“The patient was 21 years old, with healthy parents, no family history, no genetic history, at the age of 4 years old, the teeth were on the edge, the lower jaw was well developed, and the parents thought it was handsome and beautiful. at the age of 8 years old, the teeth were replaced, and the patient felt that the teeth were not properly replaced. At the age of 13, he went to the doctor, apparently the front teeth were reversed, and the doctor said it was too serious, wait for adult surgery, and the patient became what he is now. It was so severe (see picture) that perhaps surgery was the only way to go. Carefully studying the information provided by the patient from the age of 4 to the present, the following questions need to be clarified: 1. Whether the diastema is dental or bony, in fact, the early stage is basically mixed, with a component of labial tilt of the mandibular teeth, palatal tilt of the maxillary teeth, and also a component of mandibular anterior extension function, with little early bone malalignment. If early intervention is appropriate, improvement may be possible. “The meaning of intervention is to make the development between the two converge, and then stop, not to over-intervene. After a few years, you can intervene again if there is inconsistency again. Do not expect a complete cure with one correction (although half of the patients can be cured in one go), but go to the doctor for a checkup in about six months and decide whether to continue the intervention. Dental and functional factors may also eventually develop into a bony “geodesic”, not only genetic factors can cause a bony deformity. Even in the case of bony geodesis caused by genetics, early treatment may be able to modify the genetically determined bone dysplasia, thus avoiding surgery. Genetic testing is no longer a problem, and a small amount of blood can solve the problem. 2. Diagnosis of “geodysostosis” The patient’s family members are interviewed and the parents and grandparents are interviewed and observed to facilitate the detection of heredity. Bad habits and impaired tooth replacement are possible causes. Patients may have a normal facial profile during the milking period, but the mixed dentition usually shows a tendency to have a concave facial profile with anterior teeth that are anticlinal or contralateral. This is the basis for clinical establishment of the diastema, and observation of the lower jaw for recession can provide the basis for diagnostic typing. Plaster model. It is useful to further study the relationship between the teeth and provide evidence for the diagnosis. Photographic examination, which can be measured to determine if there is coordination and provide a basis for the design of diagnostic targets Line film taking, the most important diagnostic basis, if recession is possible, a lateral film of the receding position must be taken Blood tests, which can provide the necessary support for genetic diagnosis After the diagnosis is clear, treatment is not a problem, there are usually two possibilities, orthodontic and surgical, because of the presence of growth and development, the doctor’s experience and level is more important than the material.