Dental treatment strategies in cleidocranial dysplasia.

Based on the findings of our recent longitudinal study on the abnormalities of the dentition in cleidocranial dysplasia (CCD), a hypothesis has been proposed, which makes it possible to predict time of onset of formation of supernumerary teeth and their location in the jaws. It was found that a diagnosis should be made early so that formation of supernumerary teeth can be diagnosed and early intervention undertaken. It should be possible to diagnose supernumerary incisors at about 5-7 years of age and supernumerary canines and premolars a few years later. When root length of the normal permanent teeth has reached about one third of its final length, the overlying supernumerary teeth should be removed, together with overlying bone and primary teeth. In regions where no supernumerary teeth are formed, eruption may also be improved by removal of the primary teeth and surgical exposure of the underlying permanent teeth. Conventional orthodontic treatment and eventually autotransplantation of teeth may still be necessary in the future, but it can be anticipated that the new strategy, with much earlier intervention, will materially reduce the extent of surgical and orthodontic interventions, which have previously been of extremely long duration, tedious to the patients and often of limited success.