Orthodontic Management of Patients Diagnosed with Systemic Diseases: A Clinical Case Series
Simran Bhatia, Tulika Tripathi, Rinkle Sardana, Priyank Rai, Anup Kanase, Nidhi SainiBackground
Systemic diseases can alter bone metabolism, immune response, and tissue healing, affecting the safety and predictability of orthodontic treatment. This case series describes modifications before or during orthodontic management in patients diagnosed with systemic conditions.
Case Series
Four orthodontic patients diagnosed with hepatitis C, tuberculosis, congenital hypothyroidism, and acute lymphoblastic leukemia were managed with individualized treatment protocols in consultation with the respective medical specialists.
Results
In the patient with hepatitis C, orthodontic treatment was continued with strict infection-control measures, modified mechanics, lighter forces, and extended appointment intervals following medical evaluation. Treatment was deferred for 1 year in the patient diagnosed with active tuberculosis and resumed after completion of therapy and confirmation of non-infectious status. In the patient with congenital hypothyroidism and delayed puberty, Twin Block therapy was undertaken during hormone replacement therapy, resulting in skeletal and dental mandibular advancement. In the patient diagnosed with acute lymphoblastic leukemia, orthodontic appliances were removed and treatment was postponed during oncologic therapy, followed by cautious re-initiation with light forces and extended intervals.
Conclusion
Orthodontic management of medically compromised patients requires regular medical reassessment, interdisciplinary coordination, individualized treatment modifications, and, when necessary, temporary treatment discontinuation to prioritize patient safety..