmony in patients with cerebral palsy (CP) can lead to low self-esteem and functional limitations. However, medical and behavioral challenges in patients with developmental disorders often prevent dental practitioners from offering the necessary treatment. This report describes the clinical interdisciplinary management of a 20-year-old man with CP, including orthodontic, periodontal, and orthognathic surgery therapy. The patient presented with the chief complaint of having difficulty chewing, was wheelchair dependent, had poor orofacial muscle control, and exhibited a Class III malocclusion with a skeletal anterior open bite. The lower midline was shifted 3 mm to the right, there was severe maxillary spacing, and the patient had gingival overgrowth. A combined orthodontic, periodontal, and orthognathic surgery treatment approach was chosen to meet the patient's interdisciplinary needs. Because of his physical limitations, it was necessary to avoid complicated and prolonged orthodontic treatment mechanics. Interdisciplinary therapy improved the patient's oral function, periodontal health, and facial esthetics and led to a good occlusion, which remained stable 1 year after treatment. Regardless of the treatment challenges, combined orthodontic and surgical therapy in the present patient with CP led to favorable treatment results and improved the patient's self-esteem, confidence in social interactions, and speaking and chewing abilities.