ORTHODONTIC TREATMENT OF A PATIENT WITH HYPOPHOSPHATEMIC VITAMIN-D-RESISTANT RICKETS

Hypophosphatemic vitamin D-resistant rickets, when developed later in life, is less severe and may not be characterized by tickets or other osseous deformities. A Japanese girl, age nine years and one month, wa s first seen in the Dental Hospital of Osaka University, complaining o f the crowding of the maxillary; teeth. At one ear of ae, the patient was admitted to Osaka University Hospital for her leg deformities. Alt hough the patient has been administered 4 mu g 1 alpha\-hydroxyvitamin D-3 and 1.0g phosphorous daily. the serum phosphate has been low and never reached normal level. This case was a Class II division 2 malocc lusion with severe anterior crowding and retarded mandibular growth. W e treated her with a functional. appliance (elastic open activator), f ollowed by the extraction of four premolars and the use of an edgewise appliance. No unfavorable root resorption or bone defect occulted. Go od occlusion was achieved and the facial features were pleasing.