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BDS4 Orthodontics > Hypodontia > Flashcards

Hypodontia Flashcards

1
Q

What is hypodontia defined as

A

Congenital absence of one or more teeth

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2
Q

What is anodontia defined as

A

Complete absence of teeth

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3
Q

What is severe hypodontia defined as

A

o >6 more congenitally absent teeth
o Permanent teeth
o Doesn’t include third molars

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4
Q

What is severe hypodontia defined as

A

o >6 more congenitally absent teeth
o Permanent teeth
o Doesn’t include third molars

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5
Q

What is the prevalence of hypodontia

A

6%

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6
Q

What are the teeth most effected by hypodontia

A

o 8s (not considered hypodontia however)
o Lower 5s
o Upper 2s
o Upper 5s
o Lower incisors

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7
Q

Why is hypodontia of upper 2’s most problematic

A

 1-2% of population
 Greatest effect on aesthetics
 Associated with ectopic canines as laterals guide canines into position

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8
Q

What can the aetiology of hypodontia be split into

A

non-syndromic
syndromic
environmental

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9
Q

What is a non-syndromic aetiology

A

o Mutations in at least 3 genes associated with missing teeth in non-syndromic hypodontia i.e genetic tendency
o Familial
o Sporadic

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10
Q

What is a syndromic aetiology

A

o Craniofacial syndromes associated with hypodontia
o Examples: cleft lip & palate, anhidrotic ectodermal dysplasia

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11
Q

What is an environmental aetiology

A

o Trauma
o Radiotherapy/chemotherapy

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12
Q

What is the presentation of hypodontia

A
  • Delayed/asymmetric eruption
  • Retained or infraoccluded deciduous teeth
  • Absent deciduous teeth
  • Tooth form – more of a conical morphology, tend to be smaller
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13
Q

What are the associated problems with hypodontia

A
  • Microdontia!!!!!!
  • Malformation of other teeth
  • Short root anomaly
  • Impaction
  • Delayed formation and/or delayed eruption of other teeth
  • Crowding and/or malposition of other teeth
  • Maxillary canine/first premolar transposition
  • Taurodontism
  • Enamel hypoplasia
  • Altered craniofacial growth
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14
Q

What are potential problems caused by hypodontia

A
  • Spacing
  • Drifting
  • Overeruption
  • Aesthetic impairment
  • Functional problems (usually requires quite a few teeth missing to reach this stage)
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15
Q

What is the hypodontia pathway

A

GDP recognition
Referral to specialist orthodontist

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16
Q

What are the options for upper lateral incisor hypodontia

A

accept
restorative alone
orthodontics alone
combined orthodontic and restorative treatment

17
Q

What can the treatment pathways be split into

A

open the space
close the space

18
Q

What are the options if we open the space

A

RRB
implant - gold standard
autotransplantation
partial denture
conventional bridge

19
Q

What are the resin retained bridge used

A

cantilever

20
Q

What is the gold standard abutment for RRB

A

canine due to root length, crown dimensions and reduced shine through

21
Q

What are the advantages of RRB

A

o Simple
o Can do when young
o Non-destructive
o Can look good
o Can be placed on a semipermanent basis while px reaches appropriate age for implant (20/21 as requires vertical growth of alveolar processes to stop)

22
Q

What are the disadvantages of RRB

A

o Failure rate
o Appearance sometimes not good
o Orthodontic retention needs are high to prevent relapse

23
Q

What is the minimum age for implants

A

18-19
vertical growth of alveolar process must stop

24
Q

What is the minimum space for implant

A

7mm
gingival level

25
Q

How must the roots be for implants

A

Root separation required – roots must be parallel and not be leaning into the space the implant is to go into

26
Q

What is often required to facilitate implants in hypodontia cases

A

bone graft

27
Q

What are the disadvantages of implants

A
  • Technically very demanding in aesthetic zone
  • Significant extra time and cost required
28
Q

What are the options if closing the space

A

accept space closure
close space and treat to make teeth look as natural as possible

29
Q

How do you get a canine to look like a lateral

A

o Individualised extrusion of canine re-gingival contour height relative to U1
o Significant reshape of U3 – cusps flattened
o Bleaching U3 due to natural yellow shade of canine

30
Q

How do you get a premolar to look like a canine

A

o Intrude U4 to give correct gingival architecture
o Rotate to take up more space
o Composite built up/veneer U4 to restore vertical height and get it to resemble canine

31
Q

What are the advantages of close space plus

A

o No prosthesis – relatively low maintenance
o Good aesthetics with appropriate orthodontic and restorative techniques
o Can be done at an early age

BDS4 Orthodontics (10 decks)

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