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BDS4 Orthodontics > Hypodontia > Flashcards

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 teeth are most affected by hypodontia

A
  • 8s
  • L5s
  • U2s
  • U5s
  • lower incisors
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5
Q

aetiology of hypodontia

A
  1. Non-syndromic
    - mutations in at least 3 genes associated with missing teeth in non-syndromic hypodontia
    - familial
    - sporadic
  2. Syndromic
    - >100 craniofacial syndromes assoc with hypodontia
  3. Environmental
    - trauma
    - radio/chemo therapy
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6
Q

presentation of hypodontia

A
  • delayed or asymmetric eruption
  • retained/infra occlused primary teeth
  • absent primary tooth (permanent tooth germ develops from primary)
  • tooth form
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7
Q

associated problems with hypodontia

A
  • microdontia
  • malformation of other teeth
  • short root anomaly
  • impaction
  • delayed formation and/or delayed eruption other teeth
  • crowding and/or malposition of other teeth
  • max canine/first premolar transposition
  • taurodontism (enlarged pulp chambers)
  • enamel hypoplasia
  • altered craniofacial growth
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8
Q

name a syndrome associated with hypodontia

A

anhydrotic ectodermal dysplasia
- absent sweat glands
- hair thin
- absent lower teeth

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9
Q

potential problems of hypodontia

A
  • spacing
  • drifting
  • over-eruption
  • aesthetic impairment
  • functional problems
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10
Q

Tx option for this case:
- absent U2s
- ectopic canines
- midline diastema

A
  1. extraction URb, ULb
  2. sectional fixed appliance to close space between UR1 and UL1
  3. allows eruption UR3 and UL3
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11
Q

keys to successful management of hypodontia cases

A
  • inter-disciplinary team
  • joint assessment and tx planning with precise aims
  • joint collaboration at transitional stages of tx
  • follow up of treated cases
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12
Q

investigations for hypodontia

A
  • study models
  • planning models
  • radiographs
  • photographs
  • CBCT
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13
Q

options for missing lateral incisors

A
  • accept
  • restorative alone
  • ortho alone
  • combined restorative and ortho
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14
Q

ortho options for missing upper lateral incisors

A

Open space
- RBB
- autotransplantation
- implant
- partial denture
- conventional bridge

Close space
- simple
- space closure plus

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15
Q

how to chose tx option

A
  1. satisfies expected aesthetic objectives
  2. least invasive
  3. satisfies expected functional objectives
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16
Q

how to chose tx option

A
  1. satisfies expected aesthetic objectives
  2. least invasive
  3. satisfies expected functional objectives
17
Q

what has happened here

A

labial rotation of lateral incisor cantilever pontics due to mesial relapse of canines

18
Q

if using a RBB to replace missing incisor, which tooth would you use as the abutment

A

canines if possible
- root lenght
- crown dimensions
- less shine through

19
Q

advantages of RBBs

A
  • relatively simple
  • do when young
  • non-destructive
  • can look good
  • place on semi-permanent basis e.g. until old enough for implant
20
Q

disadvantages of RBBs

A
  • failure rate
  • appearance sometimes not goot
  • ortho retention needs are high
21
Q

how much space is needed for an implant

A

7mm

22
Q

RBB vs implant

A
  • can’t do implant til 18-19 yrs old
  • need minimum 7mm
  • root separation
  • often need bone graft
  • technically very demanding in aesthetic zone (metal work can be visible due to recession)
  • significant extra time to do
  • cost high
23
Q

how can you help aesthetics if doing simple space closure

A
  • disguising canines as laterals with composite
  • disguising premolars as canines with composite
24
Q

what would space closure plus include

A

adjusting:
- tooth shape/size
- tooth colour
- gingival architecture

25
Q

how do you make a canine look like a lateral

A
  • indiidualized extrusion of canine re gingival contour height relative to U1
  • significant reshape U3
  • bleaching U3
26
Q

how do you make a first premolar look like a canine

A
  • intrude U4 to give correct gingival architecture
  • rotate to take up more space
  • composite build up or veneer U4 to restore vertical height and “caninise” the U4
27
Q

how do you make a first premolar look like a canine

A
  • intrude U4 to give correct gingival architecture
  • rotate to take up more space
  • composite build up or veneer U4 to restore vertical height and “caninise” the U4
28
Q

advantages of space closure plus

A
  • no prosthesis - relatively low maintenance
  • good aesthetics with appropriate ortho and restorative techniques
  • can be done at an early age
29
Q

keys to successful management of hypodontia

A
  • inter-disciplinary team (joint appointment)
  • joint assessment and tx planning with precise aims
  • joint collaboration at transitional stages of tx
  • follow up of treated cases

BDS4 Orthodontics (2 decks)

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