Managing complex malocclusions in adult patients with severe neuromuscular disorders presents unprecedented clinical, ethical, and biomechanical challenges.
Duchenne muscular dystrophy (DMD), a progressive X-linked genetic condition, is frequently accompanied by progressive macroglossia, severe muscular weakness, and an altered craniofacial muscular balance, resulting in extensive anterior and posterior open bites, generalized spacing, and compromised masticatory efficiency.
Because traditional orthodontic protocols are constrained by physical limitations and elevated medical risks, delivering effective care requires a highly individualized and flexible approach.
In such high-risk clinical scenarios, achieving a successful outcome extends beyond standard mechanotherapy—such as fixed appliances, strategic extractions, and vertical elastics—and hinges on a rigorous, ongoing informed consent process.
Clinicians must balance the patient's personal quality-of-life expectations and functional goals against the complex risks of surgical procedures like glossectomy, adapted oral hygiene protocols, and potential stability limitations.
Navigating these decisions demands transparent communication, patient autonomy, and seamless interdisciplinary collaboration between the orthodontist, surgical team, caregivers, and medical specialists.
► DENTAL BOOK: Orthodontics - Diagnosis and Management of Malocclusion and Dentofacial Deformities - Om Prakash Kharbanda
This clinical case report documents the comprehensive orthodontic management of a 22-year-old male presenting with Duchenne muscular dystrophy, macroglossia, and severe functional compromise.
By detailing how adapted biomechanics and surgical tongue reduction were successfully executed through a patient-centered informed consent framework, this study highlights the vital equilibrium between technical execution, clinical ethics, and compassionate care in special needs orthodontics.
📖 Read the Full Study: To examine the step-by-step treatment sequence, surgical glossectomy protocols, detailed cephalometric progress, and the ethical decision-making framework of this case, you can access and download the complete article in PDF format here.
