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BDS4 Orthodontics > Hypodontia > Flashcards

Hypodontia Flashcards

1
Q

What is hypodontia?

A

congenital absence of one or more teeth

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2
Q

What is anodontia?

A

complete absence of teeth

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3
Q

What is considered severe hypodontia?

A

6 or more congenitally absence in teeth

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4
Q

What is the prevalence of hypodontia (excluding 8s)

A

approximately 6%

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5
Q

What teeth are most commonly affected by hypodontia?

A
  • 8s
  • lower 5s
  • upper 2s
  • upper 5s
  • lower incisors
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6
Q

What is the prevalence of missing upper laterals and what can this be associated with?

A
  • 1-2%
    • approximately 20% of all missing teeth
    • most hypodontia cases
  • associated with ectopic canines
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7
Q

What is the aetiology of hypodontia?

A
  • non-syndromic
    • mutations in at least 3 genes
      • associated with missing teeth
    • familial
    • sporadic
  • syndromic
    • > 100 craniofacial syndromes associated
      • cleft lip and palate
      • anhydrotic ectodermal dysplasia
  • environmental
    • trauma
    • radiotherapy or chemotherapy
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8
Q

How does hypodontia present?

A
  • delayed or asymmetrical eruption
  • retained or infra-occluded deciduous teeth
  • absent deciduous tooth
  • tooth form
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9
Q

What are the possible associated problems with hypodontia?

A
  • microdontia
  • malformation of other teeth
  • short root anomaly
  • impaction
  • delayed formation or eruption of other teeth
  • crowding or malposition of other teeth
  • maxillary canine/first premolar transposition
  • taurodontis,
  • enamel hypoplasia
  • altered craniofacial growth
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10
Q

What are the potential problems associated with hypodontia?

A
  • spacing
  • drifting
    • reduction in space for prosthetic
    • unfavourable sized spaces
    • centreline shift
  • over-eruption
    • reduction in space for prosthetic
  • aesthetic impairment
  • functional problems
    • particularly with multiple missing teeth
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11
Q

What is the hypodontia care pathway?

A
  • GDP recognition
    • especially infraocclusion
  • referral to specialist orthodontist
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12
Q

What are the keys to successful management of hypodontia?

A
  • inter-disciplinary team
  • joint assessment and treatment planning
    • precise aims
  • joint collaboration at transitional stages
  • follow up of treated case
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13
Q

What does assessment and planning for management of a hypodontia case involve?

A
  • history
  • extraoral examination
  • intraoral examination
    • orthodontic aspects
      • skeletal relationship
      • crowding
    • restorative aspects
      • size of central incisors
      • space in occlusion
      • caries
      • smile line
  • investigations
  • problem list
  • definitive plan
  • retention/maintenance
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14
Q

What investigations should be carried out for hypodontia cases?

A
  • study models
  • planning models
    • Kesling
    • diagnostic
  • radiographs
  • photographs
  • cone beam CT
    • volume of bone available
    • abnormal tooth forms
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15
Q

What are the options for replacement of missing upper lateral incisors?

A
  • accept
  • restorative alone
  • orthodontics alone
  • combined orthodontic and restorative treatment
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16
Q

What does combined orthodontic and restorative treatment involve?

A
  • space open
    • resin bonded bridge
    • implant
    • partial denture
  • space closed
    • simple closure
17
Q

What should an orthodontic treatment plan consider?

A
  • satisfied expected aesthetic objectives
  • least invasive
  • satisfies expected functional objectives
    • immediate
    • long term
      • 65+ years
18
Q

What is the most common replacement for missing teeth in hypodontia cases?

A

resin bonded bridges

19
Q

How can resin bonded bridges be used for hypodontia cases?

A
  • better success rates with cantilevers
  • ideal abutment is canine
    • root length
    • crown dimensions
    • less shine through of metal retainer
  • technique sensitive
    • grade
    • experience of operator important
20
Q

What are the advantages of resin bonded bridges?

A
  • relatively simple
  • can be carried out when young
    • complete treatment
  • non-destructive
  • can provide good aesthetics
  • placed on a semi-permanent basis
21
Q

What are the disadvantages of resin bonded bridges?

A
  • relatively high failure rate
    • 18% at 5 years
    • if survived at 5 years will make 10
  • appearance not always idea
    • can attempt again
    • different material
    • must wait 3 months
      • gingival re-contouring
  • orthodontic retention needs are high
  • poorer success rates in canine position
    • canine guidance
      • forces applied
22
Q

What can be used to determine the space available for an implant?

A
  • gauge
  • radiograph
  • CBCT
23
Q

What are the key differences between resin bonded bridges and implants?

A
  • can’t do implants until growth has finished
    • 21+
  • need minimum 7mm space for implants
  • root separation
  • often need to bone grafting for implants
  • placed in a technically demanding zone
    • highly aesthetic zone
  • implants take significantly more time
  • implants are significantly more expensive
24
Q

What must be considered during space closure?

A
  • tooth shape and size
  • tooth colour
  • gingival architecture
25
Q

How can a canine be made to look like a lateral, incisor?

A
  • individual extrusion of canine
    • gingival contour height
    • relative to upper central
  • significant reshape of upper canine
    • accompanied by bleaching
      • canine naturally darker
      • external bleaching
    • cusps flattened
26
Q

How can a first premolar be made to look like a canine?

A
  • intrude upper premolar
    • correct gingival architecture
  • rotate to take up more space
  • composite build up or veneer
    • restore vertical height
    • ‘caninise’
27
Q

What are the advantages of space closure plus?

A
  • no prosthesis
    • relatively low maintenance
  • good aesthetics
    • appropriate orthodontic and restorative
  • can be done at an early age
28
Q

What are the keys to successful management of hypodontia?

A
  • interdisciplinary team management
  • joint assessment and treatment planning
    • precise aims
  • joint collaboration at transitional stages
  • follow up of treated cases

BDS4 Orthodontics (8 decks)

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