Orthognathic Surgery in Patients With Cleidocranial Dysplasia

Abstract

The aim of this study was to report the orthodontic-surgical approach of a 21-year-old female patient diagnosed with cleidocranial dysplasia. An orthognathic surgery was performed in the maxilla and mandible during the same procedure to correct an existing dentofacial deformity (class III malocclusion). In addition, malar prostheses were used to correct midface deficiency. After surgical intervention, orthodontic treatment continued in order to promote stability, function, and aesthetics. Cases of cleidocranial dysplasia treated with the defined criteria can bring aesthetic and functional benefits to the patient.

Surgical Management and Evaluation of the Craniofacial Growth and Morphology in Cleidocranial Dysplasia

“…Early treatment of CCD has been shown to be effective at minimizing unfavorable mandibular growth 16,20 , however, in severe cases orthognathic surgery may be required. 17–19 On the other hand, our patient’s straight profile did not indicate that orthognathic surgery was necessary.…”

Craniofacial features of cleidocranial dysplasia

“…Calvarial defects in the open anterior fontanelle, sagittal suture, and metopic suture have been successfully corrected by cranioplasty using bone cement 34 . Midface deficiency can be corrected by orthognathic surgery after growth is complete 35, 36. In patients who meet the defined criteria, the above treatments can obtain substantial esthetic and functional benefits.…”

Orthodontic treatment of patients with cleidocranial dysplasia Systematic review of the literature

“…W 10% przypadków obserwuje się aplazję jednego lub obu obojczyków. Powoduje to hipermobilność obręczy barkowej i możliwość zetknięcia ramion przed klatką piersiową (11). Wśród pacjentów z CCD bardzo często można również zaobserwować niski wzrost, wąską klatkę piersiową, wyraźnie opadające ramiona i długą, zniekształconą szyję na skutek dysplazji mięśni przyczepiających się do obojczyka.…”

“…In 10% of cases an aplasia of one or both clavicles is observed. This causes a hypermobility of the shoulder girdle and the possibility to cross the arms in front of the chest (11). Among CCD patients, very often low growth, narrow chest, clearly drooping shoulders and a long, distorted neck due to muscle dysplasia attaching the clavicle is registered.…”

“…This treatment was preceded by standard orthodontic decompensation treatment. In this case, it was not necessary to apply a specific treatment protocol, because the patient came in at the age of 21 and all permanent teeth were erupted (11).…”