Long-term Observation of Orthodontic Management and Facial Growth on a Patient with Familial Cleidocranial 226 Dysplasia

Long-term Observation of Orthodontic Management and Facial Growth on a Patient with Familial Cleidocranial 226 Dysplasia

The orthodontic management of patients with cleidocranial dysplasia (CCD) is challenging, which takes a long treatment duration and observation to follow the progress. The completion of treatment is usually not finished until growth completion. This case describes the long-term stage treatment of a 22-year-old female presented with familial CCD. The first stage orthodontic treatment was separated into two phases including surgical exposure of the anterior and posterior teeth, respectively. Extraction of the delayed exfoliated deciduous incisors and supernumerary teeth to clear the eruption path of the submerged permanent anterior teeth was started at her age of 8. The impacted anterior teeth were then uncovered, followed by orthodontic force eruption and alignment of the dentition. The second phase of treatment included follow up of the posterior teeth eruption. The main treatment objective of this stage was to establish a functional occlusion by guiding the tooth development. With persistently monitoring her skeletal growth by serial cephalometric radiographs, open cranial fontanels, skeletal Class III tendency with underdeveloped maxilla, upward and forward rotated mandible were displayed. After growth completed, the present treatment was conducted by surgical-orthodontics to correct her skeletal discrepancy and improve her dental occlusion. Her lip posture and facial profile were balanced after mandibular setback.