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Introduction: Oligodontia is a rare dental developmental pathology that requires prolonged, complex and multidisciplinary treatment. Although bone augmentation is frequently required during a complete implant treatment of oligodontia. Therefore, we evaluated the ability to predict pre-implant surgery complexity based on age, number of missing teeth, and number of implants required to achieve implant-supported prosthetic rehabilitation., Material and Methods: This retrospectively registered study included all patients who underwent surgical treatment for oligodontia in our Oral and Maxillofacial Surgery Department between January 2012 and May 2023. Demographic data, number and location of missing teeth, pre- and per-implant surgical procedures, and the number of planned implants were recorded. A quantitative variable called "complexity score of pre-implant surgery" was created. This 10-point score was calculated by adding one point for each preimplant surgical procedure registered. A simple linear regression was calculated to explain the number of targeted implants based on number of missing teeth. A multiple linear regression model was used to explain the complexity score of pre-implant surgery and age, number of missing teeth and number of targeted implants., Results: 119 oligodontia patients were included in the study. The median number of tooth agenesis was 10. A total of 825 implants were placed, 14 (1.7%) of which failed. A significant regression equation was used (F(1,118) = 1098,338; p < 0.0001) to explain the number of targeted implants based on number of missing teeth, with a R 2 of 0.903. A significant regression equation was found (F(3,116) = 107,229; p < 0.0001) to explain the complexity score of pre-implant surgery and age, number of missing teeth and number of targeted implants, with a R 2 of 0.735., Discussion: These results based on patient data indicate that age, number of missing teeth and number of targeted implants could reliably explain the complexity of pre-implant surgery., (© 2024. The Author(s).)

Introduction: To present the 3-year clinical, radiographic, and aesthetic outcomes in patients with congenitally missing lateral incisors rehabilitated with two narrow-diameter implants (NDIs)., Methods: The original population consisted of 100 patients rehabilitated with a cement-retained bi-layered zirconia single-unit crown supported by either a Ø2.9 mm (Test) or a Ø3.3 mm (Control) NDI (n = 50). At the 1- and 3-year follow-up (T2, T3), implant survival rate, crestal bone level (CBL) changes, biological, and technical complications were recorded, while the assessment of the aesthetic outcomes was performed using the Copenhagen Index Score., Results: Seventy-four patients Ø2.9 mm (n = 39) or Ø3.3 mm (n = 35) reached T3, as 24 patients were lost to follow-up and 1 implant (Ø3.3 mm) was removed. Throughout the observation period, minimal CBL changes (i.e., <1 mm) were detected between groups. Despite the positive aesthetic scores recorded (i.e., 1-2), at T3 20% of patients rehabilitated with a Ø3.3 mm versus 2.6% of patients Ø2.9 mm displayed an alveolar process deficiency (Score 3). No additional technical and/or mechanical complications were recorded between T2 and T3. Tooth vitality was maintained in all neighboring teeth. Peri-implant probing depths and plaque scores remained low in both groups (p > 0.05)., Conclusion: The use of 2.9 or 3.3 diameter implants showed comparable favorable mid-term results in terms of survival rate, CBL, and aesthetic outcomes. Hence, clinicians should rely on the use of such NDIs when replacing maxillary lateral incisors., (© 2024 The Authors. Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.)

The patient presented in this case report is a 10-year-old boy with hyperdivergent skeletal Class II associated with familial genetic agenesis of the second premolars. The treatment plan chosen was to close the spaces of agenesis using a bimaxillary appliance fixed buccally. The advantages and disadvantages of this treatment option were discussed. The result was stable and made it possible to avoid an implant-prosthetic solution, which would undoubtedly have been more restrictive over time., (Copyright © 2024 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Treatment of condylar fractures in patients with edentulous mandibles or no-occlusion reference is particularly challenging due to the absence of important anatomical structures and landmark for occlusion analysis. In this case, a 69-year-old female maxillary oligodontia victim suffered from a traumatic accident with a right facial contusion, resulting in a right-side subcondylar and mandibular ramus fracture with right ramus height loss. In the preoperative planning, the 3-dimensionalimage of the left-side mandible was highlighted by the navigation software. A mirror image of the left-side mandible was made and superimposed on the right side of the face. Surgical intervention with an endoscope and 3-dimensional navigation-assisted open reduction and internal fixation of the right-side subcondylar and ramus fracture was performed. The patient recovered well with no restriction in mandibular movement, no limitation in mouth opening, and a satisfied esthetic outcome., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Mutaz B. Habal, MD.)

Introduction: the aim of this study was to report and assess the management and implant rehabilitation of oligodontia patients since its recognition in 2012 by french authorities in the nomenclature., Material and Methods: we conducted a retrospective study in the Maxillofacial Surgery and Stomatology Department of the Lille University Hospital between January 2012 and May 2022. Patients had to present an oligodontia recognized under the ALD31 in adulthood, and to have benefited from a pre-implant/implant surgical treatment in the unit., Results: a total of 106 patients were included in the study. The mean number of agenesis was 12 per patient. The most missing teeth are the ones at the end of the series. After a pre-implant surgery phase including orthognathic surgery and/or bone grafting, 97 patients benefited from implant placements. The mean age for this phase was 19.38. A total of 688 implants were placed. The median number of implants placed was 6 per patient and 5 patients presented implant failures after or during the osseointegration phase (16 implants lost). The implant success rate was 97.6%. 78 patients benefited from rehabilitations by fixed implant-supported prostheses and 3 by implant-supported mandibular removable prostheses., Discussion: The described care pathway seems to us adapted to the patients followed in our department, with good functional and esthetic results. It would be necessary to evaluate on a national scale to adapt the management process., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

A 21-year-old woman with multiple congenitally missing maxillary anterior teeth received interdisciplinary treatment to restore function and esthetics. The treatment was initiated with orthodontic treatment, followed by implant placement, bone and soft-tissue augmentation, and prosthetic treatment including a screw-retained implant-supported 2-unit cantilever fixed dental prosthesis., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

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.

