Cleidocranial dysplasia: comprehensive treatment of the dentofacial abnormalities

The prevalence, distribution, and radiological evaluation of dentigerous cysts in a Lebanese sample

Purpose

This study was performed to evaluate the prevalence, distribution, and radiological features (as per the Shear classification) of dentigerous cysts in a Lebanese sample.

Materials and Methods

It was an epidemiological, cross-sectional, 5-year retrospective study of 137 dentigerous cysts treated at Lebanese Army Dental Departments. The collected data comprised demographic and radiological information corresponding to patients from July 2015 to July 2020. Syndromic cases were excluded. Demographic data and the radiological features of cases were studied and analyzed.

Results

Dentigerous cysts were treated in 109 patients (58.7% males and 41.3% females; mean age: 28.3±16.3 years) out of 6,013 patients (52% males and 48% females), with a prevalence of 1.8%. Dentigerous cysts were more commonly found in patients in their second and third decades of life than in older age groups. Of the 109 patients, 22.9% had multiple dentigerous cysts. Of the 137 cysts, 71.5% were mandibular. The most prevalent anatomical location was the posterior mandible, followed by the posterior maxilla. The most commonly involved tooth was the mandibular third molar. Regarding radiological types, the central type was the most common (60.6%), followed by the lateral type (29.2%), and the circumferential type (10.2%).

Conclusion

The results of this study were similar to studies of other populations in terms of distribution and features. Multiple non-syndromic dentigerous cysts were more common than reported in other studies, which warrants further clinical studies to reveal previously undetected factors.

Prosthetic rehabilitation of a patient with cleidocranial dysplasia using dental implants-a clinical report

Adult patients with oral manifestations of untreated syndromic malformations usually exhibit a high degree of suffering. In this clinical report, we describe the implant-supported prosthetic treatment of a patient with cleidocranial dysplasia, a rare autosomal-dominant inherited malformation syndrome. Therapy for oral manifestations of cleidocranial dysplasia should be started in early childhood; however, the 26-year-old patient in the present study had not undergone orthodontic therapy in childhood. The treatment measures performed prior to this study were limited to the removal of several permanent teeth. Surgical pretreatment, placement of six implants each in the maxilla and mandible, and prosthetic restoration are described. The implantation was guided using a three-dimensional template. Long-term immediate temporary restoration and immediate loading of the implants were performed. The definitive prosthetic restoration was completed using fixed, acrylic resin-veneered screw-retained fixed dental prostheses. The clinical and radiological parameters observed in this case suggest that surgical and prosthetic procedure concepts from implantology can be adopted for patients with CCD.

Bi-maxillary dentigerous cyst in a non-syndromic child - review of literature with a case presentation

Dentigerous cysts are the most common developmental odontogenic cysts of the jaw, which usually occur in the second and third decade of life. It is most frequently associated with impacted mandibular third molar teeth and impacted canines. Bilateral/multiple dentigerous cysts are rare and typically associated with developmental syndromes. Non-syndromic dentigerous cyst occurring bilaterally or involving both arches at the same time is very rare. Here, we discuss the review of literature with a case of unusual occurrence of non-syndromic bi-maxillary dentigerous cysts in a child.

Removal of Infected Maxillary Third Molar from the Infra-temporal Fossa by Caldwell Luc Procedure - Rare Case Report with Literature Review

Dentigerous or follicular cysts of odontogenic origin are innocuous benign cysts that are often linked with the crowns of permanent teeth. A dentigerous cyst circumventing permanent teeth fails to erupt and is often displaced into ectopic positions in the upper and lower jaw in the maxillofacial region. In the maxilla or upper jaw region, the impacted teeth are often displaced and/or shift into the maxillary sinus and apart from the nasal septum, mandibular condyle, coronoid process and the palate, to harbour such ectopic eruptions of teeth. We report a rare case of an impacted left third molar of maxilla, associated with dentigerous cyst. The impacted tooth was embedded in the anterosuperior part of the infratemporal space. The cyst along with the tooth was removed using a modified Caldwell Luc incision.

