Surgical Orthodontic Treatment of a Patient Affected by Type 1 Myotonic Dystrophy (Steinert Syndrome)

Myotonic dystrophy, or Steinert’s disease, is themost common formofmuscular dystrophy that occurs in adults.Thismultisystemic form involves the skeletalmuscles but affects also the eye, the endocrine system, the central nervous system, and the cardiac system. Theweakness of the facialmuscles causes a characteristic facial appearance frequently associated with malocclusions. Young people withmyotonic dystrophy, who also have severemalocclusions, have bad oral functions such as chewing, breathing, and phonation. We present a case report of a 15-year-old boy with anterior open bite, upper and lower dental crowding, bilateral crossbite, and constriction of the upper jaw with a high and narrow palate. The patient’s need was to improve his quality of life. Because of the severity of skeletal malocclusion, it was necessary to schedule a combined orthodontic and surgical therapy in order to achieve the highest aesthetic and functional result. Although therapy caused an improvement in patient’s quality of life, the clinical management of the case was hard. The article shows a balance between costs and benefits of a therapy that challenges the nature of the main problem of the patient, and it is useful to identify the most appropriate course of treatment for similar cases.