Manejo estomatológico de paciente con Síndrome de Moebius con caries temprana de la infancia: reporte de un caso

Moebius syndrome is a non-progressive congenital disorder characterized by the unilateral or bilateral involvement of the VII cranial nerve (facial nerve) with impairment of VI cranial nerve (oculomotor nerve), producing facial paralysis. As a result of motor deficiency, these patients do not have adequate chewing and swallowing, so their diet is generally soft texture and with a high content of fermentable sugars, which cause the appearance of dental caries. Also, these patients present diverse stomatologic alterations. Here we describe the stomatological management of a male patient attending the clinic of the Pediatric Dentistry Specialty of the Autonomous University of the State of Mexico with a diagnosis of Moebius syndrome that presents early childhood caries and alteration in facial growth. The oral examination showed lingual atrophy, primary dentition, bilateral anterior and posterior crossbite, decreased bone height in the alveolar ridge corresponding to the dental organs 61 and 62, the presence of dentobacterial plaque, early childhood caries severe compromising all of the teeth, and the presence of a preformed nickel-chromium crown in the dental organ 72. Also, in the panoramic radiography, various radicular remains were observed. The treatment was planned in three phases: oral, prosthetic and orthopedic rehabilitation. In conclusion, the treatment of early childhood caries should be carried out with the aim of improving the oral conditions of the permanent teeth, returning the function and aesthetic commitment as much as possible. Also, in this type of patient, orthopedic management must be performed to prevent alterations in facial growth.