comment on possible prosthetic treatment options

[Deon Ferreira]

To anybody reading this comment - have you been involved restoring an occlusion of a patient suffering from primary ( idiopathic ) failure of eruption. Patient is female 15 years old and pretty. Several attempts to surgically / orthodontically erupt teeth failed, posterior open bite and although upper anterior teeth erupted she shows no teeth at all. Several treatment options available later but interim a problem.

A second patient presents with type of amelogenisis / dentinogenisis imperpecta. No clinical crowns present on all teeth. ( flush with gums ). Radiographically the roots appear normal with totally obliterated root canal systems on all teeth ( no feeling at all ). Brother and sister . Brother is 15 years old and no treatment so far. Sister is 18 and failed treatment attempt .

Thank you. Any comment will be appeciated. Best wishes to all for 2010 - come to the world cup in SA!!!!!

Kind regards

Deon Ferreira

[Ravi Kumar]

Please post photographs and radiographs. I wud like to see profile and front photographs and OPG. Diagnosis depends a lot on those. I had treated a case of Microdontia in a 16yr old female with intentional RCT and Overdenture (cud not go for FPD as teeth were that small).

AI/DI case can be treated with crown extension procedure and FPD........all depending on the prognosis after viewing radiographs / photographs.

Tough cases.......but very satisfying if successful.......best of luck!

[WebDental]

Hello Deon,
The following comments are from James Stein, one of our members on WebDental. He asked that we pass this information on to you. Please feel free to communicate directly with him on the site.

"These are very difficult clinical conditions both from a diagnostic and treatment aspect especially in young patients. Without the benefit of viewing clinical and radiographic documentation an opinion is difficult. You mention a treatment history marked by failed attempts and we will use that as a reference. In the younger 15 year old who is still growing an interim removable prosthesis might be indicated to fufill both functional and esthetic concerns. Long term your options are either a removable prosthesis or ideally dental implants to support either a removable or fixed partial dentures. The selective extraction of all the roots would be advised at the time of implant fixture placement. The prognosis for the retention of these roots with the implant supported prosthesis treatment option just adds an element of unpredictability. Good luck!"