In the early 1900s, various authors worked on "artificial roots" to replace missing teeth. E. J. Greenfield's pioneering works (1910-1913) are among the best-known today and are often cited in publications reviewing the history of oral implantology. Shortly after Greenfield's first communications in the scientific literature, a French dental surgeon, Henri Léger-Dorez, designed the first expanding dental implant, which he indicated was used successfully in cases of single tooth edentulism. Its aim was to obtain the best primary stability and thus avoid the use of dental splint during osseous healing process. Léger-Dorez's works give us a new angle on the research in oral implantology by the pioneers of the early 20th century., (Copyright 2023 © American Academy of the History of Dentistry.)

Maxillary lateral incisor agenesis (MLIA) is a condition that significantly compromises smile esthetics and is a particular concern in younger patients. The treatment options include orthodontics for space opening with rehabilitation or space closure with canine camouflage. Currently, there is some controversy regarding the most appropriate treatment. In this case report, we propose a multidisciplinary approach through the combination of orthodontic treatment, frenectomy, and a restorative finishing stage with composite resin and dental implants. More specifically, this treatment was planned to orthodontically close the anterior space by opening the premolar area for subsequent placement of implants and enameloplasty with a composite resin. The replacement of a missing lateral incisor by an implant is a predictable treatment approach, but it might best be deferred until dental maturity and then accurately placed in a well-developed site through a multidisciplinary approach. Precluding the closure of the anterior spaces and the opening of the posterior zone for implant placement, allows for a more stable and appealing esthetic and functional rehabilitation for young patients, in whom esthetic appearance and self-esteem play a primary role., (©Operative Dentistry, 2022.)

Hypodontia is commonly associated with cleft lip and/or palate and can be managed by autotransplantation of teeth. In this case report, autotransplantation of the immature mandibular right second premolar to replace the congenitally missing maxillary right second premolar was performed successfully in an 11-year-old Chinese male. An ectopic tooth resembling a premolar tooth was subsequently noted to be developing palatal to the root apex of the transplanted tooth one month after surgery. The development of a dental tooth germ at the site of the autotransplantation post-surgery is a possibility and clinicians should be aware and monitor for such development. The development of a tooth germ post-autotransplantation of an immature tooth could provide a new perspective into tooth organogenesis in patients with agenesis of permanent teeth.

Background: Ectodermal dysplasia is a congenital genetic disorder with a prevalence of 1:10,000 to 1:100,000. The clinical features of ectodermal dysplasia include sparse hair, missing teeth, and abnormal development of the skin, sweat glands, and other tissues and organs. Since 1985, dentists have used implants to correct tooth defects in patients with ectodermal dysplasia with reasonable success rates. However, there is still no widely accepted treatment for the oral defects caused by this disease. Case summary: This report describes a 19-year-old female patient with congenital ectodermal dysplasia, congenital absence of most of her teeth, and mandibular and maxillary dysplasia. The patient and her family were concerned about the patient's growth and development, so she came to our hospital to restore her missing teeth. During several months of treatment, the patient underwent bone augmentation surgery for the maxilla and mandible, implant placement, a root repositioning flap, and free gingival grafting, which was completed in five stages. The patient completed the permanent implant restoration, and the desired results were achieved., Conclusion: The patient's mouth was restored through the use of bone augmentation and soft tissue grafting techniques, enabling appropriate function and appearance.

The replacement of the missing maxillary lateral incisor continues to be a challenge for the interdisciplinary dental treatment team. Over the past two decades the dental implant has become a primary method of replacement for this tooth. However, while implants offer numerous benefits, some significant potential problems are associated with implant treatment, including the possible need for tissue grafting, the long-term stability of bone and soft tissue overlying the facial surface of the implant, as well as the continued growth of alveolar bone and eruption of teeth adjacent to the implant. This article discusses various treatment options for the replacement of the missing maxillary lateral incisor with an emphasis on the bonded zirconia bridge.

Background: GAPO (growth retardation, alopecia, pseudoanodontia, and optic atrophy) as a rare genetic disorder includes growth retardation, alopecia, pseudoanodontia, and optic atrophy. It was reported to be associated with craniosynostosis and intracranial hypertension., Case Report: A patient with such a rare disorder associated with multisuture craniosynostosis and headache is presented. Surgery has been done due to intracranial hypertension., Conclusions: Abnormal intraoperative findings including sever pericranium and dural adhesions and extraordinary bleeding related to this syndrome are described.

