[4,5,7] Cleidocranial dysplasia is characterized by abnormalities of skull, teeth, jaws, and shoulder girdle. None of the features of skull and shoulder girdle like open selleck chemical Navitoclax fontanels, Wormian bones in skull, partial to total agenesis of clavicle were reported in skull and chest X-ray of this patient. Multiple osteomas of skull and jaw bones along with multiple epidermoid sebaceous cysts of skin, desmoids tumors, the major characteristics of Gardner’s syndrome were also not associated with this case.[8] None of the clinical features were suggestive for rest of the syndromes, and thus were excluded. Among hormonal disturbances, both hypothyroidism and hypopituitarism are characterized by delayed eruption rate of permanent teeth along with retainment of primary teeth beyond normal shedding time.

[4] However, on general examination of the patient, he did not reveal any significant medical findings, which was further substantiated by normal Thyroid Stimulating Hormone (TSH), Triiodothyronine (T3), Thyroxine (T4), and GH levels of the patient. Hypoparathyroidism was also ruled out subsequently by laboratory tests for serum calcium levels and parathyroid hormone values. Treatment options for the management of impacted teeth are separated into four categories: Observation, intervention, relocation, and extraction. Each strategy has to be judged according to individual case, taking into consideration the position of the impacted teeth and the relationship to each on X-ray images, oral examination, and plaster model.

[8,9] In this case, after taking into consideration various factors, it was decided to go for extraction of all the third molars, followed by surgical exposure and orthodontic traction of impacted teeth. However, patient was not willing for any kind of surgical treatment and was lost to follow-up. This case report adds to rare reported literature on multiple retained primary teeth along with impacted permanent teeth. Early diagnosis with advanced imaging and appropriate management can minimize the potential complications caused by such impacted teeth. Dental practitioners should be aware of their clinical signs and the treatment options. Further research is needed at cellular and genetic levels to exactly localize the reasons for such failure GSK-3 of eruption. Footnotes Source of Support: Nil Conflict of Interest: None declared.
A 45-year-old male patient reported to the department with complaint of painless hard slow growing swelling on the right TMJ area and asymmetrical face since two years. He noticed reduced mouth opening and deviation of the jaw while opening and closing the mouth [Figure 1a]. There was no history of any trauma or ear infection. The medical history was non-contributory.