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Akleyin E, Yavuz Y, Yardımeden A. Three-Dimensional Modeling and Quantitative Assessment of Mandibular Volume in Ectodermal Dysplasia: A Case Series. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:528. [PMID: 38674174 PMCID: PMC11051706 DOI: 10.3390/medicina60040528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Ectodermal dysplasia (ED)-a genetic disorder-is characterized by severe tooth deficiency. We compared the mandibular volume and the sagittal and horizontal mandibular widths between patients with ED (ED group) and individuals without tooth deficiency (control group) using three-dimensional modeling. We hypothesized that the mandibular volume differs in ED cases owing to congenital tooth deficiency. Materials and Methods: We used previously obtained cone-beam computed tomography (CBCT) images of 13 patients with ED. The control group data comprised retrospective CBCT images of patients of similar age and sex with a skeletal relationship of class 1. Further, using the three-dimensional image analysis software, the tooth crowns were separated from the mandible, the mandible was reconstructed and the gonion-to-gonion distance in the mandible was marked, the distance to the menton point was measured, and the distance between the two condyles was measured and compared with the control group. Results: Overall, 46.2% and 53.8% of the participants were men and women, respectively. In the ED group, the mean age of the participants was 15.46 (range, 6-24) years, and the mean number of mandibular teeth was 4.62. Notably, the edentulous mandible volume of the ED group (27.020 mm3) was statistically significantly smaller than that of the control group (49.213 mm3) (p < 0.001). There was no difference between the two groups in terms of the marked points. For data analysis, the Shapiro-Wilk test, independent samples t-test, and Mann-Whitney U test were used. Conclusions: It has been considered that mandible volume does not develop in ED cases because of missing teeth. Modern practices, such as the CBCT technique and three-dimensional software, may be effective in identifying the true morphologic features, especially in patients with genetic syndromes affecting the maxillofacial structure.
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Affiliation(s)
- Ebru Akleyin
- Department of Pediatric Dentistry, Faculty of Dentistry, Dicle University, Diyarbakır 21010, Turkey
| | - Yasemin Yavuz
- Department of Restorative Dentistry, Faculty of Dentistry, Harran University, Urfa 63000, Turkey
| | - Ahmet Yardımeden
- Department of Mechanical Engineering, Faculty of Engineering, Dicle University, Diyarbakır 21010, Turkey
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Bohner L, Hanisch M, Kleinheinz J, Jung S. Dental implants in growing patients: a systematic review. Br J Oral Maxillofac Surg 2019; 57:397-406. [DOI: 10.1016/j.bjoms.2019.04.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
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Schnabl D, Grunert I, Schmuth M, Kapferer-Seebacher I. Prosthetic rehabilitation of patients with hypohidrotic ectodermal dysplasia: A systematic review. J Oral Rehabil 2018; 45:555-570. [PMID: 29679503 DOI: 10.1111/joor.12638] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 11/26/2022]
Abstract
Hypohidrotic ectodermal dysplasia (HED) comprises a large group of inherited disorders of ectodermal structures, characterised by hypo- or anhidrosis, hypotrichosis and hypo- or oligo- or anodontia. We aimed to systematically assess the spectrum of prosthodontic approaches with regard to the patients' age and to provide clinical implications for practicing dentists. An electronic and manual search was conducted in four databases (Medline, LIVIVO, Cochrane Library, Web of Science Core Collection). Publications of multiple study designs written in English or German without data restrictions, reporting on prosthodontic treatment of patients diagnosed with HED and afflicted with oligo- or anodontia, were included. In total, 75 articles on 146 patients were analysed according to the patients' age. In children aged 2-17 years, removable full or partial (over)dentures represented standard treatment. In the mandible, implant-supported removable dentures on two interforaminal implants presented an alternative, already in young childhood. In cases with more than six teeth per jaw, also fixed (resin) bridges were used, frequently after orthodontic treatment. In adults, fixed or removable reconstructions with the help of up to eight implants per jaw, usually placed after bone augmentation procedures, were standard. Ten case reports/series with long-term follow-up illustrated the need for consistent maintenance including denture renewals. Prosthodontic rehabilitation should start in early childhood and needs to be revised in accordance with the patients' growth. Treatment should be carried out by a multidisciplinary team addressing variable demands in different age groups.
