Clinical Difficulties and Solutions at Concomitant Hypo-Hyperdontia

Abstract

Purpose: The low frequency of concomitant hypo-hyperdontia and the lack of established clinical protocols in treatment are our motives to analyse our experience in three different clinical cases and derive principles of clinical behaviour. Material and methods: Analysis of the documentation of the 2886 patients, from which three clinical cases were with CHH: case 1 – agenesis of the second upper primary molars and hyperdontia of the upper left lateral; case 2 – Hyperdontia of the upper primary and permanent left lateral and hypodontia of the lower left second premolar; case 3 - two supernumerary (left and right) canines and hypodontia of the lower right second premolar. Results: From all the patients diagnosed and treated by us, hypodontia was found in 7.38% (excluding third molar hypodontia); hyperdontia in 1.9% and only 0.1% have concomitant hypo-hyperdontia. In the three patients, hyperdontia occurs in the frontal segment, and the phenomenon of hypodontia covers the distal segments. Discussion: Following the treatment plans of all three clinical cases, the following stereotype is required as a treatment approach: Solving the problem of hyperdontia (extraction); Levelling dental arches; Solving the problem of hypodontia - placement of implants or closing the space; Retention. In practice, it is found that the solution starts with a relatively smaller problem - hyperdontia, especially in cases where we have access to these teeth. The more serious obstacle is hypodontia, which, if unilateral, leads to disruption of the occlusal ratios. Conclusion: CHH is a rare problem, and the treatment is long, and its favourable outcome depends on early diagnosis.