Amelogenesis imperfecta: report of a successful transitional treatment in the mixed dentition

The term amelogenesis imperfecta is applied to a clinically heterogeneous group of hereditary disorders that interfere with the normal development of dental enamel. These disorders cause a deficiency in the enamel's quantity and/or the quality that may result in poor dental esthetics. The purpose of this paper was to describe a case of hypoplastic amelogenesis imperfecta in an 8-year-old girl whose dissatisfaction with the appearance of her teeth led to impaired social functioning. Since the patient was in the mixed dentition stage, a temporary treatment aiming to improve dental esthetics, preserve oral function, and allow for the recovery of the patient's self-confidence was performed by a multidisciplinary team.

Oral management of a child with mixed dentition affected by amelogenesis imperfecta

Amelogenesis Imperfecta (AI) is a hereditary developmental disorder affecting deposition, calcification or maturation of dental enamel in both the primary and permanent dentitions. Patients usually present tooth sensitivity as well as problems in chewing function and esthetics. In addition, dissatisfaction with the teeth appearance is often found, affecting the patient's social life. Oral rehabilitation of children with primary or mixed dentition is complex, since no definitive treatment can be done during periods of growth and until the end of eruption of the permanent dentition is accomplished. This clinical report describes the oral management of a 7-year-old girl with mixed dentition affected by AI. The patient showed accentuated teeth wear and root resorption, decreased occlusal vertical dimension, open bite and alteration in the sequence of eruption of permanent teeth. Most of the teeth were restored with resin modified glass ionomer cement. This approach markedly decreased the patient's dental hypersensitivity and improved functional chewing and esthetics. Positive psychological influence of the treatment on this patient was also observed.

The psychosocial impact of developmental dental defects in people with hereditary amelogenesis imperfecta

BACKGROUND

Amelogenesis imperfecta (AI) is a hereditary dental condition with poor esthetics and dental sensitivity that frequently requires extensive dental treatment. The authors hypothesized that AI is associated with a negative psychosocial outcome.

METHODS

Family members with and without AI completed a questionnaire including demographic and dental history questions, as well as a number of psychometric scales. The authors investigated the effects of AI status (with versus without), sex and age on each of the psychosocial outcomes using a generalized linear model.

RESULTS

Subjects with AI (n = 30) had higher levels of social avoidance and distress, as well as higher levels of dysfunction, discomfort and disability attributable to their oral condition compared with subjects without AI (n = 29). The relationship of AI status to fear of negative evaluation, mastery and self-esteem was age-dependent. Younger subjects with AI tended to have higher fear of negative evaluation scores, while older subjects without AI tended to have higher fear of negative evaluation scores. Additionally, subjects without AI showed a definite decrease in mastery and self-esteem scores with age, while subjects with AI tended to show an increase in mastery and self-esteem scores with age.

CONCLUSIONS

These results indicate that having AI has a marked impact on the psychosocial health of affected people comparable with the impact of systemic health conditions, especially at younger ages.

CLINICAL IMPLICATIONS

Dental coverage for AI traditionally is excluded by third-party payers as being solely for esthetic reasons. The authors' study shows that AI has marked psychosocial effects, which suggests that dental treatment could be medically necessary and has far-reaching implications for the affected person's overall health.

A retrospective study of the prosthodontic management of patients with amelogenesis imperfecta

PURPOSE

This article reports on a retrospective study on patients with a diagnosis of amelogenesis imperfecta and on their prosthodontic management, oral health status, and attitudes toward their condition.

MATERIALS AND METHODS

The study comprised 15 patients and consisted of a clinical evaluation and questionnaire. Clinical examination included records of types of restorations and cements used, rating of restoration quality, as well as complications and periodontal variables.

RESULTS

The 15 patients had a total of 213 prosthetic restorations. The median age of the restorations was 60 months. Following the California Dental Association's system, all restorations were rated as acceptable to excellent, with one exception. During the follow-up period, four (2%) restorations had been recemented and 16 (8%) restorations had been redone, five (2%) because of porcelain fractures and 11 (5%) because of caries; two (1%) endodontic treatments were performed after prosthetic restoration. Plaque and Bleeding Indices were 28% and 21%, respectively, while pocket depths of more than 3 mm were found at 7% of all tooth surfaces. All patients judged their condition as having affected them negatively. However, after prosthodontic rehabilitation, patients experienced an improvement in self-esteem.

CONCLUSION

Patients with severe clinical manifestations of amelogenesis imperfecta obtained extensive prosthodontic treatment at an early age. The restorations had in general performed well, and all patients were affected positively as a result.