Case: An 8 years old boy, was brought to the clinic by his mother for a dental check-up. During the evaluation, the mother indicated that at birth he had a heart murmur and at the age of 3 months, he was operated on for an inguinal hernia. Later, at 5 years of age, he was treated for nasal septum deviation. She also indicated that her son had 2 fused cervical vertebrae discovered by his pediatrician; this was later confirmed by a cervical radiograph.
The boy was alert, cooperative and cheerful. Physical examination: A short neck, low-set posterior hairline, partly limited neck motion, deafness in the right ear, small lower facial third and facial asymmetry (image 1a and b). It also revealed the presence of digital sucking habits. Intraoral examination showed multiple dental carious lesions and severe anterior crowding (Image 2a and b), vertical open bite, deep palate, mouth breathing…
