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BDS4 Orthodontics > 9 - Hypodontia > Flashcards

9 - Hypodontia Flashcards

1
Q

Define hypodontia.

A

Congenital absence of one or more teeth

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2
Q

Define anodontia.

A

Complete absence of teeth

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3
Q

Define severe hypodontia.

A

6 or more congenitally absent teeth

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4
Q

What is the prevalence of hypodontia?

A
  • 6% (excluding 8s)
  • F>M
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5
Q

Which teeth are most commonly affected by hypodontia?

A
  • last in the series
  • 8s > L5s > U2s > U5s > lower incisors
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6
Q

3

What is the aetiology of hypodontia?

A
  • non-syndromic: mutation in 3 genes associated, familial or sporadic
  • syndromic: >100 craniofacial syndromes associated, CLP, anhydrotic ectodermal dysplasia
  • environmental: trauma, radio/chemotherapay
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7
Q

4

Describe the presentation of hypodontia.

A
  • delayed or asymmetric eruption
  • retained or infra-occluded deciduous teeth
  • absent deciduous teeth
  • altered tooth form
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8
Q

13

What problems are associated with hypodontia?

A
  • microdontia and malformation of other teeth
  • short root anomaly
  • impaction
  • delayed formation/eruption of other teeth
  • crowding
  • maxillary canine/first premolar transposition
  • taurodontism
  • enamel hypoplasia
  • altered craniofacial growth
  • spacing, drifting
  • overeruption (no interocclusal space for restorations)
  • aesthetic impairment
  • functional problems
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9
Q

Define taurodontism.

A
  • elongated pulp chamber below CEJ
  • usually unproblematic unless endodontic treatment or malformed teeth
  • often seen in 7s
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10
Q

4

What are features of anhydrotic ectodermal dysplasia?

A
  • no sweating
  • malformed teeth
  • microdontia
  • space hair
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11
Q

What is the hypodontia care pathway?

A
  • GDP recognition
  • referral to specialist orthodontist
  • referral to hospital service (MDT with joint assessment and collaboration, especially at transition points in treatment plan)
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12
Q

What is a Kesling planning model?

A

Teeth are removed from model to move around to assess best position

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13
Q

What benefit does CBCT have over plain radiography in hypodontia cases?

A
  • localise any ectopic teeth
  • assess bone volume for implant planning
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14
Q

What are the MDT treatment options for missing upper laterals?

A

Space open
- RBB
- implant
- RPD

Space close
- simple closure
- space close plus

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15
Q

5

What are the benefits of RPDs in hypodontia treatment?

A
  • good soft tissue replacement
  • replace multiple teeth in arch
  • easy to construct
  • non destructive
  • intermediate to other treatment options
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16
Q

5

What are the benefits of RBB in hypodontia treatment?

A
  • simple
  • can be placed at young age
  • non destructive
  • good aesthetics
  • can be placed on semi-permanent basis (ie prior to implant)
17
Q

3

What are the disadvantages of RBB in hypodontia treatment?

A
  • high failure rate (80% in five years)
  • orthodontic retention needs are high
  • RBB in canine position often fail due to high forces and lateral excursion
18
Q

What are the requirements for placing an implant?

A
  • wait until growth stopped, 21+
  • 7mm space between adjacent roots
  • often require bone graft
19
Q

Why do you need to wait until growth has finished to place an implant?

A
  • anterior vertical growth of maxilla
  • if placed too early, implant would not “erupt” with bone and would appear ankylosed
20
Q

What is space close plus?

A
  • package of amendments after closure
  • adjust gingival levels
  • composite bonding
  • tooth colour eg bleaching
21
Q

4

What are the advantages of space close plus?

A
  • no prosthesis
  • low maintenance, reduced restorative burden as not beginning the cycle
  • gingival levels can be adjusted with orthodontics
  • can be done at early age
22
Q

How can the gingival margins be manipulated using orthodontics?

A
  • extrude canine to appear like lateral
  • intrude and rotate premolar to appear like canine (hide second cusp)

BDS4 Orthodontics (14 decks)

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