DOI QR코드

DOI QR Code

Complex dental anomalies in a belatedly diagnosed cleidocranial dysplasia patient

  • Lu, Hui (Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University) ;
  • Zeng, Binghui (Department of Medical Genetics, Zhongshan School of Medicine and Center for Genome Research, Sun Yat-Sen University) ;
  • Yu, Dongsheng (Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University) ;
  • Jing, Xiangyi (Department of Medical Genetics, Zhongshan School of Medicine and Center for Genome Research, Sun Yat-Sen University) ;
  • Hu, Bin (Department of Medical Genetics, Zhongshan School of Medicine and Center for Genome Research, Sun Yat-Sen University) ;
  • Zhao, Wei (Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University) ;
  • Wang, Yiming (Department of Medical Genetics, Zhongshan School of Medicine and Center for Genome Research, Sun Yat-Sen University)
  • Received : 2015.01.12
  • Accepted : 2015.04.07
  • Published : 2015.09.30

Abstract

Cleidocranial dysplasia (CCD) is a rare congenital disorder, typically characterized by persistently open skull sutures, aplastic or hypoplastic clavicles, and supernumerary teeth. Mutations in the gene encoding the runt-related transcription factor 2 (RUNX2) protein are responsible for approximately two thirds of CCD patients. We report a 20-year-old CCD patient presenting not only with typical skeletal changes, but also complex dental anomalies. A previously undiagnosed odontoma, 14 supernumerary teeth, a cystic lesion, and previously unreported fused primary teeth were discovered on cone-beam computed tomography (CBCT) scans. Mutation analysis identified the causal c.578G>A (p.R193Q) mutation in the RUNX2 gene. At 20 years of age, the patient had already missed the optimal period for dental intervention. This report describes the complex dental anomalies in a belatedly diagnosed CCD patient, and emphasizes the significance of CBCT assessment for the detection of dental anomalies and the importance of early treatment to achieve good outcomes.

Keywords

References

  1. Mundlos S. Cleidocranial dysplasia, clinical and molecular genetics. J Med Genet 1999; 36: 177-82.
  2. Ott CE, Leschik G, Trotier F, Brueton L, Brunner HG, Brussel W, et al. Deletions of the RUNX2 gene are present in about 10% of individuals with cleidocranial dysplasia. Hum Mutat 2010; 31: E1587-93. https://doi.org/10.1002/humu.21298
  3. Karsenty G. Update on the transcriptional control of osteoblast differentiation. Bonekey Osteovision 2007; 4: 164-70. https://doi.org/10.1138/20070262
  4. Camilleri S, McDonald F. Runx2 and dental development. Eur J Oral Sci 2006; 114: 361-73. https://doi.org/10.1111/j.1600-0722.2006.00399.x
  5. McNamara CM, O'Riordan BC, Blake M, Sandy JR. Cleidocranial dysplasia: radiological appearances on dental panoramic radiography. Dentomaxillofac Radiol 1999; 28: 89-97. https://doi.org/10.1038/sj.dmfr.4600417
  6. Suda N, Hamada T, Hattori M, Torii C, Kosaki K, Moriyama K. Diversity of supernumerary tooth formation in siblings with cleidocranial dysplasia having identical mutation in RUNX2: possible involvement of non-genetic or epigenetic regulation. Orthod Craniofac Res 2007; 10: 222-5. https://doi.org/10.1111/j.1601-6343.2007.00404.x
  7. Kolokitha OE, Ioannidou I. A 13-year-old Caucasian boy with cleidocranial dysplasia: a case report. BMC Res Notes 2013; 6: 6. https://doi.org/10.1186/1756-0500-6-6
  8. Wang XP, Fan J. Molecular genetics of supernumerary tooth formation. Genesis 2011; 49: 261-77. https://doi.org/10.1002/dvg.20715
  9. Chang JY, Wang JT, Wang YP, Liu BY, Sun A, Chiang CP. Odontoma: a clinicopathologic study of 81 cases. J Formos Med Assoc 2003; 102: 876-82.
  10. Rajab LD, Hamdan MA. Supernumerary teeth: review of the literature and a survey of 152 cases. Int J Paediatr Dent 2002; 12: 244-54. https://doi.org/10.1046/j.1365-263X.2002.00366.x
  11. Saracoglu U, Kurt B, Gunhan O, Guven O. MIB-1 expression in odontogenic epithelial rests, epithelium of healthy oral mucosa and epithelium of selected odontogenic cysts. An immunohistochemical study. Int J Oral Maxillofac Surg 2005; 34: 432-5. https://doi.org/10.1016/j.ijom.2004.09.005
  12. Adaki SR, Yashodadevi BK, Sujatha S, Santana N, Rakesh N, Adaki R. Incidence of cystic changes in impacted lower third molar. Indian J Dent Res 2013; 24: 183-7. https://doi.org/10.4103/0970-9290.116674
  13. Muthukumar RS, Arunkumar S, Sadasiva K. Bilateral fusion of mandibular second premolar and supernumerary tooth: a rare case report. J Oral Maxillofac Pathol 2012; 16: 128-30. https://doi.org/10.4103/0973-029X.92990
  14. Tsujino K, Yonezu T, Shintani S. Effects of different combinations of fused primary teeth on eruption of the permanent successors. Pediatr Dent 2013; 35: E64-7.
  15. Callea M, Bellacchio E, Di Stazio M, Fattori F, Bertini E, Yavuz I, et al. A case of cleidocranial dysplasia with peculiar dental features: pathogenetic role of the RUNX2 mutation and long term follow-up. Oral Health Dent Manag 2014; 13: 548-51.
  16. Park TK, Vargervik K, Oberoi S. Orthodontic and surgical management of cleidocranial dysplasia. Korean J Orthod 2013; 43: 248-60. https://doi.org/10.4041/kjod.2013.43.5.248

Cited by

  1. Eight Mutations of Three Genes ( EDA , EDAR , and WNT10A ) Identified in Seven Hypohidrotic Ectodermal Dysplasia Patients vol.7, pp.9, 2015, https://doi.org/10.3390/genes7090065
  2. Analysis of the Association between Mesiodens and SNP Genotyping vol.16, pp.3, 2015, https://doi.org/10.5466/ijoms.16.62
  3. Cone-beam CT in paediatric dentistry: DIMITRA project position statement vol.48, pp.3, 2015, https://doi.org/10.1007/s00247-017-4012-9
  4. Delayed Eruption of Permanent Dentition and Maxillary Contraction in Patients with Cleidocranial Dysplasia: Review and Report of a Family vol.2018, pp.None, 2018, https://doi.org/10.1155/2018/6591414
  5. Case of odontoma-related infection in a cleidocranial dysplasia vol.12, pp.7, 2015, https://doi.org/10.1136/bcr-2018-228748