Management of Mandibular Anterior Demineralisation Associated with Myofunctional Appliance: A Case Report

Myofunctional appliances encompass a diverse range of intraoral devices that rely on the intrinsic forces of the orofacial musculature for their functionality. These appliances are typically designed to be removable and exhibit a passive mechanism of action. Caries and demineralisation are well known adverse side effects of myofunctional orthodontic appliances, with the most frequent reports relating to fixed appliance treatment. Hereby, the authors present a case report of a 12-year-old male patient with a slight neuromotor defect who developed significant caries and demineralisation of the permanent mandibular anteriors due to the consumption of large quantities of carbonated drinks and acidic fruits while wearing a twin block appliance for eight months and failing to return for regular orthodontic follow-ups. The patient was provided with strategies for oral health training and diet modification. Fluoride varnish was applied to treat the caries and pain caused by hypersensitivity. Additionally, at-home application of GC Tooth Mousse Plus, which is rich in Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CCP-ACPF), was utilised for remineralisation and dentinal tubule occlusion. The mandibular anteriors were restored with composite resin using an ultra-conservative 3D guided technique, alongside preventive care during the fluoride varnish application. The present case report emphasises the risk of decalcification of teeth during orthodontic treatment and the importance of regular dental check-ups.