The management of severe hypodontia. Part 1: considerations and conventional restorative options

Abstract

Severe hypodontia is the absence of six or more permanent teeth and is relatively uncommon (estimated prevalence of 0.1-0.2%). This condition may have considerable functional, aesthetic and psychological implications for the patient, as well as presenting a significant challenge for the restorative dentist. There are a number of additional dental and craniofacial features that are seen frequently in patients with severe hypodontia that may complicate the provision of restorative treatment. These patients typically present at a young age and are likely to require lifelong support from the dental team. Initially this may be limited to oral health education and delivery of effective preventative regimes in childhood. Where required, missing teeth may be replaced using conventional removable and fixed prosthodontics as well as implant retained restorations. This article, part one of a two-part series, deals with the assessment of patients and factors to consider when treatment planning for the provision of conventional restorative solutions in severe hypodontia.

Management of Patient with Hypodontia: Review of Literature and Case Report

“…6) The teeth are associated with taurodontism: enlarged pulp chambers apical displacement of the bifurcation or trifurcation of roots [34]. 7) Most of the cases are associated with maxillary sinuses pneumatisation [34].…”

“…Hypodontia may be associated with craniofacial features such as: 1) Retrognathic maxilla/protrusive mandible [34].…”

“…Complex treatment is likely to require attendance at numerous appointments over a lengthy period, as well as ongoing commitment to the maintenance of oral health and repeat treatment in the future. It is important that the patient understands this long-term picture and is prepared to take responsibility for their oral health [34].…”

“…In general severe hypodontia itself is not associated with a heightened caries risk unless it is seen as part of a syndrome, such as ectodermal dysplasia of which xerostomia is a feature [34]. Caries risk should be assessed since the most useful indication of future caries risk is previous caries experience [41].…”

“…It is important to access these factors when planning restorative treatment as there may be a need to increase the lower face height and reorganize the occlusal scheme for both functional and aesthetic reasons [34].…”