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Table of Contents
REVIEW ARTICLE
Year : 2020  |  Volume : 8  |  Issue : 3  |  Page : 43-44

Ectodermal dysplasia and prosthodontic management


1 College of Dentistry, King Faisal University, Al Ahsa, Kingdom of Saudi Arabia
2 Department of Pedodontics & Preventive Dentistry, Mahe Institute of Dental Sciences & Hospital, Chalakara, Mahe, Union Territory of Puducherry, India

Date of Submission28-Aug-2020
Date of Acceptance06-Sep-2020
Date of Web Publication28-Sep-2020

Correspondence Address:
Prof. Binoy Mathews Nedumgottil
College of Dentistry, King Faisal University, PO Box 400, Al-Hofuf, Al-Hassa
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_37_20

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  Abstract 

Ectodermal dysplasia (ED) is commonly a complicated condition to manage with prosthodontics, typically because of the oral deficiencies and the afflicted individuals being quite young, when they are evaluated for treatment. These individuals must receive dental treatment at an early age for physiologic and psychosocial reasons. This review of the literature pertains to the prosthodontic management of dental disorder in ED patients.

Keywords: Dental anomalies, ectodermal dysplasia, fixed prosthodontics, implant prosthodontics, prosthodontic management, removable prosthodontics


How to cite this article:
Nedumgottil BM, Sam S. Ectodermal dysplasia and prosthodontic management. Int J Oral Care Res 2020;8:43-4

How to cite this URL:
Nedumgottil BM, Sam S. Ectodermal dysplasia and prosthodontic management. Int J Oral Care Res [serial online] 2020 [cited 2020 Oct 22];8:43-4. Available from: https://www.ijocr.org/text.asp?2020/8/3/43/296228




  Introduction Top


Ectodermal dysplasia (ED) is a group of disorders displaying two or more of the symptoms of trichodysplasia, dental anomalies, onychodysplasia, and dyshidrosis. It is usually described as being hypohidrotic or hidrotic, depending on the degree of sweat gland function.[1] Congenital malformation of teeth, hair, nails, or sweat glands may occur either as a single isolated malformation or as a part of an ED syndrome. Anhidrotic ED is considered to be a triad of hypodontia or anodontia, hypotrichosis, and hypohidrosis, and associated with other components that result from defective development of structures of ectodermal origin.[2]


  Clinical Features Top


  • Absence or incomplete or delayed development of one or more appendages derived from epidermal tissue or oral ectodermal origin during embryogenesis


  • Abnormal hair—scanty, fine, light hair on scalp, and eyebrows (hypotrichosis)


  • Abnormal or missing teeth (hypodontia, oligodontia, or anodontia)


  • Abnormal nails (onchodysplasia)


  • Abnormal or missing sweat glands (dyshidrosis)[3]


  • Other associated features include pronounced supraorbital ridge and frontal bossing, depressed nasal bridge, protuberant everted lip due to decreased facial vertical dimension.


  • Oral findings often are significant which may include anodontia, hypodontia, malformed, and widely spaced peg like teeth, protuberant lips, loss of occlusal vertical dimension, and underdeveloped alveolar ridge. With little or no dental support, a hypoplastic maxilla and mandible result in bite collapse and narrowing of the alveolar ridges.[4]


      Prosthodontic Management Top


    Removable prosthodontics

    Removable prosthesis is the most commonly reported treatment modality for the dental management of ED. In childhood, removable partial denture (RPD), complete denture, and overdenture are the most appropriate treatment options, because of the necessity to modify the intraoral prosthesis during rapid growth periods.[5],[6] These treatment options provide the ED patient and his/her family to have an effective, affordable, easy, and reversible method of oral rehabilitation. Cooperation of the patient and family is a crucial factor for the removable prosthesis to have a successful prognosis. Rationally, complete dentures are an acceptable form of treatment, overdenture, or RPD supported by natural teeth desirable for preservation of alveolar bone. Problems like loose dentures, loss of proprioception, and bone resorption can be resolved using overdenture.[7],[8],[9],[10]

    Fixed prosthodontics

    Fixed prosthodontic treatment is rarely used in the management of ED primarily because majority of afflicted individuals have a minimal number of teeth and ED patients are quite young when they are first treated. In addition, fixed partial dentures with rigid connectors should be eliminated in young, actively growing patients as they may interfere with jaw growth, especially if the prosthesis crosses the midline. Individual crown restorations have no age restrictions related to jaw growth, but larger pulp chamber and shorter crown height may cause concern.[11],[12] Crowns and direct composite restorations are often used in combination with RPDs in the prosthodontic management of these patients.