Tooth autotransplantation is performed in patients with congenitally missing teeth and those with traumatic tooth loss. We report a course of edgewise treatment of a girl with multiple congenitally missing teeth and residual features of ectodermal dysplasia, who was treated with autotransplantation of 2 premolars with developing roots. She was 8 years old at the beginning of the treatment. No signs of inflammation, root resorption, or pulp symptoms were observed during the 2.5 years of edgewise treatment after autotransplantation. Cervical external root resorption was detected 31 months postoperatively in 1 transplanted tooth (maxillary first premolar), and the same problem occurred in the other transplanted tooth (mandibular second premolar) 2 years later. Root canal treatment was immediately undertaken and resulted in inhibition of further pathology. Consequently, the survival of both transplanted teeth was achieved. The orthodontic treatment that included intervals related to diagnosis and treatment of root resorption of the transplanted premolars is described in detail., (Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Long-term assessments of implant survival and treatment outcome in patients with oligodontia are lacking., Purpose: The purpose of this retrospective clinical study was to assess which factors determine a long-term implant survival and treatment outcome of up to 25 years in a cohort of patients with oligodontia., Material and Methods: The medical records of all patients with oligodontia treated with fixed implant prosthodontics between January 1991 and December 2015 in the Department of Oral and Maxillofacial Surgery at the University Medical Center Groningen, the Netherlands, were assessed. Specifically, this involved the retrieval of records on the need for and mode of bone augmentation, implant survival, and survival of and adverse events associated with the prosthodontics. The Kaplan-Meier estimator was used to analyze implant and superstructure survival. Log-rank tests were used to compare the survival of subgroups., Results: A total of 126 patients with oligodontia were treated with dental implants. Of the 777 implants in total, 56 were lost, resulting in a 5-year cumulative survival of 95.7% (95% confidence interval [CI], 94.2% to 97.2%) and a 10-year cumulative survival of 89.2% (95% CI, 86.2% to 92.2%). The survival of implants placed in regions where bone augmentation surgery had been performed was significantly lower. The 5-year cumulative superstructure survival was 90.5% (95% CI, 87.6% to 93.5%), and the 10-year cumulative superstructure survival was 80.3% (95% CI, 75.3% to 85.3%). The performance of the screw-retained and cemented superstructures was comparable, but the survival of single crowns was significantly higher than the survival of fixed partial dentures (P<.001)., Conclusions: Implant treatment is a predictable treatment option for patients with oligodontia with a favorable long-term outcome. Survival of implants in augmented areas is lower., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Hypodontia is the most prevalent craniofacial malformation in mankind. It may present a wide variety of manifestations and, depending on the number and location of missing teeth, it may affect the esthetics, mastication, speech and occlusal balance. This paper discusses the therapeutic approaches to solve this condition, describing a case report with hypodontia of one mandibular lateral incisor, which treatment option included space closure at the region of hypodontia associated with composite resin restorations in the mandibular central incisors. The three-year follow-up after treatment revealed occlusal stability, adequate intercuspation in Class I relationship and excellent micro and macroesthetics.

It is known that congenitally missing teeth can often cause differences in craniofacial morphology; however, there are few reported cases of orthognathic surgical treatment for these patients. Herein, the authors report a rare case of maxillary hypoplasia with congenital oligodontia treated by maxillary distraction osteogenesis with internal device. A 17-year-old male presenting with multiple tooth agenesis and maxillary recession was referred to our hospital for orthognathic surgical treatment. Preoperative simulation surgery was performed using Full-Color 3-dimensional salt model. After surgery, improvement in maxillary recession and occlusal stability was observed. This report demonstrates the advantages of the method used herein, which includes reduction in operating time with increase in the safety of the procedure.

Background/aim: Autotransplantation of teeth to the anterior maxilla may be indicated after trauma or in patients with congenitally missing teeth. The aim of this systematic review was to report the current evidence concerning survival and success rate, aesthetic outcome, and patient-reported outcome of autotransplanted teeth to the anterior maxilla., Materials and Methods: A MEDLINE search followed by an additional hand search was performed to identify relevant literature. All levels of evidence except case reports were considered. Any publication reporting on 10 or more autotransplanted teeth to the anterior maxilla, and written in English were eligible for this systematic review., Results: The systematic search identified 95 abstracts. Thirty-seven full-text articles were evaluated of which 17 could finally be included. Data on survival and success rate of the transplants could be extracted from 11 studies. Survival rates ranged between 93% and 100% (weighted mean: 96.7%, median: 100%) after 9 months to 22 years of observation (median: 8.75 years). No consensus regarding definition of success criteria of the transplants could be found in the literature. Two and four studies contained data on aesthetic and patient-reported outcomes, respectively. In general, they reported favourable aesthetic results and high patient satisfaction., Conclusion: The current available evidence suggests a high survival rate after autotransplantation of teeth to the anterior maxilla. However, the level of evidence is low. Limited data on aesthetic and patient-reported outcomes warrant additional research in this field., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Here, we report a case of dental implant treatment involving computer-assisted surgery for bilateral agenesis of the maxillary lateral incisors. The patient was a 39-year-old woman with the chief complaint of functional and esthetic disturbance due to maxillary and mandibular malocclusion. The treatment plan comprised non-extraction comprehensive orthodontic treatment and prosthodontic treatment for space due to the absence of bilateral maxillary lateral incisors. A preliminary examination revealed that the mesiodistal spaces left by the absent bilateral maxillary lateral incisors were too narrow for implant placement (right, 5.49 mm; left, 5.51 mm). Additional orthodontic treatment increased these spaces to approximately 6 mm, the minimum required for implant placement if risk of damage to the adjacent teeth due to inaccuracies in directionality of drilling is to be avoided. For dental implant treatment with computer-assisted surgery, preoperative planning/simulation was performed using Simplant ® ver.12 software and a toothsupported surgical template fabricated using stereolithography. Two narrow-diameter implants were placed in a two-stage procedure. It was confirmed that there was sufficient distance between the implant fixtures and the roots of the adjacent teeth, together with no exposure of alveolar bone. Following a 4-month non-loading period, second-stage surgery and provisional restoration with a temporary screw-retained implant crown were performed. Cement-retained superstructures made of customized zirconia abutment and a zirconia-bonded ceramic crown were fitted as the final restoration. At 5 years after implant surgery, there were no complications, including inflammation of the peri-implant soft tissue and resorption of peri-implant bone. Computer-assisted implant surgery is useful in avoiding complications in bilateral agenesis of the maxillary lateral incisors when only a narrow mesiodistal space is available for implant placement.

