Orthodontic Treatment Of Impacted Teeth In Patients With Cleidocranial Dysplasia Syndrome

Craniocranial dysplasia(CCD)is an autosomal dominant genetic disease caused by the mutation of Runx2 gene.This disease is relatively rare in the clinic and is characterized by abnormal development of bone and teeth.It can be accompanied by oral abnormalities such as retention of deciduous teeth,delayed eruption of permanent teeth,multiple teeth and dentition occlusion.The treatment of CCD is complicated,often requires the participation of multiple disciplines,and the treatment process is lengthy.Most CCD patients visit the stomatology department for the first time because of the abnormal dentition.Therefore,how to accurately,efficiently,and early diagnose CCD and treat abnormal dentition of CCD patients in stomatology clinics has put forward higher requirements for the professional quality of dentists.This article reported two patients with CCD,analyzed the skeletal defect,dentition occlusion,and facial soft tissue symptoms of these two patients,and detected the gene mutation sites in the families of these two patients.The results showed that both patients had severe clinical defect phenotype.The gene mutation site in case 1 was exon7 c.1078C>T,which was a new mutation;while the gene mutation site in case 2 was exon5 c.878G>A,which was inherited from the patient’s mother.This result can provide help for the diagnosis of CCD patients in clinic and lay a foundation for genetic consultation and genetic diagnosis of CCD in the future.At the same time,with the guidance of the orthodontic treatment concept and treatment methods,combined with maxillofacial surgery,a window-assisted traction assisted surgery was performed on case 1 patient to extract 16 impacted permanent teeth.The result showed that the reasonable and standardized orthodontic traction combined with maxillofacial surgery treatment had a significant effect on the impacted teeth of CCD patients.In addition,the dentition clinical manifestations,molecular genetics mechanisms,the relationship between the Runx2 gene and the phenotype,the advantages and disadvantages of different treatment methods,and the problems that need to be paid attention to in the treatment process of CCD patients were analyzed and discussed in this article,in order to provide a certain reference for the diagnosis,treatment and related issues of CCD related cases in the future.