Nonsurgical orthodontic treatment for a patient with Sotos syndrome

Sotos syndrome is a genetic disorder characterized by overgrowth in childhood, specific facial manifestations, advanced bone age, and mental retardation. Although only one case report of Sotos syndrome treated with surgical orthodontics has thus far been published, there have also been a few detailed reports of long-term observation of Sotos syndrome through total orthodontic treatment. This article aimed to present the case of a growing patient with skeletal mandibular protrusion and unilateral posterior crossbite as present in Sotos syndrome treated with a non-surgical orthodontic technique. A 10-year-old boy was diagnosed with skeletal mandibular protrusion and posterior crossbite associated with Sotos syndrome. After maxillary lateral expansion, the skeletal Class III relationship with an anterior crossbite improved owing to mandibular clockwise rotation, while the facemask had a marginal effect. At the completion of growth at 16 years, he had a skeletal Class I relationship, and thus, conventional orthodontic treatment with preadjusted edgewise appliances was initiated. After 41 months of multibracket treatment, acceptable occlusion with a functional Class I relationship was obtained. At 12 months postretention, no or few changes in occlusion and facial features were observed. Our results demonstrate that considering the maxillofacial vertical growth during peripubertal period associated with Sotos syndrome, much attention should be paid to the early orthopedic treatment with the facemask and/or chin cap.