Dental management considerations in a child with sequelae of infantile cortical hyperostosis (Caffey disease): a case report.

AIM AND

BACKGROUND

Infantile cortical hyperostosis (Caffey disease) is a rare inflammatory skeletal disorder characterized by episodic subperiosteal bone formation, commonly involving the mandible during early craniofacial development. Residual mandibular enlargement, feeding difficulty, and developmental challenges resulting from the disease may predispose affected children to early childhood caries (ECC). However, evidence guiding dental management in such patients remains limited. This report describes the dental management of a toddler with sequelae of infantile cortical hyperostosis, highlighting condition-specific considerations influencing treatment planning.

CASE DESCRIPTION: A 2-year-10-month-old male with a history of infantile cortical hyperostosis, residual mandibular cortical thickening, gross motor developmental delay, and moderate acute malnutrition presented with severe ECC involving multiple cavitated dentinal lesions. Caries burden was assessed clinically using dmft criteria. Radiographic evaluation demonstrated diffuse mandibular cortical thickening without evidence of odontogenic infection. Considering high caries risk, extent of disease, limited cooperation, and systemic status, full-mouth rehabilitation under general anesthesia was undertaken. Treatment included glass ionomer restorations in posterior teeth, anterior composite restoration, extraction of a non-restorable molar, pit and fissure sealants, and topical fluoride application. Multidisciplinary preoperative assessment included evaluation of airway status and associated systemic considerations. The procedure was completed uneventfully, with satisfactory immediate postoperative recovery and short-term improvement in feeding.

CONCLUSION

This case highlights the need for individualized, multidisciplinary dental management in children with sequelae of infantile cortical hyperostosis. While full-mouth rehabilitation under general anesthesia was successfully performed in this instance, findings from a single case should be interpreted cautiously. Further evidence is required to establish condition-specific dental management protocols.