Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Orthodontics, Korea University Anam Hospital, Seoul, Republic of Korea.
J Med Case Rep. 2023 Mar 9;17(1):103. doi: 10.1186/s13256-023-03761-z.
Retinoblastoma is an intraocular cancer of infancy and childhood, which has been treated with radiation therapy and chemotherapy. Radiation on growing patients can cause deterioration in maxillofacial growth and development that leads to severe skeletal discrepancies between the maxilla and mandible, and dental problems such as crossbite, openbite, and hypodontia.
We present the case of a 19-year-old Korean man with chewing disability and dentofacial deformities. He had undergone enucleation of the right eye and radiation therapy of the left eye due to retinoblastoma 100 days after birth. Subsequently, he received cancer therapy for the secondary nasopharyngeal cancer at the age of 11 years. He was diagnosed with severe skeletal deformity including sagittal, transverse, and vertical growth deficiency of the maxilla and midface, and with class III malocclusion, severe anterior and posterior crossbite, posterior openbite, multiple missing upper incisors, right premolars, and second molars, and impaction of the lower right second molars. To restore impaired functions and esthetics of the jaw and dentition, the orthodontic treatment combined with two jaw surgery was performed. At the end of surgical orthodontics, dental implants were placed for prosthetic treatment of missing teeth. Additional plastic surgery for zygoma elevation was done with calvarial bone graft followed by fat graft. Facial esthetics and occlusal functions of patient were favorably enhanced with the improvement of skeletal discrepancy and the rehabilitation of maxillary dentition by prosthetic work. At the 2-year follow-up, the skeletal and dental relationships and implant prosthetics were well maintained.
In an adult patient with dentofacial deformities caused by early cancer therapy in the head and neck area, interdisciplinary interventions including additional plastic surgery of zygoma depression and prosthetic work of missing teeth as well as surgical-orthodontic treatment could establish favorable facial esthetics and oral rehabilitation.
视网膜母细胞瘤是一种婴幼儿眼内癌症，已采用放射疗法和化学疗法进行治疗。对生长中的患者进行放射治疗会导致面颌生长发育恶化，从而导致上颌和下颌之间严重的骨骼差异，并导致咬合不正、开颌和缺牙等牙齿问题。
我们介绍了一位 19 岁的韩国男性，他因咀嚼障碍和牙颌面畸形就诊。他出生后 100 天因视网膜母细胞瘤接受了右眼眼球摘除术和左眼放射治疗，随后在 11 岁时因继发鼻咽癌接受了癌症治疗。他被诊断为严重的骨骼畸形，包括上颌和中面部的矢状、横向和垂直生长不足，以及 III 类错颌、严重的前牙和后牙反颌、后开颌、多个上颌切牙、前磨牙和第二磨牙缺失以及右下第二磨牙阻生。为了恢复颌骨和牙齿受损的功能和美观，进行了正畸治疗联合双颌手术。在正颌正畸治疗结束时，为缺失牙进行了牙种植体修复治疗。在颅骨骨移植后进行了颧骨抬高的整形手术，并进行了脂肪移植。通过改善骨骼差异和修复上颌牙齿的义齿修复，患者的面部美观和咬合功能得到了显著改善。在 2 年的随访中，骨骼和牙齿关系以及种植体修复体保持良好。
对于因头颈部早期癌症治疗而导致牙颌面畸形的成年患者，包括颧骨凹陷的整形手术、缺失牙的义齿修复以及正颌正畸治疗等多学科干预措施，可以建立良好的面部美观和口腔康复。