Dental autotransplantation is the surgical transposition of a tooth from its original site to another site to replace a lost or compromised tooth in the same individual.1 It offers a method for replacing missing teeth or avulsed and traumatized teeth, particularly in children and adolescents. This surgical therapy is often overlooked as a treatment option by dentists and oral surgeons, who typically treat space closure by placing dental implants or bridges despite the fact that recent autotransplantation studies show high survival rates and success rates of 91.3%.2 Most tooth losses due to traumatic incidents occur in young patients, and implant placement is contraindicated until the completion of growth. In cases where there is no donor dilemma, and if a suitable graft is available, autotransplantation may be the therapy of choice.

Autogenous bone remains the gold standard for augmentation of the alveolar ridge in congenital hypodontia and appreciable post-traumatic deformity. This generally reflects the volume of material required for such defects and the osteogenic potential of the grafts. Morbidity at the donor site and success rates may lead to autogenous grafts being superseded by xenografts or alloplastic materials in the future, but we know of little evidence to confirm this. All patients having augmentation of the alveolar ridge or sinus lift to enable subsequent placement of implants between 01 January 2009 and 31 December 2016 were identified from a prospectively-gathered database held at the Queen Elizabeth Hospital, Birmingham. Morbidity was recorded, with overall success defined as a graft that enabled subsequent placement of an implant. During this period the following grafts: calvarial (n=4), iliac crest (n=4), and ramus (n=149) were recorded, as well as 53 sinus lifts. Sinus lift augmentation with BioOss ® had the highest success rate (51/53). Calvarial and iliac crest grafts had higher failure rates (2/4 and 3/4, respectively) than those from the mandibular ramus (6/149, 4%). Fifteen of 149 (10%) ramus grafts resulted in transient anaesthesia of the inferior alveolar nerve but no patients developed any permanent morbidity at the donor or recipient sites. Ramus grafts are a predictable method of bone augmentation with only transient morbidity at the donor site. Higher failure rates for extraoral grafts probably reflect their use in more challenging cases when more bone is required. Bilateral ramus grafts are an alternative to extraoral grafts and may be supplemented by bovine-derived particulate grafts with no appreciable increase in complications., (Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.)

Background: Hypodontia compromises appearance and function and is challenging to manage clinically., Objectives: To assess the impact of implant retained crowns on quality of life of patients and to determine clinical performance of implant retained crowns in these patients., Methods: In a 24-month prospective observation study, patients with non-syndromic mild hypodontia manifested with missing teeth in the anterior maxilla were included. Pre-treatment screening included a clinical and radiographic examination and completion of an OHIP-20. Narrow neck SLActive TiZr implants (Roxolid ® , Straumann AG, Switzerland) were provided and restored with single unit crowns. Implant stability was recorded at time of placement and abutment connection. Standardized radiographs were recorded at time of surgery, abutment connection and 12- and 24-month follow-up visits, and distance between implant shoulder and first bone contact was measured. Oral health-related quality of life was calculated using OHIP-20 scores at 12- and 24-month visits compared with pre-treatment scores. Pink (PES) and white (WES) aesthetic scores were used to objectively assess aesthetic outcome of treatment., Results: Twenty implants were placed in 12 patients (seven females, five males; mean [SD] age 19.33 [2.37] years). There was a significant improvement in oral health-related quality of life following treatment (P = 0.026), and the effect size of this change was 1.17 indicating a large clinically meaningful change. Mean PES and WES scores were high, indicated a satisfactory aesthetic outcome at 24 months. Crestal bone-level changes were considered small., Conclusion: Favourable clinical outcomes were observed. Implant retained crowns had a large and clinically meaningful impact on quality of life of patients with hypodontia., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: Premolar autotransplantation represents an effective therapeutic option for the treatment of juvenile dentition with either aquired or congenital hypodontia. The objective of this prospective clinical study was to quantitatively assess bone and soft tissue levels after autogenous premolar transplantation by clinical and radiographic parameters., Study Design: In the study, 26 premolars were transplanted in 20 patients after traumatic tooth loss (n = 16) or congenital aplasia (n = 10) in the anterior maxilla. Based on standardized photographic documentation, the relative soft tissue level was measured compared to the healthy adjacent teeth. Radiographic findings included evaluation of root resorption, pulp canal obliteration, and relative bone height., Results: Average survival rate of transplanted premolars (n = 26) was 100% over a follow-up period of 29 months (range 10-60 months). The relative soft tissue level significantly increased by +1.1 mm (P < .01). Radiographs showed a tendency toward vertical bone growth. Continuous root development and signs of pulpal healing were observed postoperatively in 18 transplants (69.2%)., Conclusions: Autogenous premolar transplantation represents a safe method to ensure functional and aesthetic rehabilitation in the anterior maxilla irrespective of the nature of tooth loss., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Hypodontia is the term most commonly applied to the condition in which teeth congenitally fail to develop. Such cases differ from teeth that have been lost early or that have failed to erupt, although their initial presentation may be similar and therefore not recognised. The range of missing teeth and their physical and psychological results is large, and the difference in complexity in the management of a patient with isolated hypodontia compared with one with oligodontia or anodontia together with skeletal and orthognathic discrepancies should not be underestimated. Surgical interventions primarily involve augmentation of bone before placement of an implant, but may include techniques such as distraction osteogenesis and orthognathic surgery. These patients are best managed by a multidisciplinary team, and in this review our aim has been to describe the role of oral and maxillofacial surgeons within it., (Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.)

