Surgical-Orthodontic Management of Mandibular Hypoplasia with Severely Short-Rooted Dentition Secondary to Anti-Leukemic Treatment: A Case Report

Abstract

Major advances in anti-leukemic treatment have increased a significant number of pediatric cancer survivors over the past few decades. Such treatment in children is also reported to cause abnormal dentofacial development including a significant mandibular hypoplasia, dental anomalies, and severely short-rooted dentition. These problems, despite a becoming both functional and psychosocial problems, are often neglected as many clinician’s lack experience in managing them. They are exacerbated by the fact that orthodontic treatments can potentially cause further root shortening. Therefore, a special consideration to minimize a risk of root resorption must be given when an orthodontic treatment plan is formulated for these patients. We report a unique treatment approach employed on a 14-year-old male patient with severe dentofacial abnormalities secondary to anti-leukemic treatment. Treatment goals were to correct dental malocclusion, optimize facial balance, and also prevent further root shortening. A treatment plan combining orthodontics, orthognathic surgery, and use of temporary anchorage devices, was developed so that light orthodontic forces could be used throughout the course of treatment. Consequently, the lighter force reduced the risk of potential root resorption. The final outcome demonstrates that the surgical-orthodontic approach optimizes facial and occlusal changes while minimizing further root resorption.