Management of Maxillary Deformity with Segmental Osteotomy followed by Implant Insertion in β-Thalassemia Major Patient

The aim of this report is to present the management of the maxillary deformity and subsequent implant therapy of a case with β-thalassemia major.

β-thalassemia is a hematologic disorder that results from the abnormality of the β-globulin chain synthesis. The best known thalassemia-induced dentofacial problem is the maxillary enlargement, and this undesirable growth of maxilla affects not only the facial esthetics but also dental occlusion, and leads to functional deficiency.

A 16-year-old female patient with β-thalasse-mia major was referred with the complaints of severe facial deformity and malocclusion, resulting in psychosocial and functional problems for her. The dentofacial deformity was characterized by an excessive premaxillary growth both in sagittal and vertical planes. Anterior maxillary osteotomy was performed with bilateral canines extraction, and dental implants were inserted to the canine regions, following bone healing. Postoperative course was free of problems with the crown restorations in function. Recurrence has not been occurred at 6 years follow-up.

With maintaining hemoglobin level over 10 gm/dl, correction of maxillary defects is stable for long-term in β-thalassemia major patient. Implant application to these patients may lead to unforeseeable results.

Although having some difficulties, such as overbleeding and stability problems, maxillary enlargement can be treated by segmental osteotomies successfully in β-thalassemia major patient. Implant failure frequency may be higher, but many other studies are needed for determining implant survival rate in β-thalassemia major patients.