Retreatment of a patient with Marfan syndrome and severe root resorption

This case report describes the retreatment of a patient with Marfan syndrome whose earlier orthodontic and surgical treatment had been unsuccessful. Marfan syndrome is an inherited connective tissue disorder transmitted as an autosomal dominant trait. The disorder results from molecular defects in the fibrillin gene that are responsible for the impaired structural integrity of the skeletal, ocular, and cardiovascular systems. When she sought retreatment, the patient had an open bite, mandibular anterior crowding, severe root resorption, and temporomandibular joint derangement with some resorption of the condyles. The second treatment, which included extractions and surgery, resulted in balanced and harmonious facial proportions, and a Class I occlusion with normal overjet and overbite. There was no further loss of condylar tissue, and the temporomandibular joints were asymptomatic. More root resorption on the mandibular left canine and the left second premolar was evident after the second treatment.