Diagnostic features and pedodontic-orthodontic management in dentinogenesis imperfecta type II: a case report

Minimally invasive orthodontics: elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta

AIM

The aim of the study was to report the use of an elastodontic therapy in a growing patient affected by Dentinogenesis Imperfecta, second class malocclusion, deep bite and lower arch crowding from the deciduous dentition to permanent one.

CASE REPORT

At first, the 5-year-old patient was treated with an elastodontic device known as "Nite-Guide". When the patient was 7 years old, during her first permanent molars and incisors eruption and after optimal house-practices, an Occlus-o-Guide Series G was placed at night and on daylight (two hours a day) performing exercises aimed to activate facial muscles and facilitate the deep bite reopening. At 9 years of age, with totally deep bite resolution, she used the Occluso-Guide only at night to hold down previous results and follow patient's dental growth. At 11 years of age, after successful teeth switching, we prescribed an Occlus-o-Guide Series N, which is functional for permanent dentition and guaranteed an eruptive guide for last dental elements.

CONCLUSIONS

This clinic case could be considered an example of approach for all those patients with systemic and/or dental diseases that do not allow adequate dental retention, which is necessary for most orthodontic appliances; elastodontic devices do not require adequate dental retention and define a minimum intervention on the surfaces of the teeth.

Dentinogenesis Imperfecta : A Family which was Affected for Over Three Generations

Dentinogenesis Imperfecta (DI) or hereditary opalescent dentin is inherited in a simple autosomal dominant mode with high penetrance and low mutation rates. It generally affects both the deciduous and the permanent dentitions. DI corresponds to a localized form of mesodermal dysplasia which is observed in the histo-differentiation. An early diagnosis and treatment are therefore fundamental, which aim at obtaining a favourable prognosis, since at late intervention makes the treatment more complex. We are presenting here a case of DI in which the disease affected the three generations of a family in India.

Full-mouth rehabilitation for a patient with dentinogenesis imperfecta: a clinical report

Dentinogenesis imperfecta (DI) is a genetic disorder affecting the structural integrity of the dentin that can result in weakened dentin. The affected teeth, especially posterior teeth, often need to be extracted due to severe wear or fracture. This frequently yields a loss of posterior occlusion and occlusal vertical dimension. Besides wear and fracture, anterior teeth often have an unesthetic appearance because of discoloration. Current treatments of choice, including composite bonding restorations and, more recently, all-ceramic restorations, are typically suggested to preserve the remaining teeth and tooth structure. However, there are a limited number of studies on dental implants in patients with DI. The effectiveness of dentin bonding and dental implants in patients with DI is not known. This clinical report describes a 32-year-old Asian woman with DI who underwent full-mouth rehabilitation. The posterior occlusion, mostly in the molar areas, was restored with dental implants and ceramometal restorations. The anterior teeth and premolars were restored with bonded lithium disilicate glass-ceramic pressed veneers and crowns made with computer-aided design/computer-aided manufacturing. This case demonstrates that restoring functional occlusion and esthetics for a patient with DI can be completed successfully using contemporary implant therapy and adhesive dentistry.

Case report: Clinical, histological and ultrastructural characterization of type II dentinogenesis imperfecta

BACKGROUND

Type II dentinogenesis imperfecta (DGIII) is an autosomal dominant dental development anomaly that affects both the primary and permanent dentition.

CASE REPORT

This case report describes the clinical, radiographic and morphological characteristics of the teeth of a seven-year-old child with DGI-II determined by optical microscopy and scanning electron microscopy.

TREATMENT

This consisted of extraction of the primary teeth with periapical lesions due to the advanced state of tooth resorption. Aesthetic restorations were performed on the mandibular anterior teeth and occlusal fissure sealants were applied to erupting teeth. A removable partial upper denture was made in order to return anterior aesthetic function and to aid mastication and speech.

FOLLOW UP

The child was examined at 3 month intervals. Over the following 3 years the prosthesis was replaced due to facial growth and fluoride was applied at each follow-up visit to all teeth. The patient remains in follow up and management.

CONCLUSION

Individuals with DGI-II must not neglect their dental health. Early diagnosis, professional advice and treatment with periodic follow-up can help improve the quality of life of such patients.

Case report: Rehabilitation of a child with dentinogenesis imperfecta and congenitally missing lateral incisors

BACKGROUND

Dentinogenesis imperfecta is one of the most common hereditary disorders of dentine formation. Opalescent teeth composed of irregularly formed and undemineralised dentine that obliterates pulp chambers and root canals characterize it. Complete-coverage crowns are usually the preferred restoration for patients with this condition.

CASE REPORT

A 9 year-old girl presented with dentinogenesis imperfecta, congenitally missing maxillary lateral incisors and maxillary right permanent second molar retention.

TREATMENT

The treatment comprised an initial approach to allow the correct eruption of the retained second molar. The use of low-fusion metal ceramic restorations comprised a second stage to improve the aesthetic appearance and decrease the risk of overload on teeth with limited value.

FOLLOW-UP

The patient has been recalled regularly and at the last visit, 10 years after initial prosthetic treatment, no problems or signs of complications have occurred. The patient is now aged 25 years and is still satisfied with the prosthetic rehabilitation.

CONCLUSION

This case illustrates the need for appropriate and timely restorative treatment to prevent deterioration of the dentition. This case will also demonstrate that low-fusion metal ceramic restoration is a viable esthetic treatment option for today's patients.

[Osteogenesis imperfecta and dentinogenesis imperfecta: diagnostic frontiers and importance in dentofacial orthopedics]

Osteogenesis imperfecta is a genetic disease that varies in severity and is characterized by fragile bones that fracture easily. Many extra-skeletal manifestations can be noted such as blue sclerotic markings, dentinogenesis imperfecta and impaired hearing or deafness. In most cases, an anomaly of collagen is the cause. It is usually accompanied by a specific Class III type cranio-facial morphology with open bite and increased incidence of impacted permanent molars. Orthodontists called upon to treat the dental aspects of this malady, should be careful to protect their patients against bacterial infection and hemorrhages, and to be well aware of the side affects that can be caused by the biophosphanates that constitute the basis of current medical treatment of osteogenesis imperfecta.

Osteogenesis imperfecta

Osteogenesis imperfecta is a relatively common hereditary connective tissue disorder characterized by bone fragility and fractures. Other frequently affected tissues include tendons, ligaments, skin, sclera, teeth, and middle and inner ear. Molecular studies have demonstrated that most cases result from mutations affecting the genes responsible for the formation of type 1 collagen. The phenotypic presentation varies from mild to lethal. Commonly observed dental abnormalities include dentinogenesis imperfecta and malocclusion. Medical therapies using bisphosphonates have resulted in reduced fracture risk and decreased bone pain. To date, no cases of bisphosphonate-associated osteonecrosis have been reported. With appropriate precautions, the patient with osteogenesis imperfecta can tolerate and benefit from the delivery of necessary dental care to control oral disease, improve function, and improve esthetics.