Korean J Orthod.  2022 Jul;52(4):298-307. 10.4041/kjod21.215.

Conservative orthodontic treatment for severe pathologic migration following total glossectomy: A case report

Affiliations
  • 1Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
  • 2Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea

Abstract

Glossectomy combined with radiotherapy causes different levels of tongue function disorders and leads to severe malocclusion, with poor periodontal status in cancer survivors. Although affected patients require regular access to orthodontic care, special considerations are crucial for treatment planning. This case report describes the satisfactory orthodontic management for the correction of severe dental crowding in a 43-year-old female 6  years after treatment for tongue cancer with total glossectomy combined with radiotherapy, to envision the possibility of orthodontic care for oral cancer survivors. Extraction was performed to correct dental crowding and establish proper occlusion following alignment, after considering the possibility of osteoradionecrosis. Orthodontic mini-implants were used to provide skeletal anchorage required for closure of the extraction space and intrusion of the anterior teeth. The dental crowding was corrected, and Class I occlusal relationship was established after 36 months of treatment. The treatment outcome was sustained after 15 months of retention, and long-term follow-up was recommended.

Keyword

Tongue squamous cell carcinoma; Total glossectomy; Intrusion; Orthodontic mini-implant

Figure

  • Figure 1 Serial panoramic and periapical radiographs showing the development of severe malocclusion over time. A, Before total glossectomy. B, Three years after tongue cancer treatment. C, Six years after tongue cancer treatment and pre-orthodontic treatment.

  • Figure 2 Pre-treatment lateral cephalometric radiograph and tracing.

  • Figure 3 Pre-treatment facial and intraoral photographs.

  • Figure 4 Intraoral photographs of treatment progress. A, Leveling and alignment. B, Closing extraction space and intruding maxillary and mandibular anterior teeth.

  • Figure 5 Periapical radiographs follow-up. A, Maxillary incisors. B, Mandibular incisors. T0, pre-treatment; T1, re-assessment after leveling and alignment; T2, T3, treatment progress with closing extraction space and intruding maxillary and mandibular anterior teeth; T4, post-treatment; T5, one year of retention.

  • Figure 6 Post-treatment facial and intraoral photographs.

  • Figure 7 Post-treatment lateral cephalometric radiograph, tracing and panoramic radiograph.

  • Figure 8 Superimposition of pre- and post-treatment cephalometric tracings.

  • Figure 9 Intraoral photographs after 15 months of retention.

  • Figure 10 Panoramic radiograph after 1 year of retention.


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