NON SYNDROMIC FAMILIAL HYPODONTIA - A CASE SERIES
Case Report
Figure 9 . Orthopantomogram , father . Figure 10 . Orthopantomogram , AA .
visit with no chief complaints . Her medical history was unremarkable with no systemic conditions or syndromes . Dental History : An extra-oral examination revealed a convex profile with an increased over-jet ( 5 mm ) and the patient ' s skin and hair were found to be normal in texture and appearance . The intraoral examination showed the child to be in the mixed dentition stage ( Fig . 1-5 ). Multiple teeth , namely 55 , 54 , 53 , 63 , 64 , 65 , 73 , 84 ( FDI Notation system ) had proximal carious lesions which were detected clinically and confirmed by the initial bitewing radiographs ( Fig . 6 , 7 ). Tooth 74 was noted to be non-restorable . A comprehensive dental treatment plan was formulated and discussed with the parent , which included restoration of the carious teeth with composite restorations and extraction of tooth 74 . The patient however did not return back for any treatment for almost one year , despite repeated attempts to contact them . Upon the child ’ s return for treatment at 9 years of age , a new dental assessment was conducted which included an orthodontic consultation due to the Class II malocclusion with the increased over-jet . A routine panoramic radiograph was thus taken which revealed agenesis of teeth 13 , 12 , 22 , 23 and 32 ( Fig . 8 ). The corresponding primary teeth ( 53 , 52 , 62 , 63 ) were retained with no radiographic evidence of tooth resorption or mobility . Tooth 72 had exfoliated and teeth 31 , 41 and 42 were present . Based on the history and clinical findings , a diagnosis of non-syndromic hypodontia was made . A comprehensive treatment plan using a multidisciplinary approach was formulated in order to restore both esthetics and function and discussed with the father . The short-term plan included restoration of the carious teeth and maintaining the retained primary teeth ( 53 , 52 , 62 63 ) until they showed clinical or radiographic signs of exfoliation on routine follow up appointments . The long term orthodontic plan would then be initiated which would involve extraction of all the retained primary teeth , moving the maxillary premolar teeth ( 14 and 24 ) into the respective canine spaces and reshaping them to resemble the maxillary canines ( 13 and 23 ). The space for the missing maxillary lateral teeth would be preserved . Once orthodontic treatment was completed , a resin retained bridge would be fabricated to replace 12 and 22 as a temporary measure until implants could be placed once the child turns 18 years of age . Due to the diagnosis of the hypodontia , a detailed medical history was obtained from the parent which revealed a non-consanguineous marriage , with no history of genetic conditions in both parents . The child was the third oldest among four children . The
Figure 11 . Intraoral frontal view post-op , AA .
Figure 12 . Upper occlusal view post-op , AA .
Figure 13 . Lower occlusal view post-op , AA .
father agreed to a panoramic radiographic evaluation of himself and was advised to bring in the remaining children for a thorough dental evaluation to detect familial hypodontia . The father ’ s radiograph showed spacing in the upper arch , no congenitally missing teeth and a history of extraction of tooth 26 ( Fig . 9 ). The two older children ( Cases 2 and 3 ) however had congenitally missing teeth . The youngest child was 2
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Stoma Edu J . 2018 ; 5 ( 1 ): 52-57 http :// www . stomaeduj . com