Integration of Digital Denture Technology in the Prosthodontic Management of Pediatric Osteopetrosis: A Case Report

Osteopetrosis is a rare hereditary disorder characterized by impaired osteoclastic bone resorption, resulting in generalized skeletal sclerosis, increased bone fragility, and a heightened risk of complications such as osteomyelitis. Prosthodontic rehabilitation in pediatric patients is particularly challenging due to ongoing craniofacial growth, incomplete dental development, and the need to avoid invasive procedures. A pediatric patient with osteopetrosis presented with mandibular Kennedy Class I, Modification I partial edentulism, misalignment of the maxillary teeth, and dentition at varying stages of development. A conservative removable prosthodontic approach was selected. Following tissue conditioning, a functional "washout" impression using a soft liner was performed to record the supporting tissues while minimizing pressure. To permit flexibility and future modification during growth, a removable partial denture (RPD) without a metal framework was fabricated. The impression surface was digitized using an intraoral scanner (TRIOS, 3Shape, Copenhagen, Denmark). The scan data guided computer-aided design and milling of a new RPD from a monolithic polymethyl methacrylate (PMMA) disk (Ivotion, Ivoclar Vivadent AG, Schaan, Liechtenstein). The tissue-borne prosthesis was extended to maximize support and contoured around the canines to provide encirclement and reciprocation, enhancing stability and retention while reducing stresses on abutment teeth. The digitally fabricated denture demonstrated an accurate intaglio fit, minimal intraoral adjustments, and improved esthetics and masticatory function. Its design allowed repeated tissue conditioning, incremental adaptation, and modifications to accommodate craniofacial growth. All digital scans were archived, enabling longitudinal superimposition to monitor growth-related changes and facilitate early identification of pressure areas or sites at risk for osteomyelitis. Recall appointments were essential for growth adjustments and monitoring. Within the limitations of this case, an acrylic resin RPD without a metal framework represents a functional and adaptable interim solution for pediatric patients with osteopetrosis. The integration of digital workflows supports long-term follow-up and early complication detection during growth.