W8: Hypodontia and Orthodontics

Question 1

Definition:

Answer 1

“Hypodontia is the developmental absence of one or more deciduous or permanent teeth , excluding the third molars.”

Question 2

Hypodontia is classified based on severity:

Answer 2

• Mild hypodontia: 1 or 2 missing teeth
• Moderate hypodontia: 3 to 6 missing teeth
• Severe hypodontia/oligodontia: more than 6 missing teeth
• Anodontia : complete absence of teeth in one or both dentitions

Question 3

Answer 3

Mild hypodontia: 1 or 2 missing teeth

Question 4

Answer 4

Moderate hypodontia: 3 to 6 missing teeth

Question 5

Answer 5

Severe hypodontia/oligodontia:
more than 6 missing teeth

Question 6

Prevalence

Answer 6

• More than 80% of people affected have mild hypodontia.
• 10% or less have moderate hypodontia.
• Less than 1% have severe hypodontia.

Question 7

Etiology:

Answer 7

Question 8

Frequency of missing teeth in Caucasians

Answer 8

Question 9

Syndromes associated with hypodontia

Answer 9

1. Cleft lip and palate
2. Ectodermal dysplasias
3. Oral-facial-digital syndromes
4. Incontinentia pigmenti
5. Down syndrome
6. Wiktop syndrome
7. Van der Woude syndrome
8. Ehlers-Danlos syndrome

Question 10

Dental anomalies commonly associated with hypodontia

Answer 10

Question 11

Dx

HISTORY – CLINICAL EXAMINATION

Answer 11

1. Abnormalities in the eruption of teeth
2. Prolonged retention of deciduous teeth
3. Inconsistencies in eruption timing between contralateral teeth more than 6 months
4. Deviation from the normal eruption sequence
5. Generalized delay in dental development

Question 12

Dx

RADIOGRAPHIC EXAMINATION

Answer 12

Panoramic radiograph

Question 13

IMPACT OF UNTREATED HYPODONTIA

Answer 13

• Hypodontia can affect everyday activities.
• It has been shown to reduce quality of life for those affected due to detrimental effects on appearance , function , and psychosocial well-being .

Question 14

Aims of treatment

Answer 14

To satisfy the needs of each growth period

• Mastication – nutrition
• Esthetics
• Psychological well-being

To establish optimum background for the final rehabilitation

• Abnormal maxillofacial growth pattern is anticipated due to genetic predisposition and lack of teeth.

Question 15

Protocol structure: 3 successive stages

Answer 15

1st (introductory) stage

• up to the construction of the first interim prosthesis

2nd stage

• childhood and adolescence

3rd (final) stage

• begins with adulthood

Question 16

1st (introductory) stage

Answer 16

First interim prosthesis:

• Usually removable partial or complete denture
• Simple, conservative, adaptable and replaceable

Question 17

2nd stage

Answer 17

Question 18

3rd stage

Answer 18

Question 19

Definite Tx plan

Answer 19

Question 20

The treatment protocol for the management of oligodontia/anodontia:

Answer 20

• Respects the uniqueness of each case and the changing conditions and needs,
• provides a wide but solid frame for treatment delivery,
• the members of the multidisciplinary team are able to focus on their specific treatment goals under a holistic perspective.

Question 21

Special protocols may apply for the management of special patients.

Answer 21

In patients with ectodermal dysplasia dental implants for managing severe hypodontia or anodontia may be used early for psychological reasons although permanent rehabilitation will take place in early adulthood.