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Interdisciplinary management of Type 3 oligodontia: A retrospective case series
Glen J Liddelow1, Steven L Singer2, Brent P Allan3
1Consultant Prosthodontist, Craniofacial Department, Perth Children's Hospital, Perth, Western Australia, Australia.
Statement Of Problem:
Type 3 oligodontia is the most dentoalveolar deficient manifestation of congenital tooth absence. There is a need to rehabilitate these children functionally and esthetically to improve quality of life.
Purpose:
The purpose of this retrospective case series was to evaluate the short- and intermediate-term outcomes of the dental treatment provided in a children's hospital and to develop a sequential interdisciplinary treatment planning protocol from infancy to the completion of jaw development.
Material And Methods:
A total of 10 patients were included in this retrospective longitudinal case series report. Different interventions had been carried out at times related to growth and development of the jaws. Implant-supported fixed dental prostheses were provided after the lateral growth of the anterior mandible had stabilized at around 12 years of age. Definitive mandibular prostheses were provided after the cessation of growth and following maxillary treatment. Treatment for the maxilla was more complex. Bone grafted and graftless implant-supported fixed prostheses were offered as alternatives to a complete denture. Implant stability and soft tissue response were evaluated at prosthesis removal.
Results:
Seven patients received a 4-implant and 2 a 5-implant-supported immediately loaded fixed mandibular prosthesis. One patient elected to maintain the interim complete denture. Of the 38 implants, 2 failed and were satisfactorily replaced. In the maxilla, 4 patients elected to maintain a complete denture, and 6 received a maxillary implant-supported fixed prosthesis: 1 with bilateral sinus lift bone grafting and 6 regular implants; 1 with 6 regular implants; 1 with 4 regular implants; 2 with bilateral zygoma implants plus 2 regular anterior implants; and 1 with 4 zygoma implants. No implant failures were recorded in the maxilla. Follow-up for mandibular treatment ranged from 1 to 12 years and for maxillary treatment 1 to 9 years. All implants were classified as asymptomatic and surviving.
Conclusions:
The use of fixed implant-supported prostheses in selected individuals with Type 3 oligodontia can improve functional and esthetic outcomes as compared with the use of removable prostheses alone. Implant-supported prostheses require an interdisciplinary approach from early childhood until growth cessation.
