Abstract:
In last decades, the number of adult patients requesting orthodontic treatments has increased. Orthognathic surgery allows correction of skeletal dysmorphoses in adults. The management of osteoporotic patients treated with bisphosphonates is a major challenge for orthodontists and maxillofacial surgeons. Few studies have been conducted in these patients and four cases of orthognathic surgery have been described to date. A rare case of orthodontic surgical treatment in an osteoporotic patient who has been treated with bisphosphonates is reported. A 38-year-old patient wishing to improve the aesthetics of her face presented in dentofacial orthopedic consultation. Anamnesis revealed a history of bisphosphonate treatment for osteoporosis. The patient presented a hyperdivergent skeletal class III with laterognathia. The occlusal diagnosis was a class III with premolar and canine open bite, interincisal media discordance and dental crowding. The patient was treated by orthodontics and maxillomandibular osteotomy. A postoperative bone Healing delay of four weeks was recorded. This case report discusses the possibility of performing orthodontic treatment associated with orthognathic surgery in patients treated with bisphosphonates in context of osteoporosis. Orthodontics and maxillofacial surgeons must be prepared for the management of patients treated with bisphosphonates. Studies should be considered in order to specify the optimal methods of management.
摘要:
在过去的几十年里,要求正畸治疗的成年患者数量有所增加。正颌手术可以矫正成人的骨骼畸形。用双膦酸盐治疗的骨质疏松患者的管理是正畸医生和颌面外科医生的主要挑战。对这些患者进行的研究很少,迄今为止已经描述了四例正颌手术。据报道,在接受双膦酸盐治疗的骨质疏松患者中,罕见的正畸手术治疗病例。一名38岁的患者希望在颌面骨科咨询中改善面部美观。回忆揭示了双膦酸盐治疗骨质疏松症的历史。该患者表现出高度发散的骨骼III类,伴有下颌畸形。咬合诊断为III类,前磨牙和犬齿开放咬伤,齿间介质不一致和牙齿拥挤。患者接受正畸和上颌下颌截骨术治疗。记录到术后骨愈合延迟4周。该病例报告讨论了在骨质疏松症中使用双膦酸盐治疗的患者进行与正颌手术相关的正畸治疗的可能性。正畸和颌面外科医生必须为使用双膦酸盐治疗的患者做好准备。应考虑进行研究,以指定最佳的管理方法。