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Shi Y, Ye Z, Liu Y, Wang H, You M. Detection and diagnosis of cleidocranial dysplasia by panoramic radiography: a retrospective study. BMC Oral Health 2022; 22:558. [PMID: 36456973 PMCID: PMC9714060 DOI: 10.1186/s12903-022-02610-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cleidocranial dysplasia (CCD) is a rare and underdiagnosed congenital disorder in dentistry. The purpose of this study was to illustrate and quantify the maxillofacial bone abnormalities detected on panoramic radiographs from a relatively large retrospective case series and to provide a series of diagnostic references for dentists to indicate the presence of disease and help in making an early and accurate diagnosis. METHODS The dental panoramic radiographs of thirty CCD patients aged 11 to 45 years (18 males and 12 females) were examined retrospectively. The dentition states, including supernumerary teeth and impacted teeth, were recorded. Twelve quantified measurements were adopted to determine the abnormalities of maxillofacial bones, including the degree of the zygomatic arch downward bend, bicondylar breadth, ramal height, mandibular height, mandibular aspect ratio, mandibular body height, condylar height, coronoid height, distance between the coronoid process and the condyle, bigonial width, gonial angle and best-fit gonial circle diameter. The Wilcoxon rank-sum test was used to compare the findings of the CCD patients with those of their matched controls (n = 300). RESULTS Supernumerary teeth were detected in 27 patients (90.0%), and all 30 patients presented impacted teeth. Compared to the matched controls, the CCD patients had a significantly larger degree of zygomatic arch downward bend (ZAD), a larger diameter of the best-fit gonial circle (BGC), and a shorter distance between the coronoid process and the condyle (DCC) in panoramic radiographs (P < 0.001). According to the reference cutoff values established from the 5th or 95th percentile of the measurements in the control group, ZAD higher than 6.90 mm, DDC less than 22.37 mm and BGC higher than 52.41 mm were significantly associated with the CCD features identified. Other panoramic measurements were not significantly different between the two groups. CONCLUSIONS Panoramic radiographs had great value in the diagnosis of CCD. In this study, we identified some dental and maxillofacial features on panoramic radiographs from a relatively large retrospective case series of CCD. A series of reliable quantitative indicators were provided for dentists that can indicate the presence of disease and improve the diagnostic specificity.
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Affiliation(s)
- Yuchao Shi
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu, 610041 Sichuan China
| | - Zelin Ye
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu, 610041 Sichuan China
| | - Yuanyuan Liu
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu, 610041 Sichuan China
| | - Hu Wang
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu, 610041 Sichuan China
| | - Meng You
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min South Road, Chengdu, 610041 Sichuan China
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Inchingolo AD, Patano A, Coloccia G, Ceci S, Inchingolo AM, Marinelli G, Malcangi G, Montenegro V, Laudadio C, Palmieri G, Bordea IR, Ponzi E, Orsini P, Ficarella R, Scarano A, Lorusso F, Dipalma G, Corsalini M, Gentile M, Venere DD, Inchingolo F. Genetic Pattern, Orthodontic and Surgical Management of Multiple Supplementary Impacted Teeth in a Rare, Cleidocranial Dysplasia Patient: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57121350. [PMID: 34946295 PMCID: PMC8709258 DOI: 10.3390/medicina57121350] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/30/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022]
Abstract
Background: Cleidocranial dysplasia (CCD) is a rare, autosomal dominant skeletal dysplasia with a prevalence of one per million births. The main causes of CCD are mutations in the core-binding factor alpha-1 (CBFA1) or runt-related transcription factor-2 (RUNX2), located at the 6p21 chromosomal region. RUNX2 plays important roles in osteoblast differentiation, chondrocyte proliferation and differentiation, and tooth formation. The disease is characterized by clavicular aplasia or hypoplasia, Wormian bones, delayed closure of cranial suture, brachycephalic head, maxillary deficiency, retention of primary teeth, inclusion of permanent teeth, and multiple supernumerary teeth. Materials and Methods: A 22-year-old girl suffering from cleidocranial dysplasia with short stature, narrow shoulders, craniofacial manifestations (short face, broad forehead, etc.) and dental anomalies (different lower dental elements under eruption, supernumerary and impacted multiple teeth, etc.) was examined at our service (Complex Operative Unit of Odontostomatology of Policlinico of Bari). RX Orthopantomography (OPG) and cone beam computed tomography (CBCT) were requested to better assess the position of the supernumerary teeth and their relationships with others and to evaluate the bone tissue. Results: Under eruption was probably caused by dental interferences with supernumerary teeth; hence, extractions of supernumerary upper canines and lower premolars were performed under general anaesthesia. Surgery outcome was excellent with good tissue healing and improvements in the therapeutic possibilities with future orthodontics. Conclusions: The objective of this article is to give an update about radiological, clinical, and molecular features of CCD and to alert the health team about the importance of establishing an early diagnosis and an appropriate treatment in these patients to prevent impacted teeth complications and to offer them a better quality of life.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Giovanni Coloccia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Valentina Montenegro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Claudia Laudadio
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: or (I.R.B.); or (F.L.); (F.I.); Tel.: +40-744919319 (I.R.B.); +39-3282132586 (F.L.); +39-3312111104 (F.I.)
| | - Emanuela Ponzi
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Paola Orsini
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Romina Ficarella
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: or (I.R.B.); or (F.L.); (F.I.); Tel.: +40-744919319 (I.R.B.); +39-3282132586 (F.L.); +39-3312111104 (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Mattia Gentile
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, 70121 Bari, Italy; (E.P.); (P.O.); (R.F.); (M.G.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (V.M.); (C.L.); (G.P.); (G.D.); (M.C.); (D.D.V.)
- Correspondence: or (I.R.B.); or (F.L.); (F.I.); Tel.: +40-744919319 (I.R.B.); +39-3282132586 (F.L.); +39-3312111104 (F.I.)
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