    Implant prosthodontics

    In ED patients, a 90% success rate is observed at second-stage surgery. There is an improvement in the physiologic and psychosocial function of adult patients. Dental implant treatment provides a beneficial impact on the preservation of alveolar bone. The most widely used implant design in prosthodontic management is root form dental implants. In treatment planning for implant dentistry in these patients, extra care must be taken to determine whether the available bone is adequate to receive the implants.[13] A cone-beam tomography will be ideal to determine the quantity and quality of bone. Diminished bone volume may limit the success of implants, especially in the maxilla.[13]


      Conclusion Top


    The nature of ED has been described with special emphasis on prosthodontic management. For a good prognosis, a multidisciplinary approach in diagnosis, treatment planning, and dental management is mandatory to regain esthetics and function of the stomatognathic system. Depending on the age, different rehabilitation options can be considered, from classic conventional solutions such as a complete denture, RPD, and overdenture to the most advanced implant-supported prosthesis. In ED patients, these early dental interventions with regular follow-up can improve aesthetics, restore functions, and address psychological issues.

    Financial support and sponsorship

    Nil.

    Conflicts of interest

    There are no conflicts of interest.



     
      References Top

    1.
    Kaul S, Reddy R Prosthetic rehabilitation of an adolescent with hypohidrotic ectodermal dysplasia with partial anodontia: Case report. J Indian Soc Pedod Prev Dent 2008;26:177-81.  Back to cited text no. 1
        
    2.
    Gupta S, Tyagi P Prosthodontic management of anhidrotic ectodermal dysplasia. Indian J Dent Res 2011;22:348-51.  Back to cited text no. 2
        
    3.
    Kramer FJ, Baethge C, Tschernitschek H Implants in children with ectodermal dysplasia: A case report and literature review. Clin Oral Implants Res 2007;18:140-6.  Back to cited text no. 3
        
    4.
    Kearns G, Sharma A, Perrott D, Schmidt B, Kaban L, Vargervik K Placement of endosseous implants in children and adolescents with hereditary ectodermal dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:5-10.  Back to cited text no. 4
        
    5.
    Pigno MA, Blackman RB, Cronin RJ Jr, Cavazos E Prosthodontic management of ectodermal dysplasia: A review of the literature. J Prosthet Dent 1996;76:541-5.  Back to cited text no. 5
        
    6.
    Guckes AD, Scurria MS, King TS, McCarthy GR, Brahim JS Prospective clinical trial of dental implants in persons with ectodermal dysplasia. J Prosthet Dent 2002;88:21-5.  Back to cited text no. 6
        
    7.
    Pinheiro M, Freire-Maia N Ectodermal dysplasias: A clinical classification and a causal review. Am J Med Genet 1994;53:153-62.  Back to cited text no. 7
        
    8.
    Tarjan I, Gabris K, Rozsa N Early prosthetic treatment of patients with ectodermal dysplasia: A clinical report. J Prosthet Dent 2005;93:419-24.  Back to cited text no. 8
        
    9.
    Ramos V, Giebink DL, Fisher JG, Christensen LC Complete dentures for a child with hypohidrotic ectodermal dysplasia: A clinical report. J Prosthet Dent 1995;74:329-31.  Back to cited text no. 9
        
    10.
    Guckes AD, McCarthy GR, Brahim J Use of endosseous implants in a 3-year-old child with ectodermal dysplasia: Case report and 5-year follow-up. Pediatr Dent 1997;19:282-5.  Back to cited text no. 10
        
    11.
    Cronin RJ Jr, Oesterle LJ, Ranly DM Mandibular implants and the growing patient. Int J Oral Maxillofac Implants 1994;9:55-62.  Back to cited text no. 11
        
    12.
    Mascoutah IL Parameters of oral health care for individuals affected by ectodermal dysplasia syndromes. Muncie, Indiana: National Foundation for Ectodermal Dysplasias; 2003. p. 1-28.  Back to cited text no. 12
        
    13.
    Tetsch P, Ackermann KL, Behneke N, Galandi M, Geis-Gerstorfer J, Kerschbaum TH, et al. Proceedings of a concensus conference on implantology, October 18, 1989, Mains, West Germany. Int J Oral Maxillofac Implants 1990;5:182-7.  Back to cited text no. 13
        




     

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      In this article
       Abstract
      Introduction
      Clinical Features
       Prosthodontic Ma...
      Conclusion
       References

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