Ectodermal dysplasia (ED) is an inherited disorder characterized by abnormality of ectodermally derived structures. A recurrent oral finding is oligodontia, which in turn leads to a severely hypotrophic alveolar process with typical knife-edge morphology and adverse ridge contours. This unfavorable anatomy can seriously hamper proper implant placement. Fresh-frozen bone (FFB) allografts recently have been proposed to augment the residual bone volume for implant placement purposes; however, scientific evidence concerning the use of FFB to treat ED patients is absent. Similarly, data reporting computer-aided template-guided implant placement in medically compromised patients are limited. Thus the purpose of this report is to illustrate the oral rehabilitation of a female patient affected by ED and treated with appositional FFB block grafts and consecutive computer-guided flapless implant placement in a 2-stage procedure. Fixed implant-supported dental prostheses were finally delivered to the patient, which improved her self-esteem and quality of life. During the follow-up recall 1 year after the prosthetic loading, the clinical examination showed healthy peri-implant soft tissues with no signs of bleeding on probing or pathologic probing depths. The panoramic radiograph confirmed the clinical stability of the result. Peri-implant marginal bone levels were radiographically stable with neither pathologic bone loss at the mesial and distal aspects of each implant nor peri-implant radiolucency. Within the limitations of this report, the use of FFB allografts in association with computer-aided flapless implant surgery might be considered a useful technique in patients affected by ED., (Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: 1. Assess treatment outcomes and oral health related quality of lifeM (OHRQoL) of hypodontia patients after completing dental treatment at the Eastman Dental Hospital and compare it with British public norms. 2. Assess factors which have an association with patients' reported OHRQoL., Methods: Hypodontia patients who finished their treatment completed a 16-item questionnaire (UK oral health related quality-of-life measure), a list of four questions about their satisfaction with treatment received and a clinical assessment using modified USPHS criteria., Results: The sample included 52 participants; median age 28 years (range 16 - 61 years). All participants had completed treatment for at least 6 months (range 6-60 months). Clinical assessment revealed 4 of the participants had complications requiring treatment. The OHRQoL mean scores of the sample were statistically significantly higher than the mean scores of the British public norms for most age groups (P⟨0.05). Factors which revealed association with OHRQoL scores were: gender (P=.047) and satisfaction with dental aesthetics (P=.006)., Conclusions: Hypodontia patients following treatment reported higher OHRQoL average scores compared to the British population. Higher OHRQoL scores were related to patients' satisfaction with dental aesthetics after treatment. Females tended to report higher OHRQoL scores than males., (Copyright© 2017 Dennis Barber Ltd)

Management of missing lateral incisors presents a challenge to attaining optimum esthetics and must be preceded by careful examination of areas of missing teeth and the relationship to adjacent soft and hard tissues. This case series describes various approaches and techniques for managing missing lateral incisors. These techniques were chosen depending mainly on the amount of space in mesiodistal and insiocervical dimensions. The amount of underlying bone played an important role in selecting the treatment modalities.

Dental fusion and agenesis present unique esthetic challenges for the dental team when discovered in a developing child. This article highlights treatment of a 9-year-old girl with fusion of a maxillary central and lateral incisor with a congenitally missing lateral over a 10-year period. The article defines the developmental anomalies, provides a review of treatment options for the clinical team, and highlights clinical management using a conservative, interdisciplinary approach to esthetic treatment.

Aim: Surgical and orthodontic treatment of a teenage cleft patient., Case Report: Authors describe the case of a 13 year old female cleft patient presented with class III malocclusion RESULT: The patient underwent comprehensive surgical secondary bone grafting and orthodontic treatment. Stable skeletal and occlusal class I relationship was achived and maintained in the post treatment observation period till the age of 16., Discussion: Although several authors suggests primary gingivoperiosteoplasty, other advocates that such early intervention can cause later restrictions in maxillary growth. For alveolar reconstruction, maxillary growth and dental age were the main considerations in determining the timing of surgical intervention., Conclusion: This case showed that borderline cases of complex dentoalveolar and skeletal anomaly in cleft patients could be successfully treated with comprehensive secondary bone grafting and orthodontic treatment thus avoiding the need for orthognatic surgery., Key Words: Alveolar bone grafting, Cleft, Malocclusion.

Objective: This retrospective study evaluated survival rates, prognosis, and overall success of autotransplanted teeth in young patients missing anterior teeth as a result of trauma, agenesis, or developmental disturbances., Study Design: Retrospective data were collected from the medical records of patients who had undergone tooth autotransplantations to anterior sites between January 2001 and December 2012. Clinical variables, such as gender, age, surgical indications, donor and recipient sites, type of anesthetics, bone augmentation, and complications during follow-up, were assessed., Results: A total of 59 donor teeth in 46 patients (30 boys and 16 girls; average age 12.15 years) were autotransplanted to the anterior region of the maxilla and mandible. After a mean follow-up period of 17.35 months (range 10-61 months), all of the transplanted teeth remained in situ with no complications., Conclusions: This study supports the autotransplantation of teeth to the anterior alveolus as a viable option suitable in growing patients with missing anterior teeth., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Autotransplantation is the technique of transplanting embedded, impacted or erupted teeth from one site into another in the same individual. Despite current scientific evidence indicating that autotransplantation has favourable long-term survival rates, autotransplantation is still not generally regarded as mainstream practice outside of Scandinavian countries. Successful autotransplantation can offer many advantages in a growing patient, including a normally functioning periodontium, proprioception and preservation of alveolar bone volume. In the event that the autotransplantation eventually fails, the bone and soft tissue conditions would still be likely to be favourable for subsequent implant treatment. This review article will identify and discuss the factors that influence case selection, the ideal timing for autotransplantation and the critical determinants for achieving a successful outcome. The limitations of the technique and alternative treatment options will also be discussed. It is hoped that through greater awareness and recognition by the dental profession, autotransplantation will become another viable treatment option in the management of compromised teeth in patients with significant remaining growth potential., (© 2016 Australian Dental Association.)

