쇄골두개 이형성증 환아의 구강내 증상과 치료 전략

ORAL MENIFESTATION AND TREATMENT STRATEGIES IN CLEIDOCRANIAL DYSPLASIA

  • 박희숙 (경북대학교 치과대학 소아치과학교실) ;
  • 김영진 (경북대학교 치과대학 소아치과학교실) ;
  • 김현정 (경북대학교 치과대학 소아치과학교실) ;
  • 남순현 (경북대학교 치과대학 소아치과학교실)
  • Park, Hee-Suk (Pediatric dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Young-Jin (Pediatric dentistry, School of Dentistry, Kyungpook National University) ;
  • Kim, Hyun-Jung (Pediatric dentistry, School of Dentistry, Kyungpook National University) ;
  • Nam, Soon-Hyeun (Pediatric dentistry, School of Dentistry, Kyungpook National University)
  • 발행 : 2009.08.31

초록

쇄골두개 이형성증(Cleidocranial Dysplasia)은 안면, 두개골, 쇄골의 비정상적인 성장을 보이는 증후군으로 상염색체 우성으로 유전되거나 유전적 요인 없이 돌연변이에 의해 야기된다. 쇄골두개 이형성증의 일반적 소견은 두개 봉합과 천문의 지연 폐쇄, 편측이나 양측성으로 쇄골의 형성 장애, 상대적으로 커진 이마에 의해 상악골이 함몰된 것처럼 보이는 안면 형태가 특징적이다. 구강내 소견으로는 유치의 만기 잔존, 그로 인한 영구치의 맹출 지연을 보이며 방사선 사진 상에서 매복된 다수의 과잉치가 존재한다. 쇄골두개 이형성증은 정신적 및 신체적으로 특별한 이상을 나타내지 않아 진단이 늦어지는 경우가 많아 영구치의 미맹출로 인하여 저작 및 심리적인 문제가 초래되는 경우가 많다. 따라서 조기 진단을 통해 적절한 시기에 유치 발치 및 과잉치 제거 후 교정적 처치로 영구치의 맹출을 유도하여 저작 기능의 회복뿐 아니라 환자의 안모도 개선시켜야 한다. 본 증례는 영구치 맹출 장애와 전치부 반대교합을 주소로 내원하여 쇄골두개 이형성증으로 진단받은 환아들의 구강내 증상과 치아 맹출 유도법을 통하여 치아를 맹출시킬 수 있었기에 보고하는 바이다.

Cleidocranial dysplasia(CCD) is a congenital disorder of skeletal and dental abnormality, which is a mesodermal dysfunction influencing many tisssues and organs. Skeletal abnormalities in CCD are delayed closure of cranial suture and fontanelle, presence of wormian bone and clavicle aplasia. CCD also has an effect on long bones, phalanges, spine, pelvis, muscles, and central nervous system. Dental manifestations include retention of deciduous teeth, multiple supernumerary teeth, delayed eruption or impaction of permanent teeth and formation of cysts around nonerupted teeth. However, due to lack of any substansive medical or physical disability, diagnosis is often late, thereby causing masticatory and psychological problems caused by delayed eruption of permanent teeth after exfoliation of deciduous teeth. For this reason, CCD requires early diagnosis, and the patient's appearance must be improved. Also, provision for a functional masticatiory mechanism by treatment of surgical removal of supernumerary teeth followed by orthodontic eruption of the natural permanent teeth at an adequate time is necessary.

키워드

참고문헌

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