title: Orthodontic treatment for a mandibular prognathic girl of short stature under growth hormone therapy.
abstract: This report presents a case of a 12-year-old girl with maxillary deficiency, mandibular prognathism, and facial asymmetry, undergoing growth hormone (GH) therapy due to idiopathic short stature. Children of short stature with or without GH deficiency have a deviating craniofacial morphology with overall smaller dimensions; facial retrognathism, especially mandibular retrognathism; and increased facial convexity. However, a complete opposite craniofacial pattern was presented in our case of a skeletal Class III girl with idiopathic short stature. The orthodontic treatment goal was to inhibit or change the direction of mandibular growth and stimulate the maxillary growth of the girl during a course of GH therapy. Maxillary protraction and mandibular retraction were achieved using occipitomental anchorage (OMA) orthopedic appliance in the first stage of treatment. In the second stage, the patient was treated with a fixed orthodontic appliance using a modified multiple-loop edgewise archwire technique of asymmetric mechanics and an active retainer of vertical chin-cup. The treatment led to an acceptable facial profile and obvious facial asymmetry improvement. Class I dental occlusion and coincident dental midline were also achieved. A 3½-year follow-up of the girl at age 18 showed a stable result of the orthodontic and dentofacial orthopedic treatment. Our case shows that the OMA orthopedic appliance of maxillary protraction combined with mandibular retraction is effective for correcting skeletal Class III malocclusion with midface deficiency and mandibular prognathism in growing children with idiopathic short stature undergoing GH therapy.
authors: Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Chin-Yun
authors: CY
authors: Pan
authors: Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dentistry, Antai Tian-Sheng Memorial Hospital, Tong-Kang Town, Pingtung County, Taiwan.
authors: Ting-Hung
authors: TH
authors: Lan
authors: Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Szu-Ting
authors: ST
authors: Chou
authors: Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Yu-Chuan
authors: YC
authors: Tseng
authors: Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Department of Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
authors: Jenny Zwei-Chieng
authors: JZ
authors: Chang
authors: Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: hopoch@kmu.edu.tw.
authors: Hong-Po
authors: HP
authors: Chang
mesh_terms: D000293:Adolescent; D002648:Child; D004393:Dwarfism, Pituitary / Q000188:drug therapy*; D005146:Facial Asymmetry / Q000150:complications; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008313:Malocclusion, Angle Class III; D009971:Orthodontics, Corrective / Q000379:methods*; D011378:Prognathism / Q000628:therapy*
chemical_list: D013006:Growth Hormone
keywords: growth hormone; idiopathic short stature; mandibular prognathism; maxillary deficiency; skeletal Class III malocclusion