Complete Mouth Rehabilitation of a Young Adult with Amelogenesis Imperfecta and Skeletal Class II Malocclusion

Case Report

J Dent App. 2017; 4(2): 392-395.

Complete Mouth Rehabilitation of a Young Adult with Amelogenesis Imperfecta and Skeletal Class II Malocclusion

Kulkarni RS¹*, Pawar RS², Pimpale SK³ and Chandorikar HM4

¹Associate Professor, Department of Prosthodontics, Nair Hospital Dental College, Mumbai, India

²Assistant Professor, Department of Prosthodontics, Nair Hospital Dental College, Mumbai, India

³Assistant Professor, Department of Periodontics, Nair Hospital Dental College, Mumbai, India

4Assistant Professor, Department of Orthodontics, Nair Hospital Dental College, Mumbai, India

*Corresponding author: Rahul S Kulkarni, Flat no. 703, B wing, Satsang – 2 Apartments, Poonam Sagar Complex, Miraroad (East), Thane, Maharashtra, India

Received: November 13, 2017; Accepted: December 05, 2017; Published: December 12, 2017

Abstract

Complete mouth rehabilitation of a patient with esthetically and functionally compromised dentition often requires a systematic approach. In these patients, functional, esthetic, biological and restorative goals must be clearly defined before starting the treatment, and their incorporation must be made in design of prosthesis for long term success of treatment and preservation of the stomatognathic system. This case report describes treatment of a patient with hypoplastic amelogenesis imperfecta having severe attrition of tooth structure, multiple missing posterior teeth, and convex profile with underlying skeletal Class II pattern.

Keywords: Fixed partial denture; Occlusal splints; Overdentures; Amelogenesis imperfecta

Case Presentation

Case history and intraoral examination

A 21-year-old female earlier diagnosed with hypoplastictype amelogenesis imperfecta (AI) was referred to Department of Prosthodontics for restorative treatment. Patient complained of unesthetic appearance of teeth, difficulty during mastication, and teeth sensitivity. Patient had non-contributory medical history. Maxillary first and mandibular first and second molars on both sides were extracted due to caries three years ago, but prosthetic treatment was not taken by patient after extractions. Careful intraoral examination revealed that she had severe attrition of teeth with brownish yellow discoloration of enamel (Figure 1 and 2). There was extrusion of maxillary first molars due to non replacement of extracted mandibular molars. Periodontal examination indicated a healthy periodontium. Lateral cephalogram indicated that patient had a skeletal Class II jaw relationship, convex facial profile, deficient chin and clockwise rotation of mandible. During assessment of occlusal vertical dimension (OVD) and interocclusal distance, the interocclusal space measured at the premolar region during physiological rest was 3mm. Patient had no facial asymmetry. Esthetic evaluation revealed incompetent lips and undesirable display of gingiva during speech and smiling (Figure 3). There were no signs or symptoms related to temporomandibular joint, such as pain, limited range of jaw opening, or clicking. Family history revealed that patient was born to nonconsanguineous parents without history of AI, and had two male siblings out of which one was affected by the condition.