title: Two-phase orthodontic treatment of a complex malocclusion: giving up efficiency in favor of effectiveness, quality of life, and functional rehabilitation?
abstract: The interceptive orthodontic treatment of patients with complex dentofacial abnormalities is frequently inefficient and produces less than ideal outcomes. Therefore, postponing therapy to a single-phase surgical-orthodontic approach might be considered a reasonable option. However, other relevant aspects of the patient's quality of life, such as possible psychosocial problems and functional impairments, should also be considered before deciding whether to intercept a severe dentofacial malocclusion while the patient is still growing, or wait and treat later. This case report describes the nonsurgical treatment of a young patient with a severe Class III open-bite malocclusion associated with a cervical cystic lymphangioma. Despite the poor interceptive therapy prognosis, a 2-phase approach was effective. A reflection about giving up efficiency in favor of effectiveness, functional rehabilitation, and the patient's quality of life is included.
authors.affiliation: Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. souki.bhe@terra.com.br
authors.forename: Bernardo Quiroga
authors.initials: BQ
authors.lastname: Souki
authors.forename: Daniel Santos Fonseca
authors.initials: DS
authors.lastname: Figueiredo
authors.forename: Izabella Lucas de Abreu
authors.initials: IL
authors.lastname: Lima
authors.forename: Dauro Douglas
authors.initials: DD
authors.lastname: Oliveira
authors.forename: José Augusto Mendes
authors.initials: JA
authors.lastname: Miguel
mesh_terms: D002508:Cephalometry / Q000379:methods; D002675:Child, Preschool; D004526:Efficiency; D004954:Esthetics; D005115:Extraoral Traction Appliances; D005152:Facial Muscles / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000503:physiopathology; D018191:Lymphangioma, Cystic / Q000150:complications; D008260:Macroglossia / Q000150:complications; D008313:Malocclusion, Angle Class III / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D008409:Mastication / Q000502:physiology; D008445:Maxillofacial Development / Q000502:physiology; D024343:Open Bite / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D016382:Orthodontic Appliance Design; D009972:Orthodontics, Interceptive / Q000379:methods*; D010155:Palatal Expansion Technique / Q000295:instrumentation; D010347:Patient Care Planning; D011379:Prognosis; D011788:Quality of Life; D014061:Tongue Habits / Q000628:therapy; D014062:Tongue Neoplasms / Q000150:complications; D016896:Treatment Outcome