Interdisciplinary rehabilitation of a patient with ectodermal dysplasia utilizing digital tools: A clinical report

Complete-arch implant rehabilitation and adjunctive orthognathic surgery of a patient with hypohidrotic ectodermal dysplasia utilizing a digital workflow: A clinical report

Hypohidrotic ectodermal dysplasia (HED) is a rare genetic disorder characterized by congenital anomalies in ectodermal tissues, with dental manifestations commonly including hypodontia or oligodontia. Addressing the significant aesthetic, functional, and psychosocial challenges associated with HED requires early surgical and prosthodontic intervention following skeletal maturation. This clinical report details a digital workflow for complete-arch implant rehabilitation of the maxilla and mandible, combined with orthognathic surgery, in an adolescent patient with HED. Integrating digital technologies enhanced treatment planning, surgical precision, and prosthetic outcomes, improving aesthetics, functionality, and overall patient quality of life.

Digital planning and decision making for severe congenital oligodontia with Angle class-III malocclusion

As maxillofacial surgery becomes increasingly digitized and the transformative impact of pre-surgical scanning and computer simulation is recognized, this clinical paper presents an algorithm for the selection of interventions in severe congenital oligodontia with Angle class-III malocclusion (OCIII) utilizing such technologies. A complex, multifactorial condition with varying degrees of craniofacial involvement, OCIII is associated with edentulous facial appearance, mandibular prognathism and deep underbite, as well as malocclusion. Our methodology involves the integration of CBCT imaging, intra- and extra- oral scanning, and 3D planning with the assessment of bone volume, number of missing teeth, skeletal discrepancies, and patient compliance in the selection of suitable treatments. This approach accounts for unique patient characteristics by promoting personalized medicine and facilitating the development of predictable treatment modality results by offering a decision-tree for standardized treatment selection in cases of OCIII. This study unequivocally establishes the importance of digital treatment planning for OCIII, enabling the adaptation of surgical protocol for specific concerns and underlying limitations, thereby orchestrating successful treatments, improving patient satisfaction, and surpassing conventional methods.

A completely digital workflow for a maxillary tooth-supported complete overdenture and mandibular telescopic denture to manage the treatment of a patient with hypohidrotic ectodermal dysplasia

This clinical report provides a complete digital workflow for the rehabilitation of a 17-year-old male patient who had been diagnosed with hypohidrotic ectodermal dysplasia. A maxillary tooth-supported overdenture was used with a mandibular computer-aided design and a computer-aided manufacturing telescopic denture with occlusal modifications. This digital workflow significantly reduced chairside time and enhanced the precision of the fit.

Orthodontic and dentofacial orthopedic treatments in patients with ectodermal dysplasia: a systematic review

Objective

The objective of this systematic review was to determine the orthodontic and dentofacial orthopedic treatments carried out in patients with ectodermal dysplasia to facilitate functional and aesthetic rehabilitation.

Methods

The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. We systematically searched PubMed, Web of Science, Scopus, Scielo, LILACS, EBSCOhost and Embase databases up to 6 January 2022. We included articles describing patients with any type of ectodermal dysplasia who received orthodontic or dentofacial orthopedic treatment to facilitate functional and aesthetic oral rehabilitation. The search was not restricted by language or year of publication. The quality of the studies was assessed using the Joanna Briggs Institute Quality Assessment Scale of the University of Adelaide for case series and case reports. The review was registered at the University of York Centre for reviews (CRD42021288030).

Results

Of the initial 403 studies found, 29 met the inclusion criteria. After applying the quality scale, 23 were left for review—21 case reports and 2 case series. The initial age of patients ranged from 34 months to 24 years. Thirteen studies were on hypohidrotic and/or anhidrotic ectodermal dysplasia, of which two were X-chromosome linked. In one study, the patient had Wiktop syndrome, and in nine the type of ectodermal dysplasia was not specified. The duration of treatment was 7 weeks to 10 years. The treatments described were: fixed orthodontic appliances or simple acrylic plates designed for tooth movement, including leveling and aligning, closing of diastemata, retraction of impacted teeth in the dental arch; clear aligners; fixed and/or removable appliances for the correction of skeletal and/or dentoalveolar relationships; palatal expanders in combination with face masks for orthopedic traction of the maxilla; and orthognathic surgery. Only three studies provided cephalometric data.

Conclusion

The level of evidence of the articles reviewed was low and most orthopedic and dentofacial orthodontic treatments described were focused on correcting dental malpositioning and jaw asymmetries and not on stimulating growth from an early age. Studies with greater scientific evidence are needed to determine the best treatment for these patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13023-022-02533-0.

Digital Implant Planning in Patients with Ectodermal Dysplasia: Clinical Report

Ectodermal dysplasia may severely affect the development of jaw growth and facial appearance. This case report describes the treatment of two patients suffering from ectodermal dysplasia, both treated with dental implant-fixed restorations by means of computer-guided surgery. Two patients presented to our clinic with congenital malformation of the jaw as a manifestation of ectodermal dysplasia, showing oligodontia and alveolar ridge deficit. Clinical examination revealed multiple unattached teeth and a need for prosthetic therapy. For both cases, dental implants were placed based on a computer-guided planning. A surgical guide was used to determine the positioning of the dental implants according to the prosthetic planning, which allowed for a satisfactory aesthetic and functional outcome. Computer-guided implant placement allowed predictable treatment of complex cases with satisfactory aesthetic and functional results. Adequate surgical and prosthetic planning is considered critical for treatment success.