[Severe hypodontia in permanent dentition. Orthodontic treatment of oligodontia in children]

Our study is aimed to focus on severe hypodontia, the absence of multiple teeth in permanent dentition. Examining the variation of the number of teeth agenesis of permanent teeth is relatively common but real oligodontia is rarely encountered during our daily work. At a number of patients recently attending the Pedodontics and Orthodontics Department of the Dental Faculty of Semmelweis University oligodontia, the absence of at least six or more permanent teeth was found. Examining the aetiology of oligodontia it can be determined that both endogen and exogenous environmental factors may contribute to the cause of the anomaly. In its pathology genetics is considered as the dominant factor what is also proved by familiar inheritance aggregation however it is hard to determine the aetiology in most cases. Severe oligodontia most often is part of certain syndromes. The anomaly causes not only aesthetical and functional problems but also may lead to several complications so early recognition and referral is considered essential. Therapy often involves multidisciplinary approach with individual assessment and planning. We would like to present the possibilities of orthodontic pre-treatment for prosthetic and implant replacement through our cases.

Prosthodontic management of patients with amelogenesis imperfecta

INTRODUCTION

Amelogenesis Imperfecta (AI) is an heterogenous genetic disorder that disturbs the developing enamel structure. This rare ectodermal defect leads to a variety of clinical manifestations due to agenesis, hypoplasia, and/or hypomineralisation of the enamel.

AIMS AND OBJECTIVES

To describe the prosthodontic management of dental anomalies commonly associated with AI.

METHODS

By using the classification of Witkop and Rao (1971), the variation in clinical presentation of the different Types of AI are illustrated and discussed, in particular Type I AI and Type 4 AI.

RESULTS AND CONCLUSIONS

Early diagnosis and prosthodontic management as part of a multidisciplinary, patient-centred approach are key factors to treatment success. Treatment options to address the oral complications are influenced by modifying factors including age, socioeconomic status, type and severity of the disorder, and intraoral status at the time of treatment planning. Ultimately, management includes pain and infection control, provision of aesthetics and restoration of function which may lead to patient satisfaction, psychological well-being and an improved quality of life.

A new methodological and clinical approach for the treatment of upper lateral incisors agenesis: the posterior space opening

AIM The purpose of this study is to present a new clinical approach for the treatment of upper lateral incisor agenesis.

MATERIALS AND METHODS

A new treatment option was conceived and applied: posterior space opening as a safeguard of occlusal integrity and dental and periodontal aesthetics of the front teeth. This is acheved by means of the anterior space closure, with the mesialisation of the canines and the bicuspids, combined with a posterior space opening to create adequate room for the placement of an implant in the second premolar area. The obtained space should be maintained with a space retainer or a provisional Maryland bridge until the patient is old enough to undergo implant rehabilitation and the canines must be reshaped into a lateral incisor.

CONCLUSION

The results of this treatment are a correct teeth alignment, without diastema, Class I occlusion, and occlusal integrity with all natural teeth in the anterior area. In this way there are many advantages for the patient; so it is an effective approach.

Surgical-orthodontic management of an adult skeletal Class III malocclusion with canine substitution

Management of missing lateral incisors requires thorough treatment planning and an interdisciplinary approach. Occlusion and alignment are significant considerations. Three treatment options are available for replacing missing lateral incisors: canine substitution, tooth-supported restorations, and single-tooth implants. The ideal treatment is the one that satisfies the esthetic and functional requirements of the patient. The pros and cons of the various treatment options must be meticulously analyzed before arriving at a decision. This article closely examines patient selection and illustrates the importance of interdisciplinary treatment planning in an adult treated with canine substitution and orthognathic surgery.

Two-unit cantilevered resin-bonded fixed partial denture as a substitute for a prosthodontic-orthodontic treatment plan: a 5-year case report

In this case report, we describe the successful long-term treatment of a patient with dental agenesis. The initial treatment plan included an orthodontic phase to provide adequate space for replacing missing lateral incisors with implants. However, because of some complications encountered after 2 years of orthodontic treatment, a revised treatment plan was considered to achieve functional and esthetic goals. The patient was completely satisfied 5 years after being treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost.

Immediate bonding to bleached enamel treated with 10% sodium ascorbate gel: a case report with one-year follow-up

It is generally not recommended that bonded restoration treatment should be carried out immediately after bleaching treatment. However, the use of antioxidants such as sodium ascorbate can be useful to avoid a waiting period. This article is a brief review about in vitro proposals to overcome low bond strength values to bleached dental surfaces. It shows a one-year follow-up case report of a young female presenting agenesis of maxillary lateral incisors reshaped with direct resin composite immediately after dental bleaching. Teeth were bleached with a combination of in-office and at-home whitening protocols, followed by the application of a 10% sodium ascorbate gel for one hour, to allow the immediate reshaping with direct resin composite restoration. After one year, the clinical performance of the restoration was successful. The use of sodium ascorbate gel can help the clinician to perform bonding procedures immediately after bleaching treatments.

Ectodermal dysplasia: dental management and benefits, a case report

This case report describes a method of restoring function and aesthetics in a 9-year-old girl with ectodermal dysplasia with 15 years follow-up. Ectodermal dysplasia is both physically and emotionally devastating to patients. It is important that they are treated at an early age to help their social interaction. With proper dental intervention, the quality of life can be improved for patients with ectodermal dysplasia.

