A novel approach to full-mouth rehabilitation of dentinogenesis imperfecta type II: Case series with review of literature.

RATIONALE: Dentinogenesis imperfecta (DI) is an autosomal-dominant disorder. The most common clinical manifestations, including obliterated tooth tissues and severe tooth wear, usually lead to tooth extractions. It remains a great challenge for dentists to preserve the residual tooth tissue and establish the esthetics and occlusion of dentitions. PATIENTS CONCERNS: 25-year-old twin sisters, who had suffered from dentinogenesis imperfecta type II for more than 10 years, presented with continuous tooth wear and discomfort from wearing a removable partial denture for more than 3 years. DIAGNOSIS: Intraoral examination showed extensive tooth wear with enamel exfoliation and typical amber-brown color with an opalescent discoloration. Their panoramic radiographs revealed completely obliterated tooth tissues and severe tooth wear. INTERVENTIONS AND OUTCOMES: The dentitions were restored with post-and-core crowns and pin lays after preparing root post paths and pin holes guided by computer-aided design/computer-aided manufacturing (CAD/CAM) procedures, resulting in a successful repair. LESSONS: Severe tooth wear and tooth tissue obliteration are typical clinical manifestations in DI-affected dentitions, increasing the complexity and difficulty in dental restorations. Early diagnosis and appropriate treatments are essential to achieve a favorable prognosis. CAD/CAM procedures, permitting accurate and effective treatment, possess promising potential in the treatment of DI-affected dentitions.

Tratamiento integral de una adolescente con dentinogénesis imperfecta tipo I / Comprehensive treatment of an adolescent with type I dentinogenesis imperfecta

La dentinogénesis imperfecta (DI) es un desorden hereditario de carácter autosómico dominante, que se origina durante la etapa de histodiferenciación en el desarrollo dental y altera la formación de la denti-na. Se considera una displasia dentinaria que puede afectar ambas denticiones con una incidencia de 1 en 6000 a 8000 nacimientos. El tratamiento del pa-ciente con DI es complejo y multidisciplinario, supone un desafío para el odontólogo, ya que por lo general están involucradas todas las piezas dentarias y afec-ta no solo la salud buco dental sino el aspecto emo-cional y psicológico de los pacientes. Objetivo: des-cribir el tratamiento integral y rehabilitador realiza-do en una paciente adolescente con diagnóstico de DI tipo I. Relato del caso: Paciente de sexo femenino de 14 años, que concurrió en demanda de atención a la Cátedra de Odontología Integral Niños de la FOU-BA derivada del Hospital "Prof. Dr. Juan P. Garrahan" con diagnóstico de osteogénesis imperfecta tipo III (OI). Nunca recibió atención odontológica y el motivo de consulta fue la apariencia estética de sus piezas dentarias. Se realizó el examen clínico y radiográfico arrojando el diagnóstico de DI tipo I asociada a OI. Conclusión: El tratamiento rehabilitador de la DI tipo I en los pacientes en crecimiento y desarrollo debe estar dirigido a intervenir de manera integral y tem-prana para resolver la apariencia estética y funcio-nal, evitar las repercusiones sociales y emocionales y acompañar a los pacientes y sus familias (AU)

Dentinogenesis imperfecta (DI) is an autosomal dominant inherited disorder that originates during the histodifferentiation stage of tooth development and alters dentin formation. It is considered a den-tin dysplasia that can affect both dentitions with an incidence of 1 in 6000 to 8000 births. The treatment of patients with DI is complex and multidisciplinary, it is a challenge for the dentist, since in general all the teeth are involved and it affects not only oral health but also the emotional and psychological aspect of the patients. Objective: To describe the comprehen-sive and rehabilitative treatment carried out in an adolescent patient with a diagnosis of DI type I. Case report: A 14-year-old female patient, who required dental attention at the Department of Pediatric Den-tistry of FOUBA and was referred from the Hospital "Prof. Dr. Juan P. Garrahan" with a diagnosis of os-teogenesis imperfecta type III (OI). The patient never received dental care and the reason for consultation was esthetic appearance of her teeth. A clinical and radiographic examination was performed, resulting in a diagnosis of DI type I associated with OI. Conclu-sion: Rehabilitative treatment of DI in growing and developing patients will be aimed at early and com-prehensive intervention to resolve esthetic and func-tional appearance, avoid social and emotional reper-cussions and accompany patients and their families (AU)

Full Mouth Rehabilitation of Two Siblings with Dentinogenesis Imperfecta Type II Using Different Treatment Modalities.