Bilateral dentigerous cysts that involve all four dental quadrants: a case report and literature review

Dentigerous cysts are common odontogenic cysts that are associated with the crown of the tooth and typically develop from single lesions. Bilateral and multiple dentigerous cysts are very rare and occur in patients with syndromic conditions. This paper presents a case report of a 15-year-old male patient that experienced non-syndromic bilateral dentigerous cysts that simultaneously occurred in all four dental quadrants around the unerupted third molars. Clinicians should confirm the extent of cystic lesions using a panoramic view and computed tomography, and should keep the possibility of bilateral dentigerous cysts in mind as a potential diagnosis, even in a non-syndromic patient.

Dentigerous cyst associated with an ectopic third molar in the maxillary sinus: A case report and review of literature

Dentigerous cysts are the most common type of developmental odontogenic cysts arising from the crowns of impacted, embedded, or unerupted teeth. They constitute about 20% of all epithelium-lined cysts of the jaws. The teeth involved most often are mandibular third molar and maxillary canines. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla. Dentigerous cysts associated with ectopic teeth within the maxillary sinus are fairly rare, and only 20 cases had been reported in Medline since 1980. In the present paper, we report an additional case of dentigerous cysts associated with ectopic third molar in the right maxillary sinus. Also, pathogenesis of ectopic tooth, role of advanced imaging, differential diagnosis, and management are discussed.

Cleidocranial dysplasia: a review of the dental, historical, and practical implications with an overview of the South African experience

Cleidocranial dysplasia (CCD) is an uncommon but well-known genetic skeletal condition. Several hundred affected persons are members of a large extended family in the Cape Town Mixed Ancestry community of South Africa. The clinical manifestations are often innocuous, but hyperdontia and other developmental abnormalities of the teeth are a major feature and may require special dental management. Over the past 40 years, the authors have encountered more than 100 affected persons in Cape Town. Emphasis has been on dental management, but medical, genetic, and social problems have also been addressed. In this article, we have reviewed the manifestations of the disorder in the light of our own experience, and performed a literature search with emphasis on the various approaches to dental management and treatment options in CCD. Advances in the understanding of the biomolecular pathogenesis of CCD are outlined and the international and local history of the disorder is documented.

Multiple dentigerous cysts in a nonsyndromic minor patient: Report of an unusual case

A dentigerous cyst is an odontogenic cyst, thought to be of developmental origin. It is associated with the crown of an unerupted (or partially erupted) tooth. The cyst cavity is lined by epithelial cells derived from the reduced enamel epithelium of the tooth forming organ. Most dentigerous cysts are solitary. Multiple/bilateral cysts are usually found in association with a number of syndromes including cleidocranial dysplasia, Maroteaux-Lamy syndrome and Gorlin--Goltz syndrome (multiple OKCs). In the absence of these syndromes, the occurrence of multiple dentigerous cysts is rare. Here, we report the unusual occurrence of non-syndromic multiple dentigerous cysts.

Treatment of nonsyndromic dentigerous cysts in primary dentition

Objective

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They usually occur singly and are located in the mandible. Nonsyndromic bilateral dentigerous cysts (NSBDC) are rarely seen during childhood. The aim of this study was to determine the long-term effects of the marsupialization technique in growing children with NSBDC.

Study design

Seven patients with NSBDC (4 female, 3 male) ranging in age from 7 to 9 years (mean 8.35 years) were involved in the study. All the individuals were treated by marsupialization. Space-maintaining appliances were applied during permanent teeth eruption. Intraoral photographs, and panoramic and periapical films were taken before surgery and during healing.

Results

The NSBDC were successfully treated by the marsupialization technique and rapid healing period was observed in the growing patients, without any loss of permanent teeth. No recurrence was seen in the long-term follow-up period (3–10 years).

Conclusion

Our clinical and radiological results revealed that using the marsupialization technique in children with NSBDC provided safe healing of permanent teeth around the dentigerous cysts in a short period. However, treatment planning and regular clinical follow-ups are necessary to ensure clinical success.

Nonsyndromic Bilateral Maxillary and Unilateral Mandibular Multiple Dentigerous Cysts in a Young Girl: Report of a Rare Case

Dentigerous cyst is a benign odontogenic cyst associated with the crowns of permanent teeth. It is usually single in occurrence and located in the mandible of middle-aged persons. The teeth commonly affected are in order of frequency, the mandibular third molars, maxillary canines, maxillary third molars and, rarely central incisors. The present case report describes the surgical enucleation of the huge bilateral maxillary dentigerous cysts involving permanent maxillary canines associated with unilateral mandibular lateral incisor, cuspid and bicuspids in a young girl. To our knowledge, bilateral maxillary and unilateral mandibular multiple dentigerous cysts in a nonsyndromic patient have not been reported previously in the literature.

