Orthodontic treatment of a patient with severe class II malocclusion, bony fibrous dysplasia, root resorptions, and missing four premolars.
BACKGROUND
A case of distal occlusion is presented with root resorptions and missing premolars, treated at the end of the growth period with Herbst appliance. Orthodontic treatment in non-progressive fibrous dysplasia is assessed.


METHODS
Anamnesis, results of extraoral and intraoral examinations, typodonts, panoramic view, hand-wrist radiogram, and cephalogram were obtained in a 14-year-old boy with severe distal occlusion, root resorptions resulting from previous orthodontic treatment, fibrous dysplasia of bone, and missing four premolars. Successful treatment was achieved with Herbst appliance followed by fixed appliances.


RESULTS
Bands were placed on upper second molars and lower first premolars and the Herbst appliance was positioned forcing the mandible forward. After three months the patient was unable to position the mandible backwards. Canine and Angle Class I were achieved, overjet and overbite were reduced to 2 mm. Lower face height was reduced and the upper lip was retracted, producing lip competence. At this point the fixed appliances were removed, an upper removable retention plate was made, and a lower flexible spiral wire retainer was bonded. Active retreatment lasted 15 months. No hypermobility of any teeth nor progression or neoplastic transformation of fibrous dysplasia were noted at the end of orthodontic treatment.


CONCLUSIONS
(1) It is possible to treat distal occlusion with Herbst appliance at the end of the growth period. (2) Root resorptions are not a contra-indication to treatment if potential benefits outweigh risks. (3) Orthodontic tooth movement appears possible and safe in patients with non-progressive fibrous dysplasia.
Janiszewska-Olszowska
Joanna
J
Zakład Ortodoncji Pomorskiej Akademii Medycznej w Szczecinie al. Powstańców Wlkp. 72. 70-111 Szczecin.
Jarowicz
Jolanta
J
Syryńska
Maria
M
Wedrychowska-Szulc
Barbara
B
D000293:Adolescent; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000150:complications / Q000628:therapy*; D017289:Orthodontic Appliances, Functional; D012391:Root Resorption / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome