Beruflich Dokumente
Kultur Dokumente
10.5005/jp-journals-10024-1127
Oral Rehabilitation of a Patient with Amelogenesis Imperfecta using Removable Overlay Denture: A Clinical Report
CASE REPORT
ABSTRACT
Aim: The aim of this study was oral rehabilitation of 17-yearold patient with amelogenesis imperfecta using removable
overlay denture in order to satisfy her esthetic and functional
expectations and enhance her self-image.
Background: Amelogenesis imperfecta (AI) is a group of
genetic disorders that primarily affect the quality and quantity
of amelogenesis in both primary and permanent dentitions. The
main clinical characteristics are severe attrition, tooth sensitivity
and unesthetic appearance.
Case report: This clinical report illustrates the oral rehabilitation
of a 17-year-old girl with hypoplastic-hypomature type of AI with
cobalt-chromium (Co-Cr) overlay removable partial denture
(ORPD) that is one of the most economical and biocompatible
replacements for noble metal and nickel-chromium (Ni-Cr) alloy.
Conclusion: The presented case report suggests that Co-Cr
ORPD can be a good temporary or even permanent treatment
option for AI patients with limited budget, low esthetic concerns
or medical limitations.
Clinical significance: There are major advantages in cast
metal ORPDs; they are simpler, less traumatic and less
expensive than fixed prosthetic options. This case report
supports their use in patients with amelogenesis imperfecta.
Keywords: Amelogenesis imperfecta, Hypoplastic enamel,
Diagnosis, Oral, Denture, Partial, Removable, Case report.
How to cite this article: Ghodsi S, Rasaeipour S, Vojdani M.
Oral Rehabilitation of a Patient with Amelogenesis Imperfecta
using Removable Overlay Denture: A Clinical Report. J
Contemp Dent Pract 2012;13(2):227-231.
Source of support: Nil
Conflict of interest: None declared
INTRODUCTION
Amelogenesis imperfecta (AI) is a hereditary disorder
encompassing a heterogeneous group of developmental
227
S Ghodsi et al
Table 1: Witkop classification of amelogenesis imperfecta
Characteristics of four main amelogenesis imperfecta types
Type
Clinical appearance
Radiographic appearance
Hypoplastic
(type I)
AD, AR X-linked D
AD, AR X-linked D
Hypomaturation
(type II)
Hypocalcified
(type III)
Hypomaturation/
hypoplasia/
taurodontism
(type IV)
CASE REPORT
A 17-year-old girl was referred to the Department of Prosthodontics of Shiraz Dentistry School (Shiraz University of
Medical Sciences, Iran) for treatment of her unpleasant
appearance and dysfunction. Her dental characteristics were
similar to hypoplastic-hypomature type of AI.
Her medical history showed no special problem.
Extraoral examination showed normal facial ratios and
symmetry of the face with convex profile. TMJs and
masticatory muscles were normal. Maximum mouth opening
was in the normal range, and there was no deviation or
deflection in opening or closing. The lymph nodes were
normal. When smiling, her high lip line showed about
6 mm of the cervical gingival tissues (gummy smile).
Intraoral examination revealed severe attrition of all the
teeth, over-retention of the primary teeth, thin enamel layer
and yellowish brown appearance of the teeth. Oral hygiene
was good and there was no calculus on the teeth and no
anterior open bite. The gingiva was normal in color and
appearance. OVD was not decreased (Fig. 1). Radiographic
examination showed multiple permanent teeth impaction
(13, 14, 15, 17, 18, 24, 25, 26, 27, 28, 32, 33, 34, 35, 37, 38,
42, 43, 44, 45, 47, 48), and overretention of the deciduous
teeth (53, 55, 73, 75, 83, 85). The enamel was undetectable
even on the impacted teeth and there was evidence of pulp
stones in the pulp chambers of the teeth (Fig. 2).
Cephalometric radiograph revealed bimaxillary protrusion.
After mounting the casts with facebow in CR, the
proposed treatment plans were as follows:
1. Orthodontic extrusion of the teeth after surgical exposure
and fixed restorative approaches: Mini-implants were
228
Inheritance
AD, AR
AD
JAYPEE
JCDP
Oral Rehabilitation of a Patient with Amelogenesis Imperfecta using Removable Overlay Denture: A Clinical Report
229
S Ghodsi et al
230
JAYPEE
JCDP
Oral Rehabilitation of a Patient with Amelogenesis Imperfecta using Removable Overlay Denture: A Clinical Report
ACKNOWLEDGMENT
The authors would like to thank Dr. Nasrin Shokrpour at
Center for Development of Clinical Research of Nemazee
Hospital for editorial assistance.
REFERENCES
1. Aren G, Ozdemir D, Firatli S, Uygur C, Sepet E, Firatli E.
Evaluation of oral and systemic manifestations in an
amelogenesis imperfecta population. J Dent 2003;31:585-91.
2. Neville BW, Douglass DD, Allen CM, Bonquot JE.
Abnormalities of teeth. Oral and Maxillofacial Pathology.
Pennsylvania: Elsevier (2nd ed). 2004;89-94.
3. Kim JW, Simmer JP, Hu YY, Lin BP, Boyd C, Wright JT.
Amelogenin p.M1T and p.W4S mutations underlying
hypoplastic X-linked amelogenesis imperfecta. J Dent Res 2004;
83:378-83.
4. Seymen F, Kiziltan B. Amelogenesis imperfecta: A scanning
electron microscopic and histopathologic study. J Clin Pediatr
Dent 2002;26:327-35.
5. Aldred MJ, Savarirayan R, Crawford PJ. Amelogenesis
imperfecta: A classification and catalogue for the 21st century.
Oral Dis 2003;9:19-23.
6. Sanjay Saraf. Textbook of oral pathology. Chapter 3:
Developmental disorders of oral and paraoral structure.
Published by gitendarpvig (1st ed). 2006;49-51.
7. Kostoulas I, Kourtis S, Andritsakis D, Doukoudakis A.
Functional and esthetic rehabilitation in amelogenesis imperfecta
with all-ceramic restorations: A case report. Quintessence Int
2005;36:329-38.
8. Crawford PJ, Aldred M, Bloch-Zupan A. Amelogenesis
imperfecta. Orphanet J Rare Dis 2007;4(2):17.
9. Hoppenreijs TJ, Voorsmit RA, Freihofer HP, vant Hof MA.
Open bite deformity in amelogenesis imperfecta (Part 2): Le
Fort I osteotomies and treatment results. J Craniomaxillofac Surg
1998;26:286-93.
10. Ozturk N, Sari Z, Ozturk B. An interdisciplinary approach for
restoring function and esthetics in a patient with amelogenesis
imperfecta and malocclusion: A clinical report. J Prosthet Dent
2004;92:112-15.
11. Sazegara H, Seyedan K, Behnia H, Ghaderi P. Prosthetic and
surgical approach for oral rehabilitation in a patient with
amelogenesis imperfecta: A clinical report. J Dent Tehran Univ
Med Scien Iran 2007;4:92-96.
12. Canger EM, Celenk P, Yensey M, Odyakmaz SZ. Amelogenesis
imperfecta, hypoplastic type associated with some dental
abnormalities: A case report. Braz Dent J 2010;21:170-74.
S Rasaeipour
Prosthodontist, Department of Prosthodontics, School of Dentistry
Shiraz University of Medical Sciences, Shiraz, Iran
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