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CASE REPORT
Year : 2013  |  Volume : 2  |  Issue : 1  |  Page : 64-66

A simplified prosthodontic approach for a nonsyndromic oligodontia patient


1 Department of Prosthodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
2 Department of Oral Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India

Date of Web Publication13-Mar-2013

Correspondence Address:
Oliganti Swetha Hima Bindu
Department of Prosthodontics, SIBAR Institute of Dental Sciences, Takellapadu, Guntur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-8632.108520

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  Abstract 

The term 'Hypodontia' refers to the developmental absence of one or more teeth, either in primary or permanent dentition, excluding the third molars. It is the most common craniofacial malformation. If six or more permanent teeth are missing, the term 'Oligodontia' is used. Oligodontia creates significant challenges to the clinicians in both diagnosis and management. Comprehensive management often requires a multidisciplinary approach. The ability to address this condition during the early stages of the dentition maximizes the potential for a treatment with functional, esthetic, and stable results. This case report presents prosthodontic management of a case of nonsyndromic Oligodontia of a 15-year-old female patient. Apart from the condition of Oligodontia, the age and compliance of the patient posed a greater difficulty during the treatment procedures. The management was possible only through multidisciplinary approach, which included oral surgery, restorative and prosthodontic specialties.

Keywords: Hypodontia, multidisciplinary approach, nonsyndromic, oligodontia, permanent teeth, primary teeth


How to cite this article:
Gopinadh A, Neelima Devi KN, Hima Bindu OS, Zakkula S. A simplified prosthodontic approach for a nonsyndromic oligodontia patient. J NTR Univ Health Sci 2013;2:64-6

How to cite this URL:
Gopinadh A, Neelima Devi KN, Hima Bindu OS, Zakkula S. A simplified prosthodontic approach for a nonsyndromic oligodontia patient. J NTR Univ Health Sci [serial online] 2013 [cited 2020 Apr 7];2:64-6. Available from: http://www.jdrntruhs.org/text.asp?2013/2/1/64/108520


  Introduction Top


Oligodontia is a condition where missing teeth are more than six. [1] The occurrence of nonsyndromic Oligodontia is a most common phenotype. [2] The etiology of Oligodontia can be genetic or environmental. Mutations in the EDA gene have also been reported in some cases of nonsyndromic Oligodontia patients. [3]

Hindrances like modern hospital facilities with postsurgical intensive care units, surgical skills, and financial burden for the patients, [4] compel most of the patients to opt for conventional prosthodontics. We report here a case of a nonsyndromic Oligodontia patient treated successfully by prosthetic rehabilitation with conventional over dentures.


  Case Report Top


A 15-year-old female presented to the postgraduate prosthodontic clinic at SIBAR institute of dental sciences, Guntur seeking comprehensive esthetic dental rehabilitation. A review of the patient's past medical history revealed no associated syndrome. On clinical examination reduction in lower facial height, marked nasolabial angle and procumbent lip contours, maximal interocclusal space 48-50 mm were observed [Figure 1]. Intraoral examination revealed underdeveloped premaxilla with a total of 23 congenitally missing teeth (excluding the third molars) except permanent first molars in all quadrants [Figure 2]. Panoramic radiograph showed the presence of impacted 27. Permanent tooth buds were not present [Figure 3].
Figure 1: Preoperative picture of the patient

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Figure 2: Preoperative intraoral picture

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Figure 3: OPG and preliminary mouth preparation

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Treatment planning procedures

Following a comprehensive clinical charting and assessment of the panoramic radiographs, preliminary study casts were made. The patient was referred to Department of Oral and Maxillofacial surgery for the extraction of the retained molar in relation to the maxillary arch. Removable over dentures were planned for both functional and esthetic dental rehabilitation. Tentative maxillomandibular record was made along with face bow index (Hanau Spring bow, Teledyne Water Pik, Fort Collins, CO, USA) to mount the cast on a Hanau wide Vue semiadjustable articulator (Hanau, Teledyne Water Pik) to assess the space available.

