Osseointegration orthodontics : interdisciplinary treatment in patients with Ectodermal Dysplasia

OBJECTIVES: This work focuses on the clinical features, inheritance patterns, pathogenesis, early detection and on the importance of a multidisciplinary management of ectodermal dysplasia. MATERIALS: This is genetic birth defect has origin during the fetal life, probably around the third or fourth month, because of a failure of the growth. Dysmorphic facial features included prominent supraorbital ridges, saddle nose deformity, protuberant lips, depresses midface. The typical intraoral findings show anodontia, hypodontia, misshapen teeth, conical teeth, generalized spacing, taurodontia, super numerary teeth, neonatal teeth, natal teeth, retained primary teeth, enamel hypoplasia, and lack of an alveolar ridge. METHODS: This study has utilized 33 patients divided into two experimental groups: the former included 13 E.D. patients, 9 men and 4 women, aged 15 to 25; the latter consisted of 20 patients, 12 men and 8 women, aged 14 to 24, with missing teeth because of agenesis, extractions, or trauma. In all the patients have been inserted osseointegrated titanium implants rehabilitating them from both esthetical and functional points of view. The two groups had poor esthetics, reduced occlusal vertical dimension, decreased alveolar bone, malocclusions. RESULTS: The clinical investigation has demonstrated that the osseointegration rates of implant fixtures in the jawbones of E.D. patients approaches that of non-E.D. edentolous patients. CONCLUSIONS: The E.D. patients showed a lack of alveolar bone both in height and in width, above all the mandibular ridge often presented a knife-edge contour, which make difficult ideal implants placement and needed a multidisciplinary approach. It is possible to insert osseointegrated implants also in E.D. patients on the ground of study data.