Original ArticlesCraniofacial Deformities in Patients With Beta-Thalassemia: Orthodontic Versus Surgical Correction—A Systematic ReviewEiny, Shmuel DMD, MSc*; Ben-Barak, Ayelet MD†,‡; Kridin, Khalaf MD, PhD§; Aizenbud, Dror DMD, MSc*,‡Author Information *Orthodontic and Craniofacial Department, School of Graduate Dentistry, Rambam Health Care Campus †Pediatric Hemato-Oncology Department, Rambam Health Care Campus ‡Bruce and Ruth Rappaport Faculty of Medicine, Technion—Israel Institute of Technology §Department of Dermatology, Rambam Health Care Campus, Haifa, Israel The authors declare no conflict of interest. Reprints: Shmuel Einy, DMD, MSc, Orthodontic and Craniofacial Department, Rambam Health Care Campus, Haifa, P.O. Box 9602, 31096, Israel (e-mail: [email protected]). Journal of Pediatric Hematology/Oncology: April 2020 - Volume 42 - Issue 3 - p 198-203 doi: 10.1097/MPH.0000000000001651 Buy SDC Metrics Abstract Rapid blood cell turnover and bone marrow expansion caused by beta-thalassemia (βT) result in craniofacial and dentoalveolar anomalies. This report presents a systematic review of the literature over the past 50 years on orthodontic and surgical considerations in the management of βT-affected patients. Seventeen publications encompassed 24 patients, 11 male individuals and 13 female individuals, 7 to 43 years of age. Eleven patients underwent only surgical treatment, eleven combined orthodontic-surgical treatment, and 2 orthodontic treatment. Surgical treatment primarily addressed typical maxillary overgrowth by maxillary reshaping, premaxillary segmental repositioning, or complete Le Fort I impaction and set back osteotomy. In severe maxilla-mandibular discrepancy and/or increased lower facial height, a bilateral sagittal split mandibular osteotomy is the treatment of choice. Although surgery involves risks of excessive bleeding, morbidity, and impaired nasal esthetics, little attention is given to the orthodontic modality. In conclusion, the current literature recommends early interceptive orthodontics aimed to decrease dentoskeletal deformities, severe malocclusion, and soft tissue imbalance. Treatment includes maxillo-mandibular orthopedic and functional manipulation with dentoalveolar treatment, which might either prevent orthosurgical procedures later or reduce its extent. This suggested a multidisciplinary approach comprising a hematologist, a pediatrician, a pediatric dentist, and an orthodontist, which might also significantly improve the patient’s quality of life. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.