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Affiliation(s)
- D Schnabl
- University Hospital for Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - I Grunert
- University Hospital for Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria
| | - M Schmuth
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - I Kapferer-Seebacher
- University Hospital for Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria
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Clinical outcomes of implant therapy in ectodermal dysplasia patients: a systematic review. Int J Oral Maxillofac Surg 2016; 45:1035-43. [DOI: 10.1016/j.ijom.2016.03.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 03/09/2016] [Accepted: 03/16/2016] [Indexed: 11/22/2022]
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Wu Y, Wang XD, Wang F, Huang W, Zhang Z, Zhang Z, Kaigler D, Zou D. Restoration of Oral Function for Adult Edentulous Patients with Ectodermal Dysplasia: A Prospective Preliminary Clinical Study. Clin Implant Dent Relat Res 2015; 17 Suppl 2:e633-42. [PMID: 25728861 DOI: 10.1111/cid.12296] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Therapy with zygomatic implants (ZIs) or conventional implants (CIs) has proven to be an effective method to restore oral function for systemically healthy patients. However, it is still a major challenge to fully restore oral function to edentulous adult patients with ectodermal dysplasia (ED). PURPOSE The aim of this study was to determine an effective treatment protocol for restoring oral function using ZIs and CIs to edentulous adult ED patients. MATERIALS AND METHODS Ten edentulous adult ED patients were treated in this study. The treatment protocol involved the following: (1) bone augmentation in the region of the anterior teeth; (2) placement of two ZIs and four CIs in the maxilla, and four CIs in the mandible; (3) fabrication of dental prosthesis; and (4) psychological and oral education. Following treatment of these patients, implant success rates, biological complications, patient satisfaction, and psychological changes were recorded. RESULTS Although there was evidence of bone graft resorption in the maxilla, bone augmentation of the mandible was successful in all patients. Nine CIs in the maxilla failed and were removed. All ZIs were successful, and the CIs success rates were 77.50% in the maxilla and 100% in the mandible, with a mean of 88.75%. The mean peri-implant bone resorption for the CIs ranged from 1.3 ± 0.4 mm to 1.8 ± 0.6 mm, and four cases exhibited gingival hyperplasia in the maxilla and mandible. One hundred percent of the patients were satisfied with the restoration of their oral function, and >50% of the patients exhibited enhanced self-confidence and self-esteem. CONCLUSIONS This study demonstrates that oral function can be restored in edentulous adult ED patients using a comprehensive and systematic treatment protocol involving psychological and oral education, bone augmentation, implant placement, and denture fabrication. Despite these positive outcomes, bone augmentation remains challenging in the anterior region of the maxilla for edentulous adult ED patients.
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Affiliation(s)
- Yiqun Wu
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Xu Dong Wang
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Feng Wang
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Wei Huang
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Zhiyong Zhang
- Department of Oral Implant, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Zhiyuan Zhang
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ninth People's Hospital Affiliated with Shanghai Jiao Tong University, Shanghai, China
| | - Darnell Kaigler
- Department of Periodontics and Oral Medicine, Department of Biomedical Engineering, Michigan Center for Oral Health Research, University of Michigan, Ann Arbor, MI, USA
| | - Duohong Zou
- Department of Dental Implant Centre, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
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Mello BZF, Silva TC, Rios D, Machado MAAM, Valarelli FP, Oliveira TM. Mini-implants: alternative for oral rehabilitation of a child with ectodermal dysplasia. Braz Dent J 2015; 26:75-8. [PMID: 25672389 DOI: 10.1590/0103-6440201300111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 11/27/2014] [Indexed: 11/21/2022] Open
Abstract
Ectodermal dysplasia is a rare congenital disease that affects several structures of ectodermal origin. The most commonly related oral characteristics are hypodontia, malformed teeth and underdeveloped alveolar ridges. New alternative treatments are needed due to the failure of the conventional prosthesis retention. This case report outlines the oral rehabilitation treatment of a 9-year-old girl with ectodermal dysplasia. The treatment was performed with conventional prosthesis upon mini-implants. The mini-implants provided prosthetic retention. The patient reported a good adaptation of the dental prosthesis and satisfaction with the treatment. The increased self-esteem improved the socialization skills of the girl. In this case report, use of prosthesis with mini-implants was satisfactory for prosthetic retention. However, clinical studies with long-term follow-up are needed to test the mini-implants as an alternative for oral rehabilitation of children with ectodermal dysplasia.