Management of a case of ectodermal dysplasia: a multidisciplinary approach

Ectodermal dysplasia (ED) is a rare disorder involving 2 or more of the ectodermal structures, which include the skin, hair, nails, teeth, mucus glands, and sweat glands. Each person with ectodermal dysplasia may have a different combination of defects. The most common form of ED is linked to the X chromosome and usually affects men. Another form of the disease affects men and women equally. The patient's special needs are taken into consideration in a treatment plan. The purpose of this case report was to describe the dental management of a 9-year-old boy with ectodermal dysplasia whose maxilla showed the presence of mobile, conical teeth that were unrestorable and a solitary permanent left molar, while his mandible was completely edentulous. These mobile, conical teeth were extracted, and a complete denture was constructed to restore the patient's esthetics, form, and function.

Orthodontic and prosthetic treatment of a patient with cystic fibrosis and agenesis of maxillary lateral incisors

The young dental patient with maxillary lateral incisor agenesis, maxillary canine impaction, and cystic fibrosis presents considerable challenges to the dentist. An interdisciplinary approach is described here for the orthodontist and restorative dentist to plan and work together with the patient's and parents' cooperation and consent. Despite some compromises, a successful outcome was achieved, as demonstrated in this case report. The use of conservative yet esthetic and durable fixed replacement prostheses is highlighted. Congenitally absent maxillary lateral incisors, impacted maxillary canines, and cystic fibrosis are clinical conditions that can significantly complicate and compromise dental treatment for any young patient. All three can be present simultaneously, as described in this case report.

Congenitally missing maxillary lateral incisors: treatment

The 2 major treatment approaches for congenitally missing maxillary lateral incisors are space closure via orthodontic therapy, or space opening to allow prosthodontic replacements either with a fixed prosthesis or single-tooth implant. Both of these treatment approaches can potentially compromise aesthetics, periodontal health, and function. It is essential for an interdisciplinary dental specialty team to establish realistic treatment objectives, communicate the sequence of treatment, interact during treatment, evaluate dental and gingival aesthetics, and position teeth to permit proper prosthetic treatment. If this interdisciplinary approach is used, the aesthetics and long-term dental health of the patient following treatment will be greatly enhanced.

Agenesis of maxillary lateral incisors: a global overview of the clinical problem

The agenesis of maxillary lateral incisors is a common developmental anomaly and represents a clinical problem impairing dental esthetics and function from a very young age. Several dental specialties deal with the management of this clinical problem because a multidisciplinary approach can cover the complete dental needs of patients with dental agenesis. There is controversy, however, about whether missing lateral incisor spaces should be orthodontically opened or closed using permanent canines to replace the missing teeth. The article presents a review of the existing literature about the prevalence, etiology, diagnostic evaluation, and treatment strategy of maxillary lateral incisor agenesis. Also, this article aims to present the key determinants leading to selection of space opening or closure and to report professional judgments and layperson perception concerning the available treatment alternatives. The English-language literature associated with this topic was searched via PubMed. The articles retrieved were then reviewed with an attempt to fulfill the aims of this review. Maxillary lateral incisors are one of the most common congenitally missing teeth, and to date, the origin of their agenesis has not been completely identified. Prompt diagnosis and careful evaluation of treatment determinants through a multidisciplinary approach are essential for the proper management of clinical problems. Each of the available means of rehabilitation has its own advantages, disadvantages, indications, and limitations. The configuration of the treatment plan should be devoid of clinician biases, whereas patients' realistic expectations should be taken into account.

Complete denture prosthodontics in children with ectodermal dysplasia: review of principles and techniques

Ectodermal dysplasia (ED) is a hereditary condition in which a minimum of two ectodermal structures fail to develop. Anodontia, or hypodontia, is one of the most common manifestations of this condition. As a result, it is critical that prosthodontic habilitation or rehabilitation is started early. Complete dentures are a simple, inexpensive, and reversible option. Several case reports have demonstrated the successful use of complete dentures in children with ED. However, few articles have exclusively addressed the principles of complete denture prosthodontics in these individuals. This report critically analyzes the literature with respect to complete denture principles and techniques in children. Evidence to date is insufficient for advocating any one technique; therefore, the authors recommend a simplified yet scientific approach in fabricating complete dentures for children. This can aid the practicing dentist in using this simple therapeutic option to provide esthetic, functional, and psychological benefits for children with ED and other congenital anomalies related to missing teeth.

Interdisciplinary treatment of an end-to-end occlusion due to congenitally missing maxillary lateral incisors

Odontogenic aplasia, or the congenital absence of permanent teeth, is relatively common. When the missing teeth include the maxillary lateral incisors, treatment considerations must reconcile both esthetic and functional objectives. In developing dentition, erupting adjacent teeth can drift from their intended positions into the edentulous space created by the congenitally missing tooth. When this movement happens (e.g., cuspids shifting more mesially than normal), esthetic and functional problems occur. A restorative solution for missing maxillary lateral incisors subsequent to the loss of the maxillary incisor spaces is presented while highlighting the use of a leucite-reinforced material. This approach allowed for a minimal preparation design and conservation of tooth structure, providing an optimal bond.