Dentigerous Cyst of Inflammatory Origin

A dentigerous cyst encloses a crown of an unerupted tooth by its follicle and is attached to the neck of the tooth. They may be of developmental or inflammatory origin. Dentigerous cyst of inflammatory origin occurs in immature tooth as a result of inflammation from preceding non-vital deciduous tooth or from other source spreading to involve the tooth follicle. These are diagnosed in the first and early part of second decade either on routine radiographic examination or when patient complains of swelling and pain. They generally involve mandibular premolars.

This article presents a case report of an 11-year-old male patient with a dentigerous cyst of inflammatory origin in the left mandibular premolar region with radiographic feature of a large unilocular radiolucency involving unerupted second premolar. The treatment rendered in this patient comprised of surgical enucleation of cyst under local anesthesia along with extraction of mandibular first and second primary molars.

Cranioplasty for midline metopic suture defects in adults with cleidocranial dysplasia

OBJECTIVE

Patients with cleidocranial dysplasia often express concerns related to their perception of an undesirable esthetic appearance of their forehead and skull because of a combination of the persistence of metopic suture defects and frontal bossing. This case series reviews the use of a cranioplasty technique that has been developed to address such concerns.

STUDY DESIGN

A series of 7 adult patients with cleidocranial dysplasia were treated using a cranioplasty technique to correct visible metopic suture defects in the forehead region. The patients were 4 males and 3 females with a mean age of 29.0 years. All 7 patients underwent identical cranioplasty procedures.

RESULTS

The metopic suture cranial defects were found to range in size from 0.6 to 2.4 cm in diameter and were present as full-thickness osseous defects in 4 of the 7 patients. All postoperative complications resolved spontaneously. Inpatient admission times ranged from 1 to 3 days. Follow-up ranged from 9 to 48 months with satisfactory subjective esthetic outcomes. The patients were content in all cases.

CONCLUSION

This cranioplasty procedure successfully addresses the specific esthetic concerns of a rare and unique group of individuals. The procedure can be offered to cleidocranial dysplasia patients as part of their overall comprehensive craniomaxillofacial management.

Bilateral maxillary dentigerous cysts: a case report

Dentigerous cysts are benign odontogenic cysts that are associated with the crowns of permanent teeth. They are usually single in occurrence and located in the mandible. Multiple cysts are reported in patients with conditions such as mucopolysaccharidosis and basal cell nevus syndrome. We present the radiologic findings of bilateral impacted maxillary cuspids with dentigerous cysts displacing the maxillary sinuses in a nonsyndromic patient, a condition that, to our knowledge, has not been previously reported.

Normal formation and development defects of the human dentition

Oral health and systemic health are intimately related, and a thorough evaluation of the oral health of children is critical in providing appropriate health care. By understanding the normal sequence and patterns of tooth development, clinicians can readily identify children who deviate from normal dental development and provide appropriate interventions or make appropriate referrals. Developmental defects of the human dentition are not uncommon and can severely adversely affect the physical and psychological health of children. Despite the severity of some developmental defects of the dentition, the ability to diagnose and manage these conditions, in most cases, allows children the benefit of optimal oral health.

Cleidocranial dysplasia. Case report

A 29-year-old Caucasian woman who presented with short stature and multiple unerupted supernumerary teeth is described. Radiological investigations of her cranial and skeletal abnormalities revealed cleidocranial dysplasia. Because of the advanced age of the patient and contraindication for orthodontic treatment, only surgical and prosthetic treatment were performed. The characteristics and treatments of this rare autosomal dominant disorder are discussed.

Surgical management of a patient with cleidocranial dysplasia: a case report

Cleidocranial dysplasia is associated with the formation of many supernumerary teeth which usually fail to erupt. In later life, cysts may form around the embedded teeth. The following report describes the management of such a case with a method which promotes satisfactory prosthodontic rehabilitation.