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Affiliation(s)
- Bianca Zeponi Fernandes Mello
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru Dental School, USP - University of São Paulo, Bauru, SP, Brazil
| | - Thiago Cruvinel Silva
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru Dental School, USP - University of São Paulo, Bauru, SP, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru Dental School, USP - University of São Paulo, Bauru, SP, Brazil
| | | | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru Dental School, USP - University of São Paulo, Bauru, SP, Brazil
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Koyuncuoglu CZ, Metin S, Saylan I, Calısir K, Tuncer O, Kantarci A. Full-mouth rehabilitation of a patient with ectodermal dysplasia with dental implants. J ORAL IMPLANTOL 2014; 40:714-21. [PMID: 25506662 DOI: 10.1563/aaid-joi-d-12-00072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oral findings in patients with ectodermal dysplasia (ED) include complete or partial hypodontia, anodontia, loss of vertical dimension of occlusion, protuberant lips, malformed and widely spaced conical-shaped teeth, and underdeveloped alveolar ridges. These patients present a substantial challenge in dental treatment. This case report presents oral rehabilitation of a 22-year-old male patient diagnosed with ED using an implant tooth-supported telescopic partial denture at the mandible and a tooth-supported telescopic partial denture at the maxilla. Implants in the mandible were placed at the sites of the right and left lateral incisor teeth. Following implant placement, the remaining buccal bone dehiscence was filled with deproteinized bovine bone graft and covered with resorbable membrane. To manage the vestibular insufficiency and to increase the keratinized mucosa in maxilla, bilateral acellular dermal matrix allograft was used on the right and left buccal aspects. The treatment described here improved the patient's functional and esthetic status while significantly restoring his oral health and self-esteem.
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Affiliation(s)
- Cenker Zeki Koyuncuoglu
- 1 Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey
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Fraiz FC, Gugisch RC, Cavalcante-Leão BL, Macedo LM. Hypohidrotic ectodermal dysplasia: a clinical case with a longitudinal approach. J Contemp Dent Pract 2014; 15:788-91. [PMID: 25825110 DOI: 10.5005/jp-journals-10024-1619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM This paper describes a clinical case of a male with hypohidrotic ectodermal dysplasia submitted to rehabilitation and occlusal dental interventions with follow-up from 3 to 14 years of age. BACKGROUND Due to the severe effects on function and esthetics, the clinical manifestations of ectodermal dysplasia exert a negative impact on quality of life. However, oral rehabilitation in childhood poses a challenge due to growth and development. CASE DESCRIPTION A male with hypohidrotic ectodermal dysplasia began dental intervention at the age of 3 years. The clinical and radiographic exams revealed the absence of several primary and permanent teeth and abnormal shape of the primary maxillary incisors. The facial characteristics were compatible with hypohidrotic ectodermal dysplasia, such as a prominent brow, everted lips, fattened bridge of the nose and small vertical facial height. The treatment proposed involved rehabilitation through successive temporary partial dentures, functional orthopedics of the jaws, esthetic reconstruction of the anterior teeth, timely occlusal intervention and preventive actions for the control of dental caries and plaque. CONCLUSION The present case demonstrates that early care plays a fundamental role in minimizing the biopsychosocial consequences of hypohidrotic ectodermal dysplasia and preparing the patient for future oral rehabilitation. CLINICAL SIGNIFICANCE Although, the literature offers a number of papers describing dental treatment for ectodermal dysplasia, few cases include long-term follow-up and the use of a functional orthopedic appliance in combination with removable dentures in such patients.
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Affiliation(s)
- Fabian Calixto Fraiz
- Associate Professor, Department of Stomatology, Avenida Prefeito Lothario Meissner 632, Jardim Botânico, Curitiba, ParanáBrazil, Zip Code: 80210-170, Phone: 55 41 3360 4021, e-mail:
| | - Renato Cordeiro Gugisch
- Associate Professor, Department of Stomatology, Universidade Federal do Paraná, Paraná, Brazil
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Implant-supported fixed prosthesis in a hypohidrotic ectodermal dysplasia patient: a case report with 3 years follow-up and review of the literature. IMPLANT DENT 2014; 23:394-400. [PMID: 25033345 DOI: 10.1097/id.0000000000000121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Ectodermal dysplasia (ED) is a rare inherited disorder that affects structures derived from embryonic ectoderm. Due to associated ridge deficiency, and anodontia found in these patients, multiple surgeries are often indicated before replacement of missing teeth with implants, resulting in increased morbidity and treatment time. MATERIALS AND METHODS In this case report, a 31-year-old woman was transitioned from failing tooth-supported fixed restorations to a fully implant-supported fixed prosthesis using immediate implants and narrow diameter implants (NDI). By using some of her existing dentition to support the provisional restorations while osseointegration took place, the patient was able to retain function during treatment. Full-fixed implant-supported prostheses were delivered, providing an esthetic and functional outcome that has been maintained for 3 years. CONCLUSION In ED patients, NDI together with immediate implant placement can be used successfully to support a complete fixed restoration and should be considered as an alternative to major reconstruction surgeries. Key factors associated with increased predictability are discussed together with a review of the literature.
