A Retrospective 3- to 5-Year Study of the Reconstruction of Oral Function Using Implant-Supported Prostheses in Patients With Hypohidrotic Ectodermal Dysplasia
The aim of this study was to evaluate oral function rehabilitation in patients with hypohidrotic ectodermal dysplasia (HED) using implant-supported prostheses based on bone augmentation. From September 2005 and March 2009, 25 HED patients were chosen for clinical data analysis in this study. The criteria for patient selection included the following: the display of clinical features of HED, the number of congenitally missing teeth (>5), the patient age (>16 years), the patient's willingness, and the patient's tolerance for bone graft surgery and implant placement. Follow-up evaluations were initiated from the time of implant prosthetic placement and scheduled annually for 3–5 years. The effects of oral function reconstruction were assessed based on the cumulative survival and success rates of implants, the health of the peri-implant area, and the degree of patient satisfaction. Twenty-five HED patients received 169 conventional implants and 10 zygomatic implants (179 total implants). During 3–5 years of post-loading evaluations, 5 of the 179 implants failed and 3 implants were removed. The 3-year success and cumulative survival rates were 97.2% and 98.3%, respectively. Furthermore, periodontal probing and radiographic assessments showed that the 3-year incidence of peri-implantitis was 4.5%. Finally, HED patients expressed high degrees of satisfaction with their facial contours, masticatory function, pronunciation ability, and comfort with the implant-supported prostheses. The results of this 3- to 5-year retrospective study indicate that the oral function of HED patients can be effectively reconstructed using bone augmentation and implant-supported prostheses; however, longer term results are warranted in the future.
The mean scores for the gingival and plaque indices through 3–5 years of follow-up assessment were <1.0. (a) Gingival index scores: 0 = no inflammation; 1 = mild inflammation, slight change in color, and little change in texture; 2 = moderate inflammation, moderate glazing, redness, edema hypertrophy, and bleeding on probing; and 3 = severe inflammation, marked redness and hypertrophy, tendency to spontaneously bleed, and ulceration. (b) Plaque index scores: 0 = no plaque; 1 = plaque was not visible to the unaided eye, but when the tip of a probe was run across the gingival margin, a thin film of plaque was observed; 2 = moderate accumulation of soft deposits at the gingival margin and/or on the tooth surface visible to the naked eye; and 3 = abundance of soft matter at the gingival margin, in the gingival pocket, and on the surface of the tooth. BL indicates baseline (implant placement).
The crestal bone values were the mean changes measured from baseline (in mm) through 3–5 years of follow-up evaluation of implants. Error bars indicate SE values. The value at each error bar indicates the number of implants evaluated at that interval.
Clinical procedure for restoring oral function in hypohidrotic ectodermal dysplasia patients with hypodontia using conventional implant-supported fixed prosthetic replacement. (a–c) Examination of patient characteristics using oral, hand, and panoramic X rays. (d–f) Placement of implants. (g–k) Implant-supported fixed prosthetic rehabilitation. (l–m) Front and side pictures following reconstruction.
Clinical procedure for restoring oral function in hypohidrotic ectodermal dysplasia patients with anodontia using zygomatic implants and conventional implant–supported fixed prosthetic replacement. (a–f) Evaluation of patient characteristics using oral, body surface, and panoramic X rays and computerized tomography. (g–j) Bone augmentation using autogenous bone grafting from the ilium and distraction osteogenesis. (k–o) Placement of implants. (p–r) Implant-supported fixed prosthetic rehabilitation. (s–t) Front and side pictures following reconstruction.
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