Interdisciplinary dental management of patient with oligodontia and maxillary hypoplasia: a case report.

BACKGROUND: The craniofacial developmental abnormality can significantly complicate the oral rehabilitation of patients with oligodontia. This case report describes an interdisciplinary approach that took 7 years to successfully treat a young patient with non-syndromic oligodontia and midface deficiency. CASE PRESENTATION: A 14-year-old patient with complex oral and maxillofacial conditions and diagnosis of oligodontia presented to our clinic. In addition to 4 retained deciduous teeth and congenitally missing 10 permanent teeth, dentofacial findings included maxillary and malar deficiency with a concave facial profile, Angle Class III malocclusion, and poor dental esthetics. The interdisciplinary treatment included pre-surgical orthodontic decompensation, high Le Fort I maxillary osteotomy, postsurgical orthodontic therapy, osseous ridge augmentation using recombinant human bone morphogenetic protein-2 (rhBMP-2), interim removable partial denture, dental implant installation, interim implant prostheses, and final prosthetic rehabilitation. CONCLUSIONS: The successful treatment of patients with oligodontia and complex dentofacial abnormalities requires the close and orderly collaboration among orthodontist, oral maxillofacial surgeon, and prosthodontist. Within the limitations of this case report, presented interdisciplinary approaches may optimize the oral rehabilitation outcome in patients with similar clinical challenges. A prospective clinical investigation is desired to verify the benefit of presented interdisciplinary approach.

Imaginal discs regulate developmental timing in Drosophila melanogaster.

The regulation of body size in animals involves mechanisms that terminate growth. In holometabolous insects growth ends at the onset of metamorphosis and is contingent on their reaching a critical size in the final larval instar. Despite the importance of critical size in regulating final body size, the developmental mechanisms regulating critical size are poorly understood. Here we demonstrate that the developing adult organs, called imaginal discs, are a regulator of critical size in larval Drosophila. We show that damage to, or slow growth of, the imaginal discs is sufficient to retard metamorphosis both by increasing critical size and extending the period between attainment of critical size and metamorphosis. Nevertheless, larvae with damaged and slow growing discs metamorphose at the same size as wild-type larvae. In contrast, complete removal of all imaginal tissue has no effect on critical size. These data indicate that both attainment of critical size and the timely onset of metamorphosis are regulated by the imaginal discs in Drosophila, and suggest that the termination of growth is coordinated among growing tissues to ensure that all organs attain a characteristic final size.