Mastication Forces and Orthodontic Treatment in Marfan Syndrome - A Case Report

The Marfan syndrome (MFS) based on an autosomal dominant genetic disorder.Beside to the main symptoms at the heart, the eyes and the limbs the patients show a constricted maxillary bone with crowded teeth and reduced mastication forces.Main disorder in the reported 13.8-yearold patient case with MFS is the frontal and lateral open bite with crowded teeth, maxillary compression.Only three molars were in occlusion at the right side and the vertical occlusal distance increased from 3 mm on the right to 5 mm at the left side.Right and left upper first molars have been removed before treatment.Treatment was initiated with a Quad helix for expansion, followed by a fixed appliance for closing the bite and alignment of the teeth.We decided to remove the lateral left incisor in the mandible after expansion of the maxilla, thus gaining the space for all frontal teeth.Unilateral open bite was closed in the patient after 9 months of orthodontic treatment.Second aim of the study was the ability for improvement of mastication function after closing the open bite and alignment of teeth.Bite force measurement with Bitefork System was done two times.T1 after occlusal contact of both sides and at T2 after debonding of fixed appliance nine months after T1.Bite force measurement shows normalization after interdigitation of all molars and bicuspids.Mastication exercises lead to strengthening of orofacial muscles.