The planning of dental management and treatment goals in CCD vary from individual to individual and primarily depends on the need of the patient, the age at diagnosis and social and economic circumstances. The main management objectives of affected individuals, remain the restoration of function and aesthetics. D’ Alessndro et al, 2010 categorized the clinical features pertinent to this paper into two major categories namely craniofacial and dental. Although a plethora of management options exists, there is a general consensus that the best results are obtained if the condition is diagnosed and treatment is started, at an early age.
The most popular orthodontic-surgical approaches include:
1. The Toronto-Melbourne approach
2. The Belfast-Hamburgh approach
3. The Jerusalem approach
The Toronto-Melbourne approach is based on timed, serial extraction of deciduous teeth and depends on the extent to which the roots of the permanent teeth have developed. During each procedure, which is performed under general anaesthetic, supernumerary teeth are removed together with the bone covering the underlying permanent teeth. The rationale is to facilitate the spontaneous eruption of the unerupted permanent teeth. Orthodontic procedures are utilized to fulfil the treatment objectives (Smylski et al, 1974; Hall and Hyland 1978).
In contrast to the Toronto-Melbourne, the Belfast-Hamburg approach, ad...
... middle of paper ...
...D, presented to the University of Western Cape, Faculty of Dentistry for management. Apart from the orodental features of CCD, he also presented with poor oral hygiene, multiple carious teeth and was believed to be affected by mild intellectual disability. However, on further clinical investigation, it elicited that he was a regular user of methamphetamine or “tik” as is it is called in South Africa. His poor oral health status and poor mental capacity was therefore a result of drug abuse and possibly poor socioeconomic status. After extensive management planning the young man absconded from treatment. Therefore management of complicated orofacial disorders may be extremely complicated in a country like South Africa. Apart from the poverty, lack of education, drug abuse and HIV, the cost of treatment is beyond what the average person can afford.
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