BACKGROUND: Dentinogenesis imperfecta (DGI) is a complex anomaly, not only by its structure but by treatment approach. The treatment protocol depends on the severity, behavior, and the age of the patient. CASE DESCRIPTION: This paper presents two siblings' cases of DGI type II (DGI-II) with different treatment based on the patient's clinical severity, behavior, and age (mixed versus primary dentition). The first case involves a patient in the primary dentition with severe attrition leading to a reduction in the vertical dimension of occlusion (VDO) treated by the fabrication of complete overlay dentures. The second case involves a patient in the early mixed dentition treated with restorations and extractions. CONCLUSION: Full mouth rehabilitation in the two patients dramatically improves function, aesthetics, and proved to be a significant psychological boost to the patient's well-being. PRACTICAL IMPLICATIONS: Early diagnosis and a multidisciplinary approach for patients with DGI to preserve the remaining teeth and rehabilitation for their function and aesthetics are essential for obtaining a favorable prognosis.

Early Rehabilitation of Incisors with Dentinogenesis Imperfecta Type II - Case Report.

Dentinogenesis imperfecta is an phenotypic alteration in the formation of the organic matrix. It causes the rapid and progressive wear of tooth structure, which may compromise tooth function and aesthetics. This is a case of a 1y, 8m-old child with dentinogenesis imperfecta. All teeth presented with an opalescent appearance and grayish color hue. Compromised structural integrity was noted as excessive wear and fracturing of the enamel from the dentin layer. With low doses of midazolam (oral) and chloral hydrate (rectal) administration, in a hospital environment, sedation was used to aid full mouth rehabilitation. Direct bonded restorations were performed on primary maxillary incisors and indirect restorations, pre-made on a plaster model using composite resin, were performed on primary mandibular incisors. After 32 months, we observed that diagnosis and early treatment allowed preventive maintenance of the patient's primary dentition, maintaining tooth function and esthetics.

A Case Report for a Complex Denture Case on a Special Care Patient with Osteogenesis Imperfecta.

This case report presents a patient with Dentogenesis Imperfecta (DI) associated with Osteogenesis Imperfecta (OI) and its subsequent dental manifestations. The patient in this report (see Figure 1) has spent his life living with his disability type III OI (also known as brittle bone disease) and its degenerative affects. The patient is independent and enjoys his social life but felt his existing dentures were having an adverse effect on the quality of his life. The patient attended Dorset County Hospitals Special Care Dentistry and on clinical examination it was noted the patient was partially dentate with a class III malocclusion and brownish discoloration of the remaining teeth caused by enamel hypoplasia. Treatment for this patient would entail making a maxillary complete denture and a mandibular partial chrome denture, normally quite simple tasks but due to the DI and its dental manifestations, the treatment would be complicated. This case demonstrates how a complex case treated by a collaborative dental team using their different skills and knowledge can lead to a successful and rewarding treatment for both patient and team.

[Ectodermal Capdepont syndrome and oral prosthetic rehabilitation. About a clinical case]. / Syndrome ectodermique de Capdepont et réhabilitation orale prothétique. A propos d'un cas Clinique.

The authors describe the ectodermal Capdepont syndrome as an anomaly characterized by anhidrosis, hypotrichosis and anodontia diagnosed in a 22 year-old adult. In front of this anodontia, oral prosthetic rehabilitation remains the only solution.

Full-mouth rehabilitation for a patient with dentinogenesis imperfecta: a clinical report.

Dentinogenesis imperfecta (DI) is a genetic disorder affecting the structural integrity of the dentin that can result in weakened dentin. The affected teeth, especially posterior teeth, often need to be extracted due to severe wear or fracture. This frequently yields a loss of posterior occlusion and occlusal vertical dimension. Besides wear and fracture, anterior teeth often have an unesthetic appearance because of discoloration. Current treatments of choice, including composite bonding restorations and, more recently, all-ceramic restorations, are typically suggested to preserve the remaining teeth and tooth structure. However, there are a limited number of studies on dental implants in patients with DI. The effectiveness of dentin bonding and dental implants in patients with DI is not known. This clinical report describes a 32-year-old Asian woman with DI who underwent full-mouth rehabilitation. The posterior occlusion, mostly in the molar areas, was restored with dental implants and ceramometal restorations. The anterior teeth and premolars were restored with bonded lithium disilicate glass-ceramic pressed veneers and crowns made with computer-aided design/computer-aided manufacturing. This case demonstrates that restoring functional occlusion and esthetics for a patient with DI can be completed successfully using contemporary implant therapy and adhesive dentistry.

