Detection and diagnosis of cleidocranial dysplasia by panoramic radiography

Abstract BackgroundThe purpose of this study was to illustrate and quantify the maxillofacial bone abnormalities detected on panoramic radiographs from a group of Chinese patients with cleidocranial dysplasia (CCD) and to provide a series of diagnostic references for dentists to indicate the presence of disease and help in making an early and accurate diagnosis.Materials and methodsThe dental panoramic radiographs of thirty CCD patients aged 11 to 45 years (18 males and 12 females) were examined retrospectively. The dentition states, including supernumerary teeth and impacted teeth, were recorded. Twelve quantified measurements were adopted to determine the abnormalities of maxillofacial bones, including the degree of the zygomatic arch downward bend, bicondylar breadth, ramal height, mandibular height, mandibular aspect ratio, mandibular body height, condylar height, coronoid height, distance between the coronoid process and the condyle, bigonial width, gonial angle and best-fit gonial circle diameter. The Wilcoxon rank-sum test was used to compare the findings of the CCD patients with those of their matched controls (n=300).ResultsSupernumerary teeth were detected in 27 patients (90.0%), and all 30 patients presented impacted teeth. Compared to the matched controls, the CCD patients had a significantly larger degree of zygomatic arch downward bend (ZAD), a larger diameter of the best-fit gonial circle (BGC), and a shorter distance between the coronoid process and the condyle (DCC) in panoramic radiographs (P<0.001). According to the reference interval established from the 5th or 95th percentile of the measurements in the control group, ZAD less than 6.90 mm, DDC greater than 22.37 mm and BGC greater than 52.41 mm were significantly associated with the CCD features identified. Other panoramic measurements were not significantly different between the two groups.ConclusionsIn this study, we identified some featured radiographic parameters of maxillofacial bones in CCD patients. These features can be recognized in commonly used dental radiographs and therefore may provide valuable information for the early diagnosis and treatment of CCD.