The objective of this study was to compare the dimensional changes in the alveolar ridge before, at the end of, and one year after orthodontic treatment in cases of Maxillary Lateral Incisor Agenesis and the possibility of using plaster models and panoramic radiographs as substitutes for cone beam-computed tomography., Material and Methods: A total of 228 measurements were performed on plaster models and panoramic radiographs: before (T1), at the end of (T2), and 1 year after orthodontic treatment (T3). At stage T2, the cone beam-computed tomography was also analyzed. Non-parametric tests were used., Results: In all 3 stages, there was no statistically significant difference regarding the thickness of the models, the height of the bone in the panoramic radiographs, the space opening and the height of the bone in the panoramic radiographs, or the space opening in the models and the thickness in the same plaster models. However, a statistically significant difference was observed for the width in the panoramic radiograph during all 3 stages. Cone beam-computed tomography did not reveal a statistically significant correlation regarding the height and width of the bone compared with the panoramic radiographs, and the thickness as compared with plaster models., Conclusion: There was no significant variation in thickness, height and width of the bone over time. It was demonstrated that plaster models and panoramic radiographs do not appear to be good substitutes for cone beam-computed tomography for these specific measurements., (Copyright © 2016 CEO. Published by Elsevier Masson SAS. All rights reserved.)

The field of dentistry is an ever-evolving discipline. A marked rise in the use of endosseous implants, adhesive ceramic bonding, and composite resins, as well as continued patient desire for minimally invasive procedures, has created a new conservative era in the practices of many restorative dentists. These trends, coupled with the significant financial impact associated with the reconstruction of failing, worn, and esthetically compromised dentitions, have facilitated a paradigm shift in the way that individual patient cases are being treatment planned today. Applying restraint to conventional practices involving the unnecessary gross removal of hard tooth structure is both a skill that needs to be cultivated as well as an evident obligation to the patient. A case report demonstrates the utilization of multiple restorative materials to provide a minimally invasive definitive treatment that was biomechanically, esthetically, and financially satisfactory for the patient.

Objective: To investigate the long-term outcome of treatment of missing maxillary incisor teeth by transplantation of premolars, with special reference to aesthetics and patient satisfaction., Subjects and Methods: Twenty subjects who had undergone transplantation of premolars to the maxillary incisor area were recalled for follow-up varying between 12 and 22 years post-surgery. Twelve subjects presented for examination, including radiography and three subjects participated only by answering questions. Three reference groups-general practitioners, orthodontists, and lay people-evaluated the aesthetic results from photographs. Patient satisfaction was evaluated by interviews and OHIP-14., Results: The mean age at transplantation was 12.3 years: 1 subject had been 20 years old and 11 were in the range of 9-14 years. Twelve to 22 years after autotransplantation, 5 subjects could not be reached: of the 15 who could be contacted, the survival rate was 15 out of 15. In the 12 subjects who presented for clinical examination, 11 out of the 12 transplants were assessed as successful. Nine transplants were restored with crowns and five had been recontoured with composite build-ups. In one patient, no restorative treatment had been undertaken. The subjects were satisfied with the aesthetic result., Conclusion: Autotransplantation of premolars is an appropriate method for treatment of missing maxillary anterior teeth. Subjects with a transplanted tooth to the maxillary anterior region perceive their oral health as good long term., (© The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Autotransplantation is a valuable technique offering a physiological type of tooth replacement to patients with missing teeth. Teeth with open apices (50-75% apical closure) will regenerate with vitality following autotransplantation. The success rate following an autotransplantation is 82%. The remaining 18% can usually still be treated successfully with a simple additional treatment. The tooth survival rate 10 years after autotransplantation is higher than 90%. The use of 3D techniques makes it possible to create a pre-operative replica of the donor tooth. With this, a new alveolus can be prepared at the transplant site even before extraction. This technique reduces the extra-alveolar time for the donor tooth and minimises the possibility of iatrogenic damage. This results in a streamlined procedure, enabling better planning with better results.

Cherubism is a rare benign, autosomal-dominant hereditary fibro-osseous condition predominantly affecting the jaws. Symmetrical cyst-like expansions of the jaws cause the characteristic facial swellings. The disease is often associated with severe malposition of teeth. The gene for cherubism is src homology 3 binding protein 2 (SH3BP2) located on chromosome 4p16.3. The repeated experience of this self-limiting disorder in affected individuals published in the medical literature has resulted in a wait-and-see strategy regarding therapeutic options. Indeed, cessation and regression of even large bone expansions can be expected in early adulthood. Nevertheless, severe facial disfiguring and functional impairment can make surgical intervention necessary. This report details the surgical procedures carried out in a patient with progressive and disfiguring jaw expansions at the end of adolescence, the mutation of SH3BP2 gene, and the limited effect of surgically assisted orthodontic tooth movement in a patient with disease-associated impaired tooth development and tooth eruption., (Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Severe hypodontia (≥6 missing teeth) is associated with aesthetic and functional problems. Its presentation is heterogenic, and a variety of treatment modalities are used resulting in different treatment outcomes. As there is currently no standard treatment approach for patients with severe hypodontia, the literature was systematically reviewed with the focus on treatment outcomes. Medline, Embase and The Cochrane Central Register of Controlled Trials were searched (last search 24 August 2015). This was completed with a manual search of the reference lists of the selected studies. To be included, studies had to describe dental treatment outcome measure(s) in patients with severe hypodontia; there were no language restrictions. The methodological quality was assessed using MINORS criteria. Twenty-one studies were eligible, but the diversity in type and quality did not allow for a meta-analysis; seventeen studies had a retrospective design; sixteen studies described the results of implant treatment. Treatment with (partial) dentures, orthodontics, fixed crowns or bridges was sparsely presented in the eligible studies. Implant survival, the most frequently reported treatment outcome, ranging from 35·7% to 98·7%, was influenced by 'location' and 'bone volume'. The results of implant treatment in severe hypodontia patients are promising, but due to its heterogenic presentation, its low prevalence and the poor quality of the studies, evidence-based decision-making in the treatment of severe hypodontia is not yet feasible, thus prompting further research., (© 2016 John Wiley & Sons Ltd.)

