Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: 16 Feb 2023

A Multidisciplinary Approach for Full-Mouth Rehabilitation in Oligodontia: A Clinical Report

DDS,
MD,
DDS,
MD, PhD, and
DDS, PhD
Page Range: 124 – 129
DOI: 10.1563/aaid-joi-D-21-00290
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The absence of teeth in children due to congenital agenesis, syndromic or not, could lead to oral dysfunctions with general repercussions and sociopsychological problems. This case was a 17-year-old girl with severe nonsyndromic oligodontia who was missing 18 permanent teeth and had a class III skeletal pattern. It was challenging to provide functional and esthetically pleasing results in terms of temporary rehabilitation during growth and long-term rehabilitation in adulthood. This case report described the originality of the realization steps of oligodontia management, in 2 main parts. The osseous time by the LeFort 1 osteotomy advancement with simultaneous parietal and xenogenic bone grafting to improve a large bimaxillary bone volume, allowing future early implant placement by absence of growth of adjacent alveolar processes. The prosthetic rehabilitation with the conservation of natural teeth for proprioception and the use of a screw-retained polymethyl-methacrylate immediate prostheses to evaluate the needed vertical dimensional changes and make functional and esthetic results more predictable. This article could be retained as a technical note to manage this kind of case with the intellectual workflow and the difficulties encountered.

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Figure 1.

Preoperative panoramic X ray.


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Figure 2.

(a) LeFort 1 type of orthognathic maxillary advancement surgery combined with a bone graft in bimaxillary apposition by unilateral parietal sampling. (b) Placement of the occlusal interposition tray and bimaxillary locking on temporarily removable partial denture (6 mm advance) by 2 anchoring screws after completion of the maxillary overhang. (c) Lateral cephalometric jaw radiograph before orthognathic procedure. (d) Lateral cephalometric jaw radiograph after orthognathic procedure.


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Figure 3.

Postimplant surgery panoramic X ray.


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Figure 4.

(a) Multiunit abutments (MUAs) in place after mucosal cicatrization; maxillary view. (b) MUAs in place after mucosal cicatrization; mandibular view.


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Figure 5.

Occlusion of the molars after vertical augmentation.


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Figure 6.

Management of the fabrication of the polymethyl methacrylate (PMMA) prostheses according to implant placement.


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Figure 7.

(a) Fitting on a plaster model. (b) Cosmetic fitting and checking the smile line.


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Figure 8.

(a) Fitting of the zirconia framework. (b) Maxillary and mandibular view, with control of occlusion and implant access shafts.


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Figure 9.

First trial in of the sintered prostheses.


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Figure 10.

Final model with ceramics at the 3-month check-up.


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Figure 11.

Five-year follow-up panoramic X ray.


Contributor Notes

Corresponding author, e-mail: estelle.demes@hotmail.fr
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