American Journal of Medical Case Reports, 2017, Vol. 5, No. 11, 270-273
Available online at http://pubs.sciepub.com/ajmcr/5/11/1
©Science and Education Publishing
DOI:10.12691/ajmcr-5-11-1
A 9-year-old Saudi Boy with Cleidocranial Dysplasia:
A Case Report
Rabab Ali Jassim AL Buainain
1
, Yasin Alavi Aruveetil
2
, Faisal Alsineedi
2
, Abdullah Faraj Alshammari
3
,
Hussain Gadelkarim Ahmed
4,*
1
Saudi Pediatric Dentistry Program, Dammam Medical Complex, Dammam, Kingdom of Saudi Arabia (KSA)
2
Department of dentistry, King Fahd Military Medical Complex, Dhahran, KSA
3
Department of Dentistry, University of Hail, KSA
4
College of Medicine, University of Hail, KSA
*Corresponding author: hussaingad1972@yahoo.com
Abstract Cleidocranial dysplasia (CCD) is an uncommon disorder associated with a genetic disorder mainly
causing dysplasia of bones and teeth with autosomal dominant inheritance pattern, which has an extremely varied
presentation. The dental indicators are principally delayed exfoliation of primary teeth and delayed eruption of
permanent teeth, and numerous impacted supernumeraries. This article represent a 9 years old Saudi boy case of
CCD and illustrates the clinical and radiological features of this patients. In this case the early diagnosis of the
condition was not associated with proper orientation of the dental treatment to offer better quality of life to patient.
Keywords: Cleidocranial dysplasia, dental treatment, Saudi
Cite This Article: Rabab Ali Jassim AL Buainain, Yasin Alavi Aruveetil, Faisal Alsineedi, Abdullah Faraj
Alshammari, and Hussain Gadelkarim Ahmed, “A 9-year-old Saudi Boy with Cleidocranial Dysplasia: A Case
Report.” American Journal of Medical Case Reports, vol. 5, no. 11 (2017): 270-273. doi: 10.12691/ajmcr-5-11-1.
1. Introduction
Cleidocranial dysplasia (CCD) is an uncommon but
well-known genetic skeletal condition, characterized by
dental anomalies and bone abnormalities [1]. The disease
is triggered by mutation in the gene RUNX2 (CBAF1),
located on the short arm of chromosome 6 [2,3]. The causing
gene, RUNX2 codes for a core-binding transcription factor
protein (CBFA1), which is intricate in the differentiation
of osteoblasts and bone construction [4-6]. RUNX2 has an
essential role in the epithelial-mesenchymal communications
that control progressive tooth morphogenesis and histo-
differentiation of the epithelial enamel organ.
Individuals affected with CCD have a distinctive facial
look with a bulky forehead, hypertelorism, and midfacial
hypoplasia [4]. Overall health is commonly good and the
intellect is unaffected. The adversative overall health effects
of CCD are generally not very severe or debilitating and
there is no accompanying deficiency in cognitive or
intellectual functioning in such patients [7].
CDD is a skeletal dysplasia described by delayed
closure of the cranial sutures, hypoplastic or aplastic
clavicles, and multiple dental abnormalities. Manifestations
may differ among persons in the same family. The most
noticeable clinical results are abnormally large, wide-open
fontanels at birth that may stay open throughout life;
mid-face retrusion; abnormal dentition, comprising delayed
eruption of secondary dentition, failure to shed the
primary teeth, supernumerary teeth with dental crowding,
and malocclusion; clavicular hypoplasia bring about thin,
leaning shoulders that can be opposed at the midline; and
hand defects such as brachydactyly, tapering fingers, and
short, broad thumbs. Persons with CCD are shorter than
their natural sibs and are more to be expected to have
other skeletal/orthopedic problems such as pes planus,
genu valgum, and scoliosis. Other medical problems
comprise repeated sinus infections and other upper-airway
problems, repeated ear infections, high incidence of
cesarean section, and mild degree of motor delay in
children under age of five years [8].
Diagnosis of CCD is rely on clinical and radiographic
results that contain imaging of the cranium, thorax, pelvis,
and hands. RUNX2 (CBFA1) is the only gene in which
mutation is identified to be associated with CCD.
Molecular genetic testing of RUNX2 detects pathogenic
variants in 60%-70% of patients with a clinical diagnosis
of CCD.
This article reports the case of a 9 year old child
diagnosed with CCD after birth. The aim is to provide the
health team with update measures toward dental
management of patient with CCD diagnosis and dental
treatment.
2. Case Presentation
2.1. Chief Complaint and Medical History
A 9 years old Saudi male attends Pediatric Dental
Clinics in Dammam Medical Complex with his mother.
The main concerns were about delay in the eruption of
permanent teeth and multiple carious teeth. The patient