Orthodontic traction of impacted upper incisors by means of rigid fixed appliance in the patient with cleidocranial dysplasia CCD
Journal Title: Forum Ortodontyczne - Year 2017, Vol 13, Issue 1
Abstract
Cleidocranial dysplasia is a rare disturbance inherited in an autosomal dominant manner with changeable expression or it is the effect of a de novo mutation. The symptoms are related to mutation of RUNX2 (CBFA1) gene, which has an indirect influence on connective tissue and endochondral ossification. Features characteristic for this syndrome comprise hypoplasia or aplasia of the clavicle, cranium anomalies and the presence of over-retained deciduous teeth, supernumerary teeth, as well as disturbances in the eruption of permanent teeth. Aim. The aim of this paper is to present the case of a patient with cleidocranial dysplasia syndrome, in whose treatment a fixed thick archwire appliance with traction elastics was used for the purpose of guiding maxillary medial incisors into eruption after their prior surgical exposure. Case description. The paper describes a 15-year-old female patient whose intraoral examination revealed four maxillary and mandibular permanent first molars and one mandibular permanent medial incisor; in the upper dental arch all the other deciduous teeth were revealed and in the lower arch deciduous teeth were revealed in the lateral sectors only. In a CBCT examination, the presence of six supernumerary teeth in the mandible and of five supernumerary teeth in the maxilla was detected. Due to the importance of the esthetic aspect during the puberty period, treatment was initiated by surgical exposure and bringing the upper incisors into the dental arch. Results and conclusions. After extraction of the over-retained deciduous and supernumerary teeth in the anterior sector of the upper arch, medial incisors were brought into the dental arch with the use of a thick archwire appliance placed on the two permanent molars, deciduous canines and deciduous molars and the anterior part of the palate. The presented above appliance construction seems to be a good solution in the first phase of guiding retained teeth into eruption until bringing a larger number of teeth into the dental arch. A correct management of cleidocranial dysplasia cases is characterized by an active long-term treatment requiring a joint collaboration of a radiologist, surgeon and orthodontist. (Turska-Malińska R, Kulczyk T, Kuras M, Tuczyńska A. Orthodontic traction of impacted upper incisors by means of rigid fixed appliance in the patient with cleidocranial dysplasia CCD. Orthod Forum 2017; 13: 43-9).
Authors and Affiliations
Renata Turska-Malińska1, Tomasz Kulczyk, Marek Kuras, Agata Turczyńska
Keywords
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