NON SYNDROMIC FAMILIAL HYPODONTIA -
A CASE SERIES
preserve the volume of the bone. This will facilitate the
future placement of an implant in favorable locations,
with a reduced need for bone grafting [4,14,16,17].
Cases 1 and 2 displayed little or no resorption of retained
maxillary primary canines at the time of diagnosis. The
short-term plan included retaining all the primary teeth
(53, 52, 62, 63) with the missing permanent successors
(13, 12, 22 and 23) as long as possible until they showed
signs of tooth resorption. This would allow for alveolar
bone growth which would help maintain bone height
for future implant placement.
According to GunaShekhar et al [4], the survival rate of
primary canines without permanent successors might
be long and would provide a functional advantage to
patients with hypodontia or oligodontia.
In cases with permanent maxillary canine agenesis, the
treatment options include:
Orthodontic movement of a premolar into the canine
space and reshaping it to resemble the canine,
esthetically and functionally; creating or retaining the
adequate space in the area of the canine tooth and
placing a prosthetic appliance such as temporary
cemented bridges, resin bonded artificial teeth, or
removable appliances with acrylic teeth to serve as space
maintainers and to improve the patient’s appearance. In
some of these cases, an implant may be placed in the
available space once the child reaches the appropriate
age at the end of the facial growth period [18].
In both Case 1 and 2, the maxillary premolar teeth (14
and 24) were orthodontically moved to the missing
canine (13 and 23) space and reshaped to resemble
maxillary canines. The long-term plan also included
preserving the space for the maxillary lateral incisors
(12 and 22), placing a temporary resin cemented bridge
followed by implant placement in the region once the
facial growth period is completed at approximately 18
years of age.
In Case 3, the space for missing tooth 45 was also retained
for a future implant and the peg shaped maxillary lateral
incisors were built up cosmetically.
The diagnosis of hypodontia should thus be made early
which will help making the patients and parents aware
of the existing condition as well as help in the treatment
planning.
4. Conclusion
Hypodontia is a multifactorial dental anomaly which
may occur in isolation or as part of a genetic syndrome.
The number of missing teeth varies among individuals
and negatively affects esthetics and function. The
most commonly missing teeth are the mandibular
second premolars and maxillary lateral incisors. The
management of this condition is multifactorial and an
early diagnosis can lead to effective treatment planning.
Author contributions
Equal contribution to the paper.
Chandawani for her help and support.
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Acknowledgements
We would like to thank all of the study subjects for
their participation in our research especially Dr. Neeta
56
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