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Trivedi BD, Bhatia R. Complete and removable partial prosthesis for a child with hypohidrotic ectodermal dysplasia. Int J Clin Pediatr Dent 2013; 6:71-4. [PMID: 25206194 PMCID: PMC4034639 DOI: 10.5005/jp-journals-10005-1192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 03/14/2013] [Indexed: 12/04/2022] Open
Abstract
Young children with hypodontia caused by hypohidrotic ectodermal dysplasia (HED) not only have difficulties in mastication and speech but can also sense that their appearance is different from others. Enabling children with HED to look like their peers through the use of well-fitting and functioning complete and removable partial dentures with age appropriate teeth will greatly assist in their transitioning in to their school years and add to their psychological well-being. Although denture construction requires multiple patient appointments and good co-operation, dentist also should educate and encourage parents and patient to tackle the difficulties that may come across during denture construction. In this present case the child, a 4-year-old, required a complete denture in the lower arch and removable partial denture in upper arch to achieve functionality and enhanced esthetics. How to cite this article: Trivedi BD, Bhatia R. Complete and Removable Partial Prosthesis for a Child with Hypohidrotic Ectodermal Dysplasia. Int J Clin Pediatr Dent 2013;6(1):71-74.
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Affiliation(s)
- Bhavesh D Trivedi
- Postgraduate Student, Department of Pediatric and Preventive Dentistry Padmashree Dr DY Patil Dental College and Hospital, Navi Mumbai Maharashtra
| | - Rupinder Bhatia
- Professor and Head, Department of Pediatric and Preventive Dentistry Padmashree Dr DY Patil Dental College and Hospital, Vidyanagar, Nerul Navi Mumbai, Maharashtra, India
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Singer SL, Henry PJ, Liddelow G, Rosenberg I. Long-term follow-up of implant treatment for oligodontia in an actively growing individual: A clinical report. J Prosthet Dent 2012; 108:279-85. [PMID: 23107235 DOI: 10.1016/s0022-3913(12)60176-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dellavia C, Catti F, Sforza C, Tommasi DG, Ferrario VF. Craniofacial growth in ectodermal dysplasia. An 8 year longitudinal evaluation of Italian subjects. Angle Orthod 2010; 80:733-39. [PMID: 20482361 DOI: 10.2319/101909-584.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To identify the main directions of growth of facial structures in subjects with hypohidrotic ectodermal dysplasia (HED). MATERIALS AND METHODS The 3D noninvasive facial measurements were collected in 12 subjects (6 boys, 6 girls) with HED during four assessments (at 8, 11, 12, and 15 years) using an electromagnetic digitizer. The modifications of linear distances in the upper, middle, and lower third of the face were analyzed and compared with cross-sectional data obtained in normal healthy coetaneous. For each distance, differential values between the last and the initial data were calculated individually, separately for a first (8-11 years) and a second growth period (12-15 years). RESULTS In the first time span, the growth of all facial measurements was reduced in HED subjects compared with control subjects. During this interval, most of the HED children underwent a functional and/or prosthetic treatment. During adolescence, the width and height of the lower and upper facial thirds showed a larger growth in HED subjects than in control subjects, while all facial depths and all distances in the middle facial third maintained a reduced growth. CONCLUSIONS The deviation from normal facial growth of HED subjects tends to lessen with age. Functional and prosthetic appliances may have enhanced facial growth.
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Affiliation(s)
- Claudia Dellavia
- Department of Human Morphology and Biomedical Sciences, Università degli Studi di Milano, Milano, Italy.
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Abstract
Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s) in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities.
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The interdisciplinary management of a Class II division 1 malocclusion with an associated mandibular defect following surgical excision of fibromatosis: a clinical report. J Prosthet Dent 2009; 102:279-85. [PMID: 19853168 DOI: 10.1016/s0022-3913(09)60172-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Surgical excision of malignant or nonmalignant tumors of the maxillofacial region can result in significant anatomical loss/compromise. Correction of the residual defect can be complicated by the presence of an underlying malocclusion and can be a significant clinical challenge if large numbers of teeth have been lost in surgery. This clinical report discusses the interdisciplinary treatment to rehabilitate a patient with a history of surgical removal of fibromatosis. Treatment involved the use of osseointegrated implants to facilitate orthodontic correction of an underlying malocclusion. The implants were subsequently used in the prosthodontic rehabilitation of the residual surgical defect.
