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Clinical Case

Integral treatment of the malocclusion in the Turner syndrome. A case report

2013, Volumen 43, Número 2
Raúl Ferrando Cascales, Domingo Martín Salvador, Benito Ramos Medina, Álvaro Ferrando Cascales
Doctor en Odontología. Diplomado por el Roth Williams Center for Functional Occlusion. Miembro y docente del FACE-RW Center for Functional Occlusion. Práctica privada con dedicación exclusiva a Ortodoncia en Murcia

Introduction. Turner syndrome (ST) was described in 1938. It affects only females and its main feature is the absence of one X chromosome in the karyotype of the patients. The maxillofacial aspect usually presents biretrusion and open bite with a relation of Class II between maxilla and mandible. Case report. We treated a case of ST with open bite, maxillary hypoplasia open bite, and hypoplasia of enamel using a combined treatment of orthodontics, orthognathic surgery and prosthetic rehabilitation. Clinical picture. Patient of 16 years affected ST (45, X0). Presents biretrusive profile with labial incompetence and appearance of Class III, Class I molar occlusion with bilateral posterior crossbite and open bite from the teeth 15-25. Treatment. a) orthopedic phase: disjunction maxilla; b) orthodontic phase: correction of dental axs; c) surgical phase: four maxilla orthognathic surgery, and d) prosthetic phase: dental rehabilitation. Results. Orthopedic phase: we obtained a disjunction of 6 mm among canines and 2.5 mm at the posterior nasal spine. Orthodontic phase: dental axs were corrected within the limitations of treatment. Surgical phase: using segmentation in 4 of the upper jaw, we got an expansion of 8 mm and closed the bite. Prosthetic phase: dental aesthetics was improved and the patient was provided of functional guides. Discussion. Due to the age of the patient (16), the choice between doing a disjunction or a conventional maxillary expansion surgically assisted is controversial.  (Rev Esp Ortod. 2013;43(2):107-114)

Key words:
Turner syndrome. Malocclusion. Treatment. Craneofacial morphology.
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