In the context of a case presentation of a 16-year-old girl treated for retrognathia associated with Freeman-Burian syndrome (FBS), importance of early orthodontic evaluation and unique problems posed by FBS are discussed. Freeman-Burian syndrome universally presents limited oral access and risk of pulmonary complications, making immaculate oral health-care arduous but mandatory. With early identification and conscientious planning, satisfactory orthodontic and overall health outcomes can be achieved. Sella turcica bridging, when presenting in FBS in the absence of endocrine pathology, may be related to the underlying myopathy of FBS.
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