The abutment teeth considered were 16, 26, 36, and 46. After the endodontic therapy, the abutment teeth were prepared to receive metal copings. Prior to cementation, the copings were disinfected and cementation procedure was carried on using a luting agent [Figure 4]. After 3 days the patient was evaluated for the condition of the cemented copings and final impressions made with Elastomeric impression material (Affinis), and maxillomandibular relations were established. Esthetics and phonetics checked in try in stage, finished prosthesis is delivered to the patient [Figure 5].
Figure 4: Cemented metal copings over the prepared abutment teeth

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Figure 5: Intra oral view of completed overdentures

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Follow up care

Patients with overdenture are at increased risk of dental caries. [5] This patient was advised to regularly clean the prostheses. Fluoride applications to the intaglio surface of the denture were advised. Three to six-month hygiene recall visits were scheduled to maintain and reinforce home care performance and also to clinically assess the need to reline, rebase, or remake prosthesis.

The final outcome of the treatment gave satisfactory function and appearance, which seemingly improved her self-confidence [Figure 6].
Figure 6: Postoperative photos of the patient

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  Discussion Top


Restorative and prosthetic treatment options for Oligodontia include over dentures, conventional complete dentures, implant supported over dentures, Treatment partial dentures and implant fixed prosthesis. Treatment of the adolescent patient requires special considerations. Beyond the psychological features of the younger patient and the concerns of the parents, facial growth is a prominent concern. Any treatment should reflect the needs of the growing patient. [6] Endosseous implants placed in young patients act as ankylosed teeth resulting in infraocclusion of the restorations or if the implants are fixed together can cause jaw growth disturbances. [7] The placement of implants in the growing maxilla should be avoided until early adulthood. [3] In contrast, the lack of teeth in these patients is often associated with a developmental failure of alveolar bone, resulting in an apparent atrophy of the ridge. [8] Finnema et al. reported an overall implant survival rate of 86% and 96% for the maxilla and mandible, respectively, in Oligodontia patients (grown patients). [4]


  Conclusion Top


Overdenture supported by natural teeth or implants have been described in the literature in the treatment of patients with Oligodontia, restores ideal occlusion, increases the vertical dimension, improves facial esthetics, and restores the self image of these patients. [9] Clinical observations from case reports revealed no evidence of growth restrictions induced by the overdenture treatment. [10] Conventional prosthodontic treatment was chosen for this patient rather than dental implants because of the continued growth of face, atrophic maxilla, and poor economic status.

 
  References Top

1.Reagan SE, Dao TM. Oral rehabilitation of a patient with congenital partial anodontia using a rotational path removable partial denture: Report of a case. Quintessence Int 1995;26:181-5.  Back to cited text no. 1
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2.He X, Shu W, Kang Y, Li Z, Zhang J, Kari K, et al. Esthetic and functional rehabilitation of a patient with nonsyndromic oligodontia: A Case report from China. J Esthet Restor Dent 2007;19:137-42.  Back to cited text no. 2
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3.Thalji GN, Cooper LF. The Role of Complete Overdentures in Esthetic Rehabilitation of the Adolescent Oligodontia Patient. A Case Report. J Esthet Restor Dent 2010;22:213-22.  Back to cited text no. 3
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4.Finnema KJ, Raghoebar GM, Meijer HJ, Vissink A. Oral Rehabilitation with Dental Implants in Oligodontia Patients. Int J Prosthodont 2005;18:203-9.  Back to cited text no. 4
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5.Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH, Mericske-Stern R. Prosthodontic Treatment for Edentulous Patients. 12 th ed., Mosby: Elsevier publications. co, 2004. p. 160-76.  Back to cited text no. 5
    
6.Tripodakis AP. Congenital Partial Anodontia: Prosthodontic Considerations. Int J Prosthodont 1968;1:175-80.  Back to cited text no. 6
    
7.Westwood RM, Duncan JM. Implants in adolescents: A literature review and case reports. Int J Oral Maxillofac Implants 1996;11:750-5.  Back to cited text no. 7
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8.Gunbay T, Koyuncu BO, Sipahi A, Bulut H, Dundar M. Multidisciplinary Approach to a Nonsyndromic Oligodontia Patient Using Advanced Surgical Techniques. Int J Periodontics Restorative Dent 2011;31:297-305.  Back to cited text no. 8
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9.Tarjan I, Gabris K, Rozsa N. Early prosthetic treatment of patients with ectodermal dysplasia: A clinical report. J Prosthet Dent 2005;93:419-24.  Back to cited text no. 9
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10.Bonilla ED, Guerra L, Luna O. Overdenture prosthesis for oral rehabilitation of hypohidrotic ectodermal dysplasia: A case report. Quintessence Int 1997;28:657-65.  Back to cited text no. 10
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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   Abstract
  Introduction
  Case Report
  Discussion
  Conclusion
   References
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