Osseointegrated Supported Prosthesis and Interdisciplinary Approach for Prosthodontic Rehabilitation of a Young Patient with Ectodermal Dysplasia

Abstract

Anhidrotic ectodermal dysplasia is a triad of hypodontia or anodontia, hypotrichosis, and hypohydrosis, associated with other problems that result from the defective development of structures of ectodermal origin (Freire-Maia, Pinheiro (1988)). Early and extensive dental treatment is needed keeping in mind the effect on the craniofacial growth. Due to rapid growth of the jaws, the patients are rehabilitated using removable prostheses (Tarjan et al. (2005)). Hence for a young patient in this case report, the placement of endosseous osseointegrated implants was delayed till adulthood. Finally a definitive fixed tooth-supported and osseointegrated implant supported fixed partial denture therapy was used to rehabilitate the patient satisfactorily after she had completed her growth (Sweeney et al. (2005)). A review of the current literature relevant to several aspects of syndromic hypodontia, patient selection, and implant planning is discussed.

Prosthetic rehabilitation of patients with hypohidrotic ectodermal dysplasia: A systematic review

“…Eight case reports and two case series described the long‐term care of 17 HED‐individuals (14 males, 3 females) with several prosthetic follow‐up treatments (Table ); the case report by Bergendal 1991 with a follow‐up of 9 years was described again by Bergendal 2015 with a follow‐up of 29 years. At the time of first described prosthetic rehabilitation, the patients were 6 (3/11.6) years old.…”

“…The extraction of firm, non‐carious teeth and the subsequent provision of a full denture, as described by Jain et al 2010, does not appear to be a warrantable procedure to the authors. A consistent attendance comprising oral hygiene, denture adaptation and renewal, and a stepwise approach to treatment goals, serves as a basis for treatment success. Renewal of full‐ or overdentures has to be expected after 1‐3 years, and renewal of partial dentures after one to 6 years …”

“…31 Removable devices were replaced by new ones every 2.5 (1/5) years. Three individuals were monitored until adulthood, 83,88 and received fixed teeth-and/ or implant-supported dentures at the age of 20-22 years. In three individuals presented in the case series Sfeir et al, 89 mini implants were used to either attach single or linked crowns or to retain a removable mandibular denture.…”

Oral rehabilitation with removable dental prosthesis in a six-year-old patient with hypohidrotic ectodermal dysplasia

“…Treatment should be initiated as early as possible so that the increased resorption or atrophy of the alveolar ridges, attributable to the complete or partial absence of teeth, can be reversed. Additionally, early treatment allows for the VDO to be controlled or stabilized [11,15]. The psychological and esthetic-related issues become more apparent to the patient as they progress through the stages of childhood development.…”

Prosthodontic Management of Children with Ectodermal Dysplasia: Review of Literature

“…Year Reported Gender Age Dentition Treatment Nandini Y [55] 2013 M 14 Oligodontia Removable partial denture with metal crown on existing teeth Aydinbelge et al [56] 2013 F 7 Oligodontia Maxillary overdenture and implant supported mandibular overdenture Kalaskar et al [57] 2013 F 7 Oligodontia Flexible denture overdenture Sadashiva et al [58] 2013 F 14 Oligodontia Overdenture Ladda et al [59] 2013 M 8 Anodontia Complete denture Paulus et al [60] 2013 M 6 Oligodontia Maxillary and mandibular implant borne prosthetic Jain et al [61] 2012 M 11 Oligodontia Maxillary flexible overdenture and mandibular conventional complete denture Singer SL [62] 2012 M 11 Oligodontia RPD in maxilla and implant supported prosthesis in maxilla Shigli et al [46] 2012 M 10 Oligodontia Removable partial denture Bildik et al [63] 2012 M 14 Oligodontia upper teeth with copings and fabrication of upper and lower complete dentures El Osta et al [64] 2011 F 9 Oligodontia Preformed pediatric crown with Removable partial denture followed by orthodontic treatment and fixed prosthesis after 8 years Manuja et al [65] 2011 treatment to regain esthetics and function of the stomatognathic system. Considering the age, different rehabilitation options can be considered, from classic conventional solutions such as complete denture, removable partial denture, overdentures and to the most up to date implant supported prosthetics.…”