Abstract
Hypodontia often leads to limited bone availability of the alveolar ridges. Oral rehabilitation of severe hypodontia patients is challenging. In this retrospective study, we evaluated the functional and aesthetic results after dental implants in hypodontia patients, corroborated by Albrektsson implant success criteria. Over a period of 15 years (2000–2015), a total of 43 patients were diagnosed with hypodontia and 165 dental implants were inserted. Six patients who received 10 implants were lost in the follow-up. We examined 155 implants in 37 patients between December 2015 and May 2017. Besides family history, patients evaluated the general satisfaction, functionality, and aesthetics of the implants. Study subjects were between 17 and 44 years old (mean ± SD: 21.4 ± 5.6). Hypodontia patients were missing one to five teeth (n = 28), whereas patients diagnosed with oligodontia (≥6 missing teeth, n = 9). In this study, 24 patients (64.9%) with hypodontia had a positive family history; the remaining 13 patients had no family member with hypodontia. The final follow-up time ranged between 5 and 189 months after implant placement. Orthodontic treatment was performed in 32 patients (86%) before implant placement. Rehabilitation resulted in 62% of the cases being treated with 1–2 implants and 38% treated with 3–15 implants. However, out of 155 inserted dental implants, 18 implants failed to meet Albrektsson criteria, under which two implants were removed. Only autografts were used for bone augmentation with 97 implants. More than two-thirds of the patients showed high general satisfaction and masticatory function (69.4%) as well as phonetic ability (80.6%). The aesthetic outcome was rated as excellent by 17 patients (47.2%). The findings emphasize the importance of interdisciplinary treatment of hypodontia, leading to a satisfactory, functional, and long-term fixed prosthodontics using dental implants.
Highlights
Hypodontia is the most common congenital anomaly in tooth development [1,2,3] that results in tooth agenesis
Twenty-eight patients were diagnosed with hypodontia when missing one to five teeth, whereas the nine patients diagnosed with severe hypodontia were missing 6–20 teeth
One advantage of dental implantation is the use of existing dental implants as an anchor for prosthetic choices in cases of further tooth loss next to the implant [5]
Summary
Hypodontia is the most common congenital anomaly in tooth development [1,2,3] that results in tooth agenesis. Tooth agenesis be associated with other syndromes or occur as a result of genetic factors [8,9,10,11,12], the exact mechanism of hypodontia is not fully understood [13]. Hypodontia may result in complex sociopsychological problems, especially during puberty and in the case of face disproportion. A multidisciplinary team is often required with different competences, including maxillofacial surgeons, orthodontists, prosthodontists, speech pathologists, and psychologists, to treat severe hypodontia [14,15,16,17,18]
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