Rapid maxillary disjunction associated with Petit mask for Class III treatment in a patient with myelomeningocele - case report

Abstract

Myelomeningocele is a malformation of the central nervous system that can cause several difficulties in physical and cognitive development. This case report describes the orthopedic treatment of a 13-year-old patient with skeletal Class III malocclusion associated with myelomeningocele. The patient was treated with a modified Hyrax device, combined with the Petit facial mask, with the aim of promoting maxillary expansion and correcting the maxillomandibular discrepancy. During treatment, challenges were faced due to the patient's clinical conditions, including motor difficulties, limitations in opening the mouth and exacerbation of the gag reflex. However, parental cooperation was essential, allowing the effective use of the mask and the performance of jaw disjunction. The results of the treatment were positive, with significant improvements in malocclusion. The patient will continue with the fixed orthodontic phase to stabilize long-term results. The report highlights the importance of a personalized approach adapted to the specific needs of patients with complex conditions such as myelomeningocele.