ABSTRACT
This report describes the case of a 12-year-old female patient with a long mandible experiencing difficulty chewing with the right molar. Considering the age of the patient, bone-anchored maxillary protraction using four miniplates placed below the maxillary zygomatic arch and anterior symphysis of the mandible and Class III intermaxillary elastics were planned. After 12 months, orthodontic treatment was initiated. After extraction of the impacted maxillary right second premolar and mandibular right second primary molar, protraction of the mandibular right molars was performed using a miniplate placed on the anterior part of the mandible as an anchor. Miniscrews were placed in the left posterior part of the mandible to improve the molar relationship and correct the dental midline through distalization of the mandibular left posterior teeth. We reported successful sequential comprehensive nonsurgical treatment in an adolescent with skeletal Class III malocclusion.
ABSTRACT
Becker's nevus is a relatively common skin lesion with brown hyperpigmentation and hypertrichosis. It may be expressed simultaneously with other cutaneous, muscular, or skeletal defects, such as hypoplasia of the breast or scoliosis, for which the term "Becker's nevus syndrome" has been proposed. An 8-year-old boy presented with a Becker's nevus on the right cheek, chin, and upper neck with alveolar bone hypertrophy in the anterior mandible, which led to an anterior crossbite and severe canting of the mandibular anterior teeth. Through orthopedic treatment using a face mask, the anteroposterior jaw relationship was improved. In phase 2 treatment, we corrected the canting of the mandibular anterior teeth with a segmental intrusion of the mandibular anterior right teeth into the hypertrophic alveolar bone area. The facial profile was improved along with acceptable occlusion, and the treatment result was stable at 1 year after the end of the treatment, without any periodontal attachment loss, root resorption of mandibular anterior teeth, or increase in the size of the hypertrophic region. This case report describes the successful comprehensive treatment of a growing patient with skeletal Class III malocclusion and multiple characteristics of Becker's nevus syndrome.
ABSTRACT
Odontogenic keratocysts (OKCs) are one of the most aggressive cysts in the oral and maxillofacial area because of their high recurrence rate and infiltrative behavior. In growing patients with OKCs, a radical treatment approach might cause numerous complications, including the disturbance of jaw growth and loss of the involved tooth. This case report describes successful comprehensive orthodontic treatment combined with marsupialization of the cyst in a young girl who exhibited an OKC with impacted teeth. The 10-year-old girl presented with an OKC extending from the mandibular symphysis through the left mandibular body, with ectopic impaction of the mandibular left canine and first premolar, as well as congenitally missing bilateral mandibular second premolars. Interestingly, spontaneous improvement of the positions of the ectopic impacted teeth, along with a reduction in the size of the cyst, occurred during marsupialization. The sequential use of removable and fixed appliances enabled orthodontic traction of the impacted teeth. The treatment outcome was stable at 2.5 years after the end of the treatment. We speculate that comprehensive orthodontic treatment combined with marsupialization can be an effective treatment strategy for patients with OKCs, especially when they are encountered in young, growing patients with impacted teeth.
