Multidisciplinary Management of a Child with Severe Open Bite and Amelogenesis Imperfecta

Abstract

To present a case of multidisciplinary management and fixed rehabilitation of a young girl with amelogenesis imperfecta (AI), a severe open bite and occlusal instability. AI is a genetic disorder characterized by enamel malformations, disturbances in tooth eruption and significant attrition. Early diagnosis is essential, since rapid breakdown of tooth structure may occur, giving rise to acute symptoms and complicated treatment. As AI is frequently accompanied by unesthetic appearance, open bite deformity and malocclusion, a multidisciplinary approach is often required. This clinical report describes the condition and presents the case of a 10-year-old girl with hypocalcified form of AI. Orthodontic treatment and orthognathic surgery were performed as part of the prosthetic treatment plan to achieve acceptable and durable results. They consisted of correcting class II, posterior crossbite and anterior open bite with a fixed orthodontic appliance, Lefort I osteotomy, bilateral mandibular ramus osteotomy and genioplasty. Prosthodontics treatment consisted of metal-ceramic crowns with low-fusing ceramic for good long-term results. No deterioration in the rehabilitation was found after 5 years of follow-up. Complete restoration of severe AI is a long and complex process generally extending over several years. This article shows the important role of interdisciplinary approach to treating a patient with AI over a period of 8 years.