Congenital hypodontia: treatment suggestions?

Just a shot in the dark since no other posts. Upper and lower Maryland bridge. Make upper with third central in middle. It will not be noticed.

I suggest sectional ortho to close diastema and opening space to restore laterals,later implant supported full mouth rehab.

Hi Dr These are the most challenging cases as the plan needs really to be a 10-15 treatment programme. The approach I take is to minimise the number of implants required and get any teeth that can be maintained into the correct position with the correct vertical dimension and anterior tooth display. To this end, I would discuss this with your orthodontist and paediatric dentist. Full record taking. Temporary (IPC) or mini implants could be used to replace posterior teeth and provide orthodontic anchorage. This would allow positioning of the anterior teeth. A maryland in the lower arch could help with symmetry and OB, OJ. Shortened dental arch at correct VDO using mini-implants until growth over. This is just an outline and I would work closely with others Hope this helps

Make an upper bridge and canter lever the upper Right Lower bridge and cantilever both posterior sections The bridge need not sacrifice too much tooth enamel Make sure she wears a splint at night Final prosthetic solution can be planned in five years Keeps it simple. Saves the kid from adolescent trauma

Hi, I would firstly look at fixed orthodotics to position all the teeth present in the correct location. If the ptient is 13 then you will be waiting until facial rowth is completed (around 21 - 22 for fmeales) before you can even consider implants. Any bone augmentation procedures at this point would be futile. Use composite to re-shape the existing teeth for proper form, Maryland bridges can be used to restore the missing upper laterals but tha would ony give you canine-to-canine aesthetics and you need to seriously consider how to gain posterior support to stabilise the upper anteriors. Your only real option is to provide removable prosthesis. The patient and her parents need to get real about what is needed and what can be provided at this time. Preparing teeth in a child for fixed bridgework is not the best thing to do. As a prosthodontist I would get the opinions of an orthodontist and a pedodontist then have a sit down with them and th patient and her parents. This patient has a good 10 years of continous dental care and there will be set backs so she needs to be primed for that now. If you take this case on then you need be ready for the long haul.

First of all many thanks for this very interesting case.Isuggest 1-orthodontic treatment for space closure with the use of minimplant as an anchorage 2-The use of short implant supported bridge for 7 years until complete facial bone development 3-Ridge augmentation with autogenous bone graft to restore proper hight and width to place implants with suitable length and diameter that can withstand force of mastication and allow getting good esthatics

Complex case for prosthodontist and oral surgeon when growth is complete around age 18. Best determination with serial cephs no growth changes. All this preliminary work, ortho, Marilyn bridges will not be long term solution and cost a lot of money. Due to medical condition may be covered at appropriate time by medical insurance. Final prosthesis will most likely implant supported prosthesis. That said perhaps a snap on smile during school and esthetics only, pt may not tolerate it. Appropriate referral to specialists, your portion hygiene, caries control and family support. Do the right thing with patient's and family's best interest at heart, get them to the right practioner, they will love you for it.