다수의 매복치 및 과잉치를 동반한 쇄골두개이형성증 환자에서 골내고정원 및 악간견인을 이용한 교정치료

Abstract

Cleidocranial dysplasia (CCD) is a genetic skeletal condition with autosomal dominant inheritance. It is characterized by various skeletal and dental abnormalities, such as missing clavicles, hypoplastic maxilla, retained deciduous teeth, and supernumerary and impacted permanent teeth. In such patients forced eruption of impacted teeth tends to be challenging due to the limited osteogenesis. The present case illustrates the orthodontic and surgical management of a 15-year-old female patient with CCD accompanied by multiple supernumerary and impacted teeth using intermaxillary traction and bone-borne anchorage. After the surgical opening of the impacted teeth, a miniscrew-assisted rapid palatal expander (MARPE) was delivered in combination with a facemask for anteroposterior and transverse development of the maxilla. Following the maxillary expansion, a fixed appliance was bonded sequentially, first in the maxilla and then in the mandible for space regaining and eruption of the impacted teeth. Supernumerary teeth were removed successively during the treatment. The treatment was completed after 31 months with successful eruption and alignment of the impacted teeth, and the 3-year-follow-up showed satisfactory posttreatment stability. As shown in the present case, early diagnosis and timely orthodontic and surgical interventions are crucial to avoid further skeletal and dental complications and to facilitate aesthetic and functional rehabilitation in patients with CCD.