Hypodontia Flashcards
What is hypotonia?
The congenital absence of one or more teeth
What is anodontia?
Complete absence of teeth
What is classes as severe hypodontia?
6 or more congenitally absent teeth
What are the most commonly affected teeth in hypodontia?
Lower 5s
Upper 2s
Upper 5s
What are common clinical findings alongside missing upper laterals
Ectopic canines are common in these cases
What is the aetiology of hypodontia?
Can be non syndromic - mutations in at least 3 genes (familial or sporadic).
Or syndromic - associated with craneofacial syndromes eg. CLP, anhydrotic ectodermal dysplasia.
Or can be environmental - eg trauma to primary, radiotherapy/ chemotherapy
What is anhydrotic ectodermal dysplasia?
Craneofacial syndrome which results in abnormalities in tooth from (pointed shape), hypodontia and disrupted temperature control (excess sweating).
What is the common presentation of hypodontia?
Delayed or asymmetric eruption
Retained or infra occluded teeth
Absent deciduous teeth
Tooth form altered
What are some dental problems associated with hypodontia?
Microdontia
Malformation of other teeth
Short root anatomy
Imp action
Enamel hypoplasia
Taurodontism
What is taurodotnism?
Elongated pulp chamber (below floor of CEJ), common in 7s, makes endo difficult.
What are some potential problems caused by hypodontia?
Spacing and drifting (unfavourable gaps for restorative treatment)
Overeruption of teeth into gaps
Aesthetic immpairement
Functional impairment if severe
When should hypodontia cases be referred?
When complete absence of space for tooth eruption, abnormalities in sequence, severely infraoccluded teeth.
What causes teeth to be infraoccluded?
Ankylosis to alveolar bone gives the appearance tooth is submerged compared to adjacent teeth and gingiva wich are growing normally).
Who is involved in MDT care of hypodontia patient?
GDP
Specialist orthodontis
Pads dentist
Restorative dentist
What are the management options for hypodontia
Accept
Restorative only
Ortho only
Combined ortho and restorative
What is involved in the assessment for treatment planning of hypodontia?
Ortho - skeletal pattern, crowding, occlusion
Restorative - size of centrals, space in occlusion for pros work, smile line
What is involved with restorative management?
Partial denture - if multiple spaces, soft tissue replacement, can be used until gingiva settles.
Resin bonded bridges - often provide with bonded retainer to ensure no movement of teeth, simple treatment, non destructive, good aesthetics although not ideal if high smile line.
Implant - good success rate although complications are difficult if failure.
In pt with missing upper laterals, what is a common treatment option?
Resin bonded bridge, using canine as abutment
Why is canine an ideal abutment for resin bonded cantilever bridges?
Root length and Crown dimensions are favourable
Less shine through than central incisors.
What are the requirements for implant placement?
Minimum 7mm space
Cannot place until 21 yo
Need sufficient space (between roots) and sufficient bone
Significant cost