Dentinogenesis imperfecta: full-mouth rehabilitation using implants and sinus grafts--a case report.

UNLABELLED: This case report outlines one possible treatment modality to manage the developmental abnormality dentinogenesis imperfecta (DI). In this case, the patient's dentition is restored using a combination of full-coverage crowns for the remaining teeth and implant-supported crowns to replace missing teeth in a re-organized occlusal scheme. The case also demonstrates the effective use of the sinus graft procedure with simultaneous placement of dental implants. This paper also aims to make the reader aware of the current thinking behind treatment delivered to this group of patients, focusing on full-mouth rehabilitation using a combination of implant-supported and conventional metal ceramic crowns. CLINICAL RELEVANCE: For the general dental practitioner this case outlines the prevalence and cause of DI. It demonstrates how early diagnosis and appropriate referral has an impact on future treatment.

All-ceramic restorations in different indications: a case series.

BACKGROUND: Encompassing a vast array of materials, today's all-ceramic systems are suitable for a large range of indications in almost all areas of fixed restorative dentistry. METHODS: The authors describe five clinical cases involving different indications to illustrate the use of different ceramic materials and combinations of materials. They describe the collaboration between the dentist and dental technician for single-tooth restorations and for complex cases, including all stages of the restorative procedures from treatment planning with an analytic wax-up to the selection of appropriate materials, tooth preparation and cementation. RESULTS: The patients described experienced significant functional and esthetic improvement, even those who had severely discolored teeth. This was possible because the authors executed the working steps in a strictly synchronized manner and selected the restorative materials carefully to meet the specific needs of each patient. CONCLUSIONS: All-ceramic systems have expanded the range of restorative treatment options significantly; at the same time, their handling has been simplified substantially. The use of lithium disilicate glass-ceramic-and zirconium oxide-based frameworks along with an identical veneering ceramic enables the dental care professional to cover almost all indications in fixed prosthodontics while achieving the same esthetic results.

Dental rehabilitation of a patient with dentinogensis imperfecta: a clinical report.

This clinical report describes the multidiscipline treatment for a 19-year-old service member who entered the military diagnosed with dentinogenesis imperfecta. The patient presented with multiple teeth with extensive dental caries, considerable sensitivity, and an inability to function due to the extent of the dental disease. The goal of the treatment was to restore function and aesthetics. A combined treatment approach was initiated which involved prosthodontics, periodontics, and dental implant therapies. Functional and aesthetic results were achieved.

Case report: Rehabilitation of a child with dentinogenesis imperfecta and congenitally missing lateral incisors.

BACKGROUND: Dentinogenesis imperfecta is one of the most common hereditary disorders of dentine formation. Opalescent teeth composed of irregularly formed and undemineralised dentine that obliterates pulp chambers and root canals characterize it. Complete-coverage crowns are usually the preferred restoration for patients with this condition. CASE REPORT: A 9 year-old girl presented with dentinogenesis imperfecta, congenitally missing maxillary lateral incisors and maxillary right permanent second molar retention. TREATMENT: The treatment comprised an initial approach to allow the correct eruption of the retained second molar. The use of low-fusion metal ceramic restorations comprised a second stage to improve the aesthetic appearance and decrease the risk of overload on teeth with limited value. FOLLOW-UP: The patient has been recalled regularly and at the last visit, 10 years after initial prosthetic treatment, no problems or signs of complications have occurred. The patient is now aged 25 years and is still satisfied with the prosthetic rehabilitation. CONCLUSION: This case illustrates the need for appropriate and timely restorative treatment to prevent deterioration of the dentition. This case will also demonstrate that low-fusion metal ceramic restoration is a viable esthetic treatment option for today's patients.

Complex all-ceramic rehabilitation of a young patient with a severely compromised dentition: a case report.

A young patient with dentinogenesisimperfecta and a dentition severely compromised by discolorations,abrasion, and breakage of enamel on several teeth was prosthodontically treated with CAD/CAM-manufactured all-ceramic restorations. To reduce treatment risk, preparations were limited paragingivally. Maxillary anterior teeth and premolars were restored with adhesively luted ceramic crowns. All other teeth were treated with zirconia-based restorations luted with a self-etching resin-based material. Considering the deficient pretreatment situation, the use of tooth-colored restoration and luting materials yielded a satisfying functional and good esthetic result. The patient is highly satisfied, even though 3 minor chippings occurred shortly after the completion of treatment

Dentinogenesis imperfecta: long-term rehabilitation in a child.