Introduction: Ectodermal dysplasia patients require complex oral rehabilitation. Bone matrix Osteotensors activate the patient's own stem cells to promote new bone formation through an autogenous growth factor cascade generated by a targeted flapless bone distraction before implant and/or bone graft therapy., Materials and Methods: The maxillary and mandibular bone were activated 21 (for type I bone) to 45 days (for type IV bone) before implant and/or bone substitute installation. Purpose-designed Osteotensors initiated massive recruitment of stem cells in the intended bone recipient site, thereby triggering neoangiogenesis and osteogenesis. After new bone formation, root-form implants and Diskimplants were installed. Functional loading was obtained at 48 hours using highly rigid, screw-secured fixed upper and lower full-arch prostheses., Results: At 3 years, all implants appeared clinically and radiologically osseointegrated with an excellent functional and esthetic outcome., Conclusion: Flapless distraction osteogenesis using bone matrix Osteotensors several weeks before surgery improved the initial quality and volume of the recipient bone bed. This minimally invasive approach allows future successful immediate implant-supported complete maxillomandibular fixed rehabilitation without preliminary grafting procedures in patients with an unfavorable initial bone anatomy.

Objective: To express the early prosthodontic treatment strategies for severe oligodontia patients with or without a syndrome and to share details of their experiences of the long-term follow-up., Methods: Patients with severe oligodontia (excluding the third molars, and with six or more congenitally missing permanent teeth) who had finished prosthetic rehabilitation between 2001 and 2014 and who had undergone at least 1-year follow-up at the Department of Prosthodontics, Peking University School of Stomatology were included in the study. The general and oral characteristics were determined and examined, interdisciplinary plans were provided, and the prosthodontic treatment conditions were described and evaluated., Results: In total 26 subjects were included. Twenty males and six females, whose first dental visit occurred between the ages of 2 years and 9 months old, and 31 years old were recorded, of which, 12 (46.2%) subjects had non-syndromic oligodontia and 14 (53.8%) had oligodontia with different syndromes. The number of congenitally missing teeth (excluding the third molars) was between 7 to 28 (mean = 18), with 14 and 21 teeth in the non-syndromic and syndromic oligodontia patients, respectively. Most of the patients accepted conventional prostheses and two had implant-supported crowns or bridges. The age of the first prosthesis delivery ranged from 3.5 to 31 years old. The follow-up period ranged from 15 months (1 year and 3 months) to 162 months (13.5 years), with a mean of 108 months (9 years)., Conclusion: Early treatment for young patients and long-term follow-up greatly benefits patients. Interdisciplinary treatment ensures more satisfactory results.

Introduction: In some skeletal Class III adult patients with nasomaxillary hypoplasia, the LeFort I osteotomy provides insufficient correction. This case report describes a 20-year-old woman with a combination of nasomaxillary hypoplasia and a protrusive mandible with a congenitally missing mandibular second premolar., Methods: We performed a LeFort II osteotomy for maxillary advancement. Autotransplantation of a tooth was also performed; the donor tooth was used to replace the missing permanent tooth. To increase the chance of success, we applied light continuous force with an improved superelastic nickel-titanium alloy wire technique before extraction and after transplantation., Results: The patient's profile and malocclusion were corrected, and the autotransplanted tooth functioned well. The postero-occlusal relationships were improved, and ideal overbite and overjet relationships were achieved., Conclusions: The methods used in this case represent a remarkable treatment., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

It is very common for cleft lip and palate patients to have congenitally missing teeth. Insufficient buccopalatal bone volume, a shallow vestibule, and lack of soft tissue resulting from previous surgical scarring render it difficult for clinicians to place implants in the missing area. This report describes guide surgery that represents a treatment option for cases in which implants need to be placed in tight spaces with minimal bone space, to minimize as far as possible manual placement errors.

