Angle Orthod. 2018 Jul;88(4):416-424. doi: 10.2319/092617-647.1. Epub 2018 Apr 17.
To investigate the characteristics of the dental phenotype in patients with cleidocranial dysplasia (CCD) using longitudinal data.
Twelve unrelated Korean CCD patients were observed using a longitudinal series of radiographs and clinical photographs. Statistical analysis was performed on the dental phenotypic data.
Although dysplasia of the clavicles, open fontanelle, and wormian bone were observed in all 12 patients, delayed fusion of the mandibular symphysis was found in four patients. One patient did not have a supernumerary tooth (ST). However, 62 STs were found in 11 patients (mean, 5.6 per patient; range of ST emergence, 5 years 6 months-14 years 8 months; developing position, occlusal to the permanent incisors, canines, and premolars and distal and apical to the permanent molars). The mandibular premolar region was the most frequent area of ST development (50.0%, P < .001). All 12 patients showed impacted permanent teeth (IPT), including one patient without ST (mean, 17.8 per patient). Impaction occurred most frequently in the mandibular premolar region and least frequently in the maxillary molar region (93.8% vs 39.6%, P < .01). The ratio of spontaneous eruption of IPT after removal of retained deciduous teeth and/or ST was highest for the maxillary and mandibular incisors (all 54.6%) and lowest for the mandibular canines and premolars (26.7% and 28.9%, respectively); however, the difference was not significant.
The emergence time and development position of ST and the root development of IPT should be considered to determine the timing for the removal of ST and forced eruption of IPT.
通过纵向研究探讨颅锁骨发育不全(CCD)患者的牙齿表型特征。
观察 12 例非相关的韩国 CCD 患者,使用一系列纵向的影像学和临床照片。对牙齿表型数据进行统计学分析。
12 例患者均存在锁骨、囟门和颅骨缝骨发育不全,但下颌联合骨融合延迟仅见于 4 例。1 例患者无额外牙(ST)。然而,11 例患者发现 62 颗 ST(平均每例 5.6 颗;ST 萌出时间范围为 5 岁 6 个月至 14 岁 8 个月;萌出位置为恒牙切牙、尖牙和前磨牙的近中及远中,磨牙的远中及根尖)。下颌前磨牙区是 ST 最常发生的区域(50.0%,P<.001)。所有 12 例患者均存在恒牙阻生(IPT),其中 1 例无 ST(平均每例 17.8 颗)。阻生牙最常发生于下颌前磨牙区,最少见于上颌磨牙区(93.8% vs 39.6%,P<.01)。保留乳牙和/或 ST 后 IPT 自然萌出的比例以上颌和下颌切牙最高(均为 54.6%),下颌尖牙和前磨牙最低(分别为 26.7%和 28.9%);但差异无统计学意义。
ST 的萌出时间和萌出位置以及 IPT 的牙根发育情况应予以考虑,以确定 ST 去除和 IPT 强制萌出的时机。