Hypodontia

Question 1

List 3 reasons why hypodontia is relevant to GDP’s in patient management?

Answer 1

Know when to refer to specialist
GDP’s carry out treatment requested by orthodontist
Lifetime maintenance of patient

Question 2

What is classed as SEVERE hypodontia?

Answer 2

6 or more congenitally absent teeth

Question 3

Anodontia definition?

Answer 3

Complete absence of teeth
Very rare

Question 4

What are the most commonly affected teeth in hypodontia? (most to least common)

Answer 4

8’s
Lower 5’s
Upper 2’s
Upper 5’s

Question 5

What syndromes are associated with hypodontia?

Answer 5

CLP
Down syndrome
Ectodermal dysplasia
Hurler’s syndrome

Question 6

Name 10 associated problems with hypodontia

Answer 6

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

Question 7

What is the definition of taurodontism?

Answer 7

Elongated pulp chamber where the floor of the pulp is below the ECJ

Question 8

What are potential problems that could occur from lack of teeth due to hypodontia?

Answer 8

Spacing
Drifting of other teeth
Over-eruption
Infra-occlusion primary teeth
Aesthetic impairment
Functional impairment
Psycho-social effects

Question 9

What is the age, if an E has lasted until, will it last the rest of a patient’s life?

Answer 9

20

Question 10

What are options for missing upper lateral incisors?

Answer 10

Accept
Fixed restorative - bridge, implant
Removable pros - denture, essix retainer with pontic
Ortho tx. alone
Combined ortho and restorative treatment

Question 11

What are the necessities for implants?

Answer 11

Need minimum 7mm space
Can’t do implant until growth has ceased 21+
May need bone graft

Question 12

What is the environmental aetiology of hypodontia?

Answer 12

Trauma
Radiotherapy/ chemotherapy

Question 13

What is the syndromic aetiology of hypodontia?

Answer 13

Ectodermal dysplasia
CLP
Down’s syndrome
Hurler’s syndrome

Question 14

What is the non-syndromic aetiology of hypodontia?

Answer 14

Familial
Genetic mutations associated with missing teeth

Question 15

What is an early intervention for missing permanent upper lateral incisors?

Answer 15

Extraction primary B’s
Sectional fixed appliance to close space between upper centrals
Allows eruption of permanent canines

Question 16

What clinical presentation might indicate hypodontia?

Answer 16

Delayed or asymmetric eruption
Retained or infra-occluded deciduous teeth
Absent deciduous tooth (if no primary = no permanent)
Tooth form

Question 17

What are some examples of open space hypodontia treatment?

Answer 17

RBB
Partial dentures
Implants

Question 18

Name 5 members of the MDT who might be involved in hypodontia patient care?

Answer 18

Paediatric dentist
GDP
Orthodontist
Restorative dentist
Prosthodontist

Question 19

What is the incidence of hypodontia in the UK?

Answer 19

6%

Question 20

What is the incidence of missing primary teeth?

Answer 20

<1%