Surgery-First Technique for a Patient with Major β-Thalassemia
Regeneration, Reconstruction & Restoration (Triple R),
Vol. 5 (2020),
24 Farvardin 2020
,
Page e22
https://doi.org/10.22037/rrr.v5i.30698
Abstract
Introduction: Thalassemic patients commonly present malocclusions, which require both orthognathic treatments and surgury. This study aimed to assess prioritizing the surgery over orthodontic treatment.
Case report: Surgery-first method was performed to treat severe gummy smile and mild retrognathic mandible and prognathic maxilla in a 24-year-old Iranian girl with major β-thalassemia. Brackets and Ni-Ti wires were adjusted on all teeth to align their levels for one month. Then, the patient underwent the surgery, and the soft tissue was excised for Lefort dissection by two cutting lines, followed by osteotomy. Afterwards, down fracture and bilateral septoplasty were carried out, and excessive bones were removed. The surgery retruded the maxilla by 10 mm.
Results: The 2-year follow-up revealed no overgrowth of the maxilla or malocclusion.
Conclusion: Surgery-first method can be successfully used for treatment of malocclusions in patients with major thalassemia.
- Malocclusion
- Orthodontics
- Orthognathic
- Surgery
- Thalassemia
How to Cite
References
Muncie JH, Campbell J. Alpha and beta thalassemia. American family physician. 2009;80(4):339-44.
Williams TN, Weatherall DJ. World distribution, population genetics, and health burden of the hemoglobinopathies. Cold Spring Harbor perspectives in medicine. 2012;2(9):a011692.
Rund D, Rachmilewitz E. β-Thalassemia. New England Journal of Medicine. 2005;353(11):1135-46.
Schrier SL. Pathophysiology of thalassemia. Current opinion in hematology. 2002;9(2):123-6.
Steinberg MH, Forget BG, Higgs DR, Weatherall DJ. Disorders of hemoglobin: genetics, pathophysiology, and clinical management: Cambridge University Press; 2009.
De DM, Pettini P, Sabato V, Rubini G, Laforgia A, Schettini F. Oromaxillofacial changes in thalassemia major. Minerva pediatrica. 1996;48(1-2):11-20.
Azarkeivan A, Ansari S, Ahmadi MH, Hajibeigy B, Maghsudlu M, Nasizadeh S, et al. Blood transfusion and alloimmunization in patients with thalassemia: multicenter study. Pediatric hematology and oncology. 2011;28(6):479-85.
Letsky E, Miller F, Worwood M, Flynn D. Serum ferritin in children with thalassaemia regularly transfused. Journal of Clinical Pathology. 1974;27(8):652-5.
Aessopos A, Farmakis D, Deftereos S, Tsironi M, Polonifi A, Moyssakis I, et al. Cardiovascular effects of splenomegaly and splenectomy in β-thalassemia. Annals of hematology. 2005;84(6):353-7.
Einy S, Hazan-Molina H, Ben-Barak A, Aizenbud D. Orthodontic consideration in patients with beta-thalassemia major: case report and literature review. Journal of Clinical Pediatric Dentistry. 2016;40(3):241-6.
Gotte P, Consolo U, Faccioni F, Bertoldi C. Associated orthodontic, surgical and hematological management of Cooley s anemia. Report of a case. Minerva stomatologica. 2001;50(1-2):47-54.
Association WM. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization. 2001;79(4):373.
Nagasaka H, Sugawara J, Kawamura H, Nanda R. " Surgery first" skeletal Class III correction using the Skeletal Anchorage System. Journal of clinical orthodontics: JCO. 2009;43(2):97.
Pusaksrikit S, Isarangkura P, Hathirat P. Occlusion of the teeth in thalassemic patients. 1987.
Mortazavi SH, Khojasteh A. Superior repositioning of the maxilla in thalassemia-induced facial deformity: report of 3 cases and a review of the literature. Journal of oral and maxillofacial surgery. 2007;65(5):1023-31.
Misch CM, Jolly RL, Williams DR, Chorazy CJ. Maxillary implant surgery on a patient with thalassemia: a case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1998;86(4):401-5.
Park N, Lazow S, Berger J. β-Thalassemia: medical and surgical considerations in managing facial deformities: case report and review of the literature. Journal of oral and maxillofacial surgery. 2012;70(4):e284-e9.
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