Wednesday, 1 February 2017

Hypodontia Study Day 2017

The Kings Hypodontia study day is being held on the 19th of April at Kings College Hospital. This course is aimed at trainees and specialty grades but is likely to provide some useful information to consultants involved in the management of the condition that may be looking at updating the evidence base for decision making. 

Important issues such as definitions and aetiology and the need for joint planning will be presented followed by management of the mixed dentition and orthodontic considerations. Towards the end of the day techniques in adhesive dentistry such as the utilisation of composite and resin bonded bridges will be described. The last presentation will review the need for implants and considerations when providing these. 

Information on registering and attendance will be provided on the below link. 

Monday, 9 January 2017

Do implants provide the best aesthetic outcome for patients with hypodontia ?

A study by Hvaring and colleagues has looked at the outcomes for patients with hypodontia and more specifically the treatment for missing teeth. They looked at a cohort of 50 patients with 6 missing teeth or more with a mean age of 26. These patients were examined clinically assessing mucosal discolouration, crown morphology, colour, and papilla index. 

Deciduous teeth showed good outcomes whereas implants had poorer results. Changes in gingiva colour was seen only for implants and occurred for all fixtures in the anterior mandible and the majority of those in the anterior maxilla. As you would expect papilla index scores were poorer for implants and conventional bridges when compared with orthodontic space closure.

A pubmed link to the paper is below 

Implants are a popular treatment modality in the management of patients with hypodontia as they provide tooth replacement without the need for adjacent tooth support or retention. Over time those working in the hospital services have seen case from 5 years or more return with either mechanical or biological complications. Patients with hypodontia may have adequate bone stock around the top of the ridge but this becomes more compromised higher in the alveolus. Over time the alveolus is likely to continue to resorb as illustrated in the above research resulting in mucosal discolouration due to the slow exposure implant threads. In such patients, who have such underdeveloped ridges, alternative tried and tested treatments maybe wiser to consider. Resin bonded bridges are predictable, efficient with good long term outcome data. Consideration for the patients long term maintenance-especially if treated in late adolescents-needs to be a significant consideration.