Fixed multibracket orthodontic treatment in a patient with Pierre Robin sequence and delay in cognitive development: a case report

Aim: the aim of this work is to present a clinical case of a 13-year-old patient affected by Pierre Robin Sequence (PRS) who was treated with fixed multibrackets therapy. PRS is a rare pathology associated with micromandibulia, glossoptosis and cleft palate. The main objective of the treatment was tooth alignment and occlusion improvement to improve oral hygiene and aesthetics (as requested by the patient and his family). Methods: the patient, who underwent previous surgery to treat the cleft palate, showed a skeletal and dental class II, labial incompetence and micromandibulia, complete permanent dentition, very severe crowding, ogival palate and increased overjet. The patient was initially uncompliant, since PRS can lead to a delay in cognitive development. A classic 4 extraction fixed orthodontic treatment was performed together with the use of class II elastics. The aim of this treatment was to improve the dental alignment and the dental and skeletal relationship and to facilitate teeth brushing by the patient. The treatment lasted 18 months and, at the end of it, the patient received upper and lower removable retainers. Results: improved tooth alignment and improved dental class II, solving crowding and optimizing occlusion for better brushing and to facilitate social relationships. Conclusions: although this was a complex case, considering patient’s clinical history and limited compliance, the treatment achieved a good orthodontic compromise, improving function, oral hygiene and aesthetics.