J Adv Prosthodont.  2016 Jun;8(3):241-250. 10.4047/jap.2016.8.3.241.

Rehabilitation of a patient with non-syndromic partial oligodontia

• Kang HG
• Huh YH
• Park CJ
• Cho LR

• KMID: 2376851
• DOI: http://doi.org/10.4047/jap.2016.8.3.241

Abstract

Oligodontia is defined as a congenital tooth agenesis with the absence of six or more permanent teeth. This clinical report describes a patient with non-syndromic partial oligodontia, with retained deciduous teeth and the absence of 16 permanent teeth. Anterior esthetic problems were caused by interarch tooth size discrepancy, interdental space, aberrant tooth dimensions, and the absence of centric contacts of the anterior teeth. Prosthetic restoration after orthodontic and implant treatment was performed with a multi-disciplinary team approach. Favorable functional and esthetic results were obtained using a definitive prosthesis.

Keyword

Anterior guidance; Congenital tooth agenesis; Interarch tooth size discrepancy; Oligodontia

MeSH Terms

Humans
Prostheses and Implants
Rehabilitation*
Tooth
Tooth, Deciduous

Figure

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  Fig. 1 Panoramic radiograph.

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  Fig. 2 Pre-operative intraoral photographs. (A) Maxillary occlusal view, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Mandibular occlusal view.

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  Fig. 3 (A) Anterior tooth size discrepancy. Bolton anterior ratio = 85.3%, (B) Kesling setup.

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  Fig. 4 Orthodontic treatment. (A) Pre-orthodontic treatment, (B) Post-orthodontic treatment.

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  Fig. 5 Diagnostic wax-up. (A) Resting, (B) Smile, (C) Esthetic design of the planned crown. Red lines represent the ideal cervical margin. Blue lines represent the incisal edge of maxillary incisors, (D) Soft tissue contour design. Red lines represent the ideal cervical margin. Blue "T" represents the zenith of the planned anterior crowns. White lines represent the natural balance of gingival levels, (E) Diagnostic waxing after soft tissue contour design, (F) Interarch tooth size discrepany (2 mm) indicated by the Bolton anterior ratio.

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  Fig. 6 CBCT images. Narrow ridge and inadequate bone width of both maxillary deciduous lateral incisor and mandibular left deciduous canine areas.

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  Fig. 7 Distance between the cervical margin of the crown and the planned implant position.

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  Fig. 8 Implant surgery procedures. (A) Bucco-lingual bone thickness of mandibular left canine region, (B) Implant placement of mandibular left canine, (C) Extraction of both maxillary deciduous canines, (D) Implant placement of both maxillary canines, (E) Provisional restorations. Note the concave emergence profile.

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  Fig. 9 Provisional restorations. (A) Immediately after implant placement in canine areas, (B) First provisional restoration, (C) Second provisional restoration.

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  Fig. 10 Impression procedures. (A) Preliminary impression, (B) Customized pick-up impression coping and customized tray, (C) Capturing both peri-implant and pontic gingival contours, (D) Definitive impression.

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  Fig. 11 (A) Fabrication of zirconia coping, (B) Trial placement.

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  Fig. 12 Resin infiltration. (A) Pre-orthodontic treatment, (B) Post-orthodontic treatment, (C) After resin infiltration.

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  Fig. 13 Definitive prosthesis. (A) Working side during right lateral excursion, (B) Maxillary occlusal view, (C) Non-working side during right lateral excursion, (D) Left lateral view at centric occlusion, (E) Frontal view at centric occlusion, (F) Right lateral view at centric occlusion, (G) Non-working side during left lateral excursion, (H) Mandibular occlusal view, (I) Working side during left lateral excursion.

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  Fig. 14 Periapical radiographs. (A) Implant placement, (B) Provisional restoration, (C) Recall check after 18 months.

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