Comprehensive Oral Rehabilitation of a Patient With Dentinogenesis Imperfecta

The treatment of dentinogenesis imperfecta is complex and requires a team approach. The aim of this case report is to describe the steps taken in the long-term rehabilitation of a middle-aged female with dentinogenesis imperfecta with severe attrition. This treatment included an initial temporary treatment to restore esthetic appearance and function followed by a complete prosthetic rehabilitation with implants in the second stage. In advanced stages of dentinogenesis imperfecta, patients can benefit from full-mouth rehabilitation where the deteriorated - yet still present - teeth can be used as abutments for a fixed, temporary restoration throughout the stages of treatment. Detailed pretreatment planning of how much bone and soft tissue are to be removed and an accurate determination of where the implants should be placed must be considered very thoroughly.

All teeth were ultimately extracted and replaced with fixed implant-supported prostheses in a staged approach using remaining teeth for interim support and/or retention of provisional prostheses.

Early and accurate diagnosis of dentinogenesis imperfecta is essential to enable preventive interventions. In many patients, this has not occurred and severe loss of tooth structure, esthetics, and function results. If restorability and prognosis of these teeth are questionable or poor, their replacement with implant-supported fixed or removable prostheses should be the treatment of choice in modern dentistry. Given the appropriate indication and availability of financial means, a fixed solution appears preferable for reasons documented in this case presentation.