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Clauss F, Manière MC, Obry F, Waltmann E, Hadj-Rabia S, Bodemer C, Alembik Y, Lesot H, Schmittbuhl M. Dento-craniofacial phenotypes and underlying molecular mechanisms in hypohidrotic ectodermal dysplasia (HED): a review. J Dent Res 2009; 87:1089-99. [PMID: 19029074 DOI: 10.1177/154405910808701205] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The hypohidrotic ectodermal dysplasias (HED) belong to a large and heterogeneous nosological group of polymalfomative syndromes characterized by dystrophy or agenesis of ectodermal derivatives. Molecular etiologies of HED consist of mutations of the genes involved in the Ectodysplasin (EDA)-NF-kappaB pathway. Besides the classic ectodermal signs, craniofacial and bone manifestations are associated with the phenotypic spectrum of HED. The dental phenotype of HED consists of various degrees of oligodontia with other dental abnormalities, and these are important in the early diagnosis and identification of persons with HED. Phenotypic dental markers of heterozygous females for EDA gene mutation-moderate oligodontia, conical incisors, and delayed dental eruption-are important for individuals giving reliable genetic counseling. Some dental ageneses observed in HED are also encountered in non-syndromic oligodontia. These clinical similarities may reflect possible interactions between homeobox genes implicated in early steps of odontogenesis and the Ectodysplasin (EDA)-NF-kappaB pathway. Craniofacial dysmorphologies and bone structural anomalies are also associated with the phenotypic spectrum of persons with HED patients. The corresponding molecular mechanisms involve altered interactions between the EDA-NF-kappaB pathway and signaling molecules essential in skeletogenic neural crest cell differentiation, migration, and osteoclastic differentiation. Regarding oral treatment of persons with HED, implant-supported prostheses are used with a relatively high implant survival rate. Recently, groundbreaking experimental approaches with recombinant EDA or transgenesis of EDA-A1 were developed from the perspective of systemic treatment and appear very promising. All these clinical observations and molecular data allow for the specification of the craniofacial phenotypic spectrum in HED and provide a better understanding of the mechanisms involved in the pathogenesis of this syndrome.
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Affiliation(s)
- F Clauss
- Department of Pediatric Dentistry, Louis Pasteur University, National French Reference Center for Dental Manifestations of Rare Diseases, University Hospital, place de l'Hôpital, F-67000 Strasbourg, France.
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Dellavia C, Catti F, Sforza C, Grandi G, Ferrario VF. Non-invasive longitudinal assessment of facial growth in children and adolescents with hypohidrotic ectodermal dysplasia. Eur J Oral Sci 2008; 116:305-11. [PMID: 18705797 DOI: 10.1111/j.1600-0722.2008.00550.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Facial growth patterns in 12 subjects (six boys and six girls) with hypohidrotic ectodermal dysplasia (HED) were analyzed and compared with facial growth patterns obtained in healthy reference peers. All subjects with HED were aged 7 yr (mean age +/- standard deviation: 7.08 +/- 0.41 yr) at the first examination and 14 yr (mean age +/- standard deviation: 14.56 +/- 0.34 yr) at the last examination. In each subject, the three-dimensional coordinates of facial landmarks were collected non-invasively at eight subsequent years. The volumes of forehead, nose, maxilla and mandible, upper lips, and lower lips were estimated. For each facial volume, differential values between different time points were calculated individually, separately for the 'childhood' (7-10 yr) and the 'adolescence' (11-14 yr) growth period in both HED and reference subjects. Children and adolescents with HED had a slightly reduced global facial growth in comparison with normal reference peers. The peak mandibular and maxillary development was delayed by approximately 2 yr towards later adolescence. The present non-invasive system seems to be useful for studying longitudinal changes of facial growth in healthy and syndromic subjects.
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Affiliation(s)
- Claudia Dellavia
- Department of Human Morphology, Faculty of Medicine and Surgery, University of Milan, Milano, Italy
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Carmichael RP, Sándor GKB. Use of dental implants in the management of syndromal oligodontia. Atlas Oral Maxillofac Surg Clin North Am 2008; 16:33-47. [PMID: 18319168 DOI: 10.1016/j.cxom.2007.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Robert P Carmichael
- Bloorview Kids Rehab, Suite 2E-285, 150 Kilgour Road, Toronto, Ontario M4G 1R8, Canada.
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