Shinh Manhar
Department of Dentistry, Adesh Institute of Dental Sciences and Research, Bathinda, IND.
Cureus. 2025 Jul 30;17(7):e89098. doi: 10.7759/cureus.89098. eCollection 2025 Jul.
This report describes an unusual case of a 27-year-old male presenting with cleidocranial dysplasia (CCD), a rare genetic disorder affecting bone and dental development. The patient exhibited classic features, including short stature, drooping shoulders with hypermobility, broad forehead, maxillary deficiency, and mandibular prognathism. Intraoral examination revealed multiple missing teeth, retained deciduous teeth, and gingival swelling in the maxillary anterior region. Radiographic evaluation, including orthopantomogram and cone beam CT (CBCT), revealed 45 impacted permanent and supernumerary teeth, a rare finding, along with multiple dentigerous cysts, notably a large cyst in the right maxilla causing cortical plate breaches and nasal cavity displacement. Additional skeletal abnormalities included hypoplastic clavicles, open cranial sutures, and underdeveloped sinuses. Genetic testing confirmed a Runt-related transcription factor 2 ( gene) mutation, thus confirming the diagnosis. The extensive number of impacted teeth and cystic lesions sets this case apart from the typical presentations, which usually involve fewer supernumerary teeth and rare cystic changes. The complexity of dental and skeletal anomalies necessitates a multidisciplinary approach involving oral surgery, orthodontics, and prosthodontics to restore function and aesthetics. Early diagnosis through clinical, radiographic, and genetic assessments is crucial to prevent complications, such as cyst expansion or bone resorption. This case emphasizes the importance of comprehensive evaluation and tailored treatment planning in managing the severe manifestations of CCD, highlighting its diverse clinical spectrum and the need for individualized care.
本报告描述了一例不同寻常的病例,一名27岁男性患有锁骨颅骨发育不全(CCD),这是一种影响骨骼和牙齿发育的罕见遗传疾病。该患者表现出典型特征,包括身材矮小、肩部下垂且活动过度、额头宽阔、上颌骨发育不全以及下颌前突。口腔内检查发现多颗牙齿缺失、乳牙滞留以及上颌前部牙龈肿胀。影像学评估,包括全景曲面断层片和锥形束CT(CBCT),显示有45颗埋伏恒牙和多生牙,这一罕见发现还伴有多个含牙囊肿,尤其是右上颌的一个大囊肿导致皮质骨板破裂和鼻腔移位。其他骨骼异常包括锁骨发育不全、颅骨缝未闭合以及鼻窦发育不全。基因检测证实存在一种与Runt相关的转录因子2(基因)突变,从而确诊。大量的埋伏牙和囊性病变使该病例有别于典型表现,典型表现通常涉及较少的多生牙和罕见的囊性改变。牙齿和骨骼异常的复杂性需要口腔外科、正畸科和修复科等多学科方法来恢复功能和美观。通过临床、影像学和基因评估进行早期诊断对于预防并发症(如囊肿扩大或骨质吸收)至关重要。该病例强调了在管理CCD严重表现时进行全面评估和制定个性化治疗计划的重要性,突出了其多样的临床谱以及个性化护理的必要性。