Ectodermal Dysplasia: Management of Knife-Edged Irregular Ridge and Its Rehabilitation with Hybrid Implant Prosthesis

Ectodermal Dysplasia Syndrome (EDS) is mainly X-linked inherited disorder with male predominance. According to Lyon hypothesis, female patients may show partial expression of EDS. Oral findings include hypodontia, rarely anodontia, protuberant lips, hyposalivation, conical teeth and loss of vertical dimension. The alveolar process fails to develop in the three dimensions. Such patients present a challenge to dental treatment due to an irregular residual ridge. This case report presents oral, functional and aesthetic rehabilitation of a 21-year-old female diagnosed with EDS using implants in the anterior maxilla at the sites of the canines bilaterally. Following, implant placement, it was noted that implant in the region of right canine was labially inclined compared to implant in the region of left canine, but both were centered in the ridge. To manage non-parallelism, one-piece titanium framework was fabricated using computer numeric controlled (CNC) machine. Subsequently, tooth and gingival shade ceramics were fired to simulate natural teeth and compensate for gingival deficiency respectively. The treatment described here restored patient's aesthetics, function, self-confidence and status in society.