Multidisciplinary approach of ectodermal dysplasia with implant retained fixed prosthesis
A 22-year-old female reported with complaints of multiple missing teeth in upper and lower anterior region. Patient also complained of skin appeared dry with decreased sweating. Patient gave history of difficulty in mastication and swallowing. On examination, patient′s skin was dry and soft on face and increased thickness of nails; palm and sole were normal. She is normotensive and febrile with no mental retardation. She did not give positive family history. Her chest and skull radiographs and organ function tests were normal. Intraoral examination showed normal appearing mucosa and salivary output was apparently normal. The patient had 18, 15, 12, 22, 27, 28, 38, 45, and 48 missing teeth with generalized microdontia. The canines had cone shaped clinical crowns, and molars appeared malformed [] with obliterated occlusal tables. Permanent maxillary right central incisor was present, which is a rare finding. Vertical dimensions were reduced due to a lack of occlusion and vertical stop causing protuberant lips. The panoramic radiograph confirmed presence of retained primary teeth in both the arches. With the above findings and orthopantomogram (OPG) figure, we came to a conclusion and diagnosed as HAED.\nTo restore the missing teeth[] To increase the vertical dimension To correct size of teeth Alignment of teeth.[]\nTreatment plan included compensating microdontia by increasing tooth size using FPD retained by implant. To use implants, enough space was required; so orthodontic alignment of teeth was required. As teeth were distributed unevenly, it had to be aligned to gain space for implants.\nRetained deciduous teeth were extracted and orthodontic correction [] done with aligning and leveling. Enough space for implant was created within 1 year.\nTwo implants [] were placed in region of 12, 13 and one in the region of 45.\nThree months were given for osseointegration. In the meantime, crown preparation was done for required teeth for FPD. Wax try-in was done for FPD to restore vertical dimension. Final FPD [] was given and orthopantomograph [] taken posttreatment.\nThe prosthetic rehabilitation provides the patient with esthetic, functional, and phonetic benefits, as well as a better outlook towards her social life and peers oral hygiene instructions, were given to the patient, and he was asked to report for follow up and assessment of her fixed prosthetic appliance after 6 months.