The data of clinical examination, diagnostic models and panoramic x-rays investigation of the 332 patients at the age from 6 to 18 years with adentia were analysed. The congenital absence of more than 6 teeth was defined as oligodontia. The purpose of the study was to evaluate the prevalence of missing teeth patterns and other dental abnormalities such as microdontia, persistent deciduous teeth, ankylosis, taurodontism, impaction and transposition in children and adolescents with isolated and syndromic oligodontia to optimize the diagnostic and orthodontic treatment plan. The total number of 332 patients were devided into three groups: 1-132 patients with hypodontia, 2-119 subjects with isolated oligodontia and 3 - 81 with syndromic oligodontia. The subgroup comprised of 45 children with ectodermal dysplasia (ED) syndromes and oligodontia 1,5-6 years at baseline examination was selected from the patients of group 3. The main type of inheritance was X-linked recessive and the most spread syndrome was hypohidrotic ectodermal dysplasia or Christ-Siemens-Touraine syndrome. The female patients were twice more than males in hypodontia and isolated oligodontia groups, but in group of 3 syndromic patients the rate of males to females was 1,56:1. The most stable to agenesis teeth were the upper central deciduous and permanent incisors. In group 2 the most often absent teeth were upper second premolars and in group 3-the upper lateral incisors. In syndromic patients with temporary dentition the upper lateral incisors and all lower incisors were always absent. It was concluded that the absence of teeth at the age of 1,5 years, male gender and absense of more than 14 teeth in the temporary dentition and 20 teeth in the permanent dentition were the signs of syndromic oligidontia. It is necessary for such patients to be examined besides dentists and pediatrician by other medical specialist such as dermatologist and geneticist.

We report the successful treatment of a woman aged 25 years 3 months with bilateral cleft lip and palate. She had a protruded premaxilla, collapsed posterior segments, wide alveolar defects with oronasal fistulae, a congenital missing tooth, and severe facial asymmetry with a transverse occlusal cant. The comprehensive treatment approach included (1) premaxillary osteotomy combined with alveolar bone grafting to reposition the premaxilla and minimize the wide alveolar defects, (2) autotransplantation of a tooth with complete root formation to the grafted bone region to restore the missing tooth without a prosthesis such as a dental implant or bridge, and (3) 2-jaw surgery to improve facial asymmetry. The premaxillary osteotomy was managed orthodontically, in combination with bone grafting. The results suggest that surgical orthodontic treatment with tooth autotransplantation might be useful to improve the occlusion and facial esthetics without prosthetics., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The treatment of adult malocclusion is usually complex and pluridisciplinary. Its prognosis is not reliable. We present a new clinical protocol to improve the management and final result., Technical Note: We use a specific software (Simplant®, OMS®, Materialise Dental) and its accessory modules. It allows visualization of the expected final clinical result of the orthodontic treatment. Combined with guided-surgery, it allows placing implants at the beginning of treatment in a position that is compatible with the final position. The implants serve as absolute anchorage for dental motions during the orthodontic step; it is also used to support the final prosthesis. The treatment is thus optimized and its prognosis is improved. Finally, the reversed surgical sequences shorten the treatment thus promoting the compliance of patients., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Aim: To assess the clinical and radiographic outcomes of 36 transplanted teeth and the possible factors affecting the results., Materials and Methods: In 26 children, 36 teeth transplants were performed. The main reason for transplantations was the loss of anterior teeth due to trauma; 80.5% of transplanted teeth were immature bicuspids. The transplants were clinically and radiolographycally monitored in respect of pulp vitality, root canal obliteration, periradicular changes and root formation. Fisher Exact Test and Kaplan-Meier analyses were performed to determine the association between the variables and estimation of survival rates, respectively., Results: Thirty (83.3%) of the transplantations were recorded as successful and six as unsuccessful (16.7%). The survival rate was 97.2% during average time of 47.5 months ± 27.8 SD. Only one tooth had been extracted and 5 had survived in not ideal conditions. The majority of immature transplanted teeth developed pulp canal obliteration., Conclusion: Factors associated to successful outcome were immature root formation of donor tooth and short flexible splinting period. The main factor associated to failure was replacement resorption. The surgical technique did not present statistical significance in the clinical outcome. Tooth transplantation has shown high success and survival rates, and should be considered as a real option in growing patients.

The first part of this series on severe hypodontia discussed the assessment of patients and factors to consider when treatment planning for the provision of conventional restorative solutions. This article discusses the provision of implant supported prostheses in the severe hypodontia patient who typically presents with inadequate bone volume and other associated dental and craniofacial anomalies. The role of bone augmentation to facilitate implant placement is discussed, in addition to prosthesis design and long-term maintenance. With careful case selection and planning most patients with severe hypodontia can be rehabilitated effectively, both functionally and aesthetically, with implant supported prostheses. In complex cases the involvement of a multidisciplinary team is needed to improve outcome. It should be highlighted that these patients will require ongoing follow up, maintenance and retreatment procedures over their lifetimes.

Introduction: The purpose of this study was to evaluate the alveolar bone dimensional changes with cone-beam computed tomography after space-opening procedures for an endosseous implant in patients with unilateral or bilateral maxillary lateral incisor agenesis., Methods: A pilot retrospective cohort study was conducted of 11 patients (13 sites) in whom the canines had erupted less than 2 mm distally to the central incisors. Pretreatment and posttreatment scans obtained from 3 private practice offices were evaluated for changes in alveolar bone width, height, and labial concavity. A fiducial line representing the ideal location of the longitudinal axis of an endosseous dental implant was used as a reference for the spatial location of the alveolar bone at the lateral incisor site in reference to the adjacent tooth roots at posttreatment. The posttreatment width and height measurements scans were compared with normative data from the contralateral incisor in patients with unilateral agenesis (n = 6)., Results: Alveolar bone width was significantly decreased on average from 17% to 25% along the height of the ridge (2-10 mm) (P <0.05). The labial concavity was significantly increased compared with the initial dimensions (P <0.05). No significant changes were found in alveolar bone ridge height., Conclusions: Significant alveolar bone width decreases and increases in labial concavity were found after implant ridge development in patients with maxillary lateral incisor agenesis. The alveolar bone ridge was located more lingually than the adjacent teeth, suggesting a need for bone grafting to achieve proper fixture placement., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)