Use of cone-beam CT in a patient with cleidocranial dysplasia dramatically reduced the operation time

摘要

Cleidocranial dysplasia (CCD) is a rare congenital disorder with prolonged retention of the primary teeth, unerupted permanent teeth, and supernumerary teeth. We report a 19-year-old well-developed and well-nourished Thai woman who presented with intermittent dull pain in the lower left jaw for about a week. CCD was diagnosed based on a panoramic radiograph that revealed 32 unerupted teeth affecting all four quadrants of her jaw. Chest and skull radiographs were added to evaluate the clavicles and skull bone formation to confirm the diagnosis of CCD. Family members, including parents and siblings, were radiographically investigated and showed no abnormality. After a 6-h first operation in the lower left jaw to remove five supernumerary teeth, a deciduous canine, and a permanent third molar, three-dimensional imaging by cone-beam computed tomography was conducted as an aid for planning further dental surgery and orthodontic treatment. A second operation was conducted to remove the other unerupted teeth in the four quadrants in 6 h, the same as the initial operation time, although the second involved the whole jaw, as compared with the first operation in only one quadrant.