The treatment of dentinogenesis imperfecta represents a challenge for the dental practitioner. The aim of this case report was to describe the chronology and problems encountered in the long-term rehabilitation of a young girl suffering from dentinogenesis imperfecta with severe attrition. A 2-stage treatment over a period of 9 years is described and discussed. This treatment comprised an initial treatment to restore esthetic appearance and function during primary and mixed dentitions and a complete prosthetic rehabilitation in a second stage to protect permanent teeth with low-fusion ceramicmetal individual crowns. Discovery of a follicular cyst is also reported and its treatment is described.

The placement of osseointegrated dental implants in a patient with type IV B osteogenesis imperfecta: a 9-year follow-up.

Osteogenesis imperfecta (OI) is a rare autosomal dominant connective tissue and metabolic disorder. Typically, patients with OI exhibit bone fragility, with the sclera, joints, skin, and tooth dentin being affected to varying degrees. Despite existing classifications, there is an extreme phenotypic variation within this population, and at times the mild forms of OI may be difficult to diagnose. Comprehensive management of the severe types of OI involves aggressive physical and surgical orthopaedic treatment to improve muscle structure and joint mobility. For those patients with associated dentinogenesis imperfecta (DI), early and definitive management can help prevent excessive tooth wear and sensitivity. A case of a late diagnosis of type IV OI with DI successfully treated with implant-supported dentures is reported. To date, 9 years after implant surgery and prosthetic loading, the patient continues to be clinically and radiographically normal.

An integrated treatment approach: a case report for dentinogenesis imperfecta type II.

Dentinogenesis imperfecta type II or hereditary opalscent dentin is one of the most common autosomal dominant anomaly of dentin that occurs in both sex affecting approximately 1:8000 persons. Clinically this disorder is characterized by variable blue gray to yellow brown teeth, with fracture of enamel and excessive wear. The treatment strategy is focused towards protecting teeth from further wear and tear and total oral rehabilitation of patient with paramount importance to aesthetics, obtaining an appropriate vertical dimension and providing soft tissue support which will help to return the facial profile to a more normal appearance. A multidisciplinary treatment planning is required for treatment of these individuals.

Three patient reports illustrating the use of dentin adhesives to cement crowns to severely worn teeth.

PURPOSE: Severely worn and broken down teeth present clinical treatment planning dilemmas. Extreme examples of worn teeth present in patients suffering from bulimia nervosa and dentinogenesis imperfecta. Bulimia nervosa typically presents early in adult life with a myriad of clinical features and a most important dental sign of eroded palatal surfaces on the maxillary teeth. Dentinogenesis imperfecta is a relatively uncommon disorder that presents with varying severity of unsupported enamel and results in teeth more susceptible to wear. MATERIALS AND METHODS: Dental treatment for both conditions when wear has resulted in the complete loss of the tooth can either be directed toward restoring remaining tooth tissue or extraction and replacement with implants or dentures. This article presents the clinical management of three case histories, each with one or more severely broken down teeth, which were restored with adhesively retained crowns. RESULTS: Treatment lasted nearly 10 years in one patient and failed after 6 years in another. The third patient was treated more recently. CONCLUSION: All three case histories serve as examples of using adhesive cements to retain indirect restorations as a possible prosthodontic management strategy.

Hereditary opalescent dentin--a case report.

A female patient aged 6 years reported with brown coloured small sized teeth that were continuously wearing out. The teeth were badly attrited upto the gingival margins. The occlusal surfaces were flattened. The clinical and radiographical examination confirmed the case as Hereditary opalescent Dentin. The rationale for early diagnosis and treatment has been discussed.

Dentinogénesis imperfecta / Dentinogenesis imperfecta

Se presenta la resolución quirúrgica con la completa regeneración de las estructuras óseas, y la rehabilitación de una paciente con un quiste en la zona anteroinferior de la mandíbula y dentinogénesis imperfecta tipo II. El tratamiento adecuado para restituir la funcionalidad y estética a pacientes portadores de estas complejas anomalías, constituye un desafío para el odontopediatra (AU)

All-ceramic restorations for complete-mouth rehabilitation in dentinogenesis imperfecta: a case report.

Prosthetic treatment of patients with dentinogenesis imperfecta is a challenge for the dental practitioner because numerous factors have to be considered. The use of all-ceramic restorations to rehabilitate the dentition of a young patient with dentinogenesis imperfecta is reported. Clinical and laboratory procedures are described.