Severe hypodontia - interdisciplinary planning, outcome and psychosocial impact
Appears in the following Collection
AbstractThe general purpose of this thesis was to increase the knowledge and understanding of treatment outcome and psychosocial status in patients with severe hypodontia. Paper I is a retrospective study aiming at pointing out the limiting prognostic factor for the persistence of primary mandibular molars whose successors are lacking. Primary mandibular molars and their degree of infraocclusion, root resorption and restorations were assessed on panoramic radiographs in 111 subjects missing at least one second mandibular premolar. The patients had a mean age of 12.6 years and missed 8.4 teeth on average. All persisting primary mandibular molars were included in the study, as no decision had been made as to whether they should be kept or extracted. Clinically significant infraocclusion was observed in 43.6 per cent of the patients and classified as severe in 18.8 per cent. The mesial and distal root exhibited no resorption in 18.9 and 33.3 per cent, respectively (P = 0.01). Most primary molars had no restorations (78.4 per cent). A significant correlation was found between root resorption and infraocclusion. Infraocclusion was estimated to be a more critical factor for the prognosis of retained primary molars than root resorption. Paper II is a cross-sectional survey assessing the discriminative ability of the generic and condition specific (CS) forms of the oral impact on daily performance (OIDP) inventory among adolescents with hypodontia and with a malocclusion of similar treatment need. The groups consisted of 62 patients with non-syndromic hypodontia and 101 patients with a malocclusion. The mean number of missing teeth in the hypodontia group was 6.2. Both groups reported a considerable burden of oral impacts. The prevalence of generic and CS oral impacts in the hypodontia group were 64% and 30%, respectively, and the corresponding rates in the non-hypodontia group were 62% and 10%. The CS OIDP measure discriminated most effectively between patients with and without hypodontia and was related to severity and upper anterior location of hypodontia. Paper III is a longitudinal follow-up study of 50 patients with severe hypodontia aged 18 years or more (mean age, 25.6 years). The purpose of the study was to describe types and locations of substitutes for missing teeth in patients with severe hypodontia, and to compare the crown and soft tissue morphologies of orthodontic space closure, dental implants, and tooth-supported fixed dental prostheses replacing teeth in the anterior region. The patients were examined clinically, with panoramic radiographs and clinical photographs being taken. Dental implants, orthodontic space closure, and retaining deciduous teeth were the most commonly prescribed treatments. Persisting deciduous teeth showed a good survival rate at the follow-up examination. Dental implants in the anterior region proved to be an inadequate treatment modality in patients with severe hypodontia because of mucosal discoloration seen for almost all fixtures in the anterior mandible and two thirds of those in the anterior maxilla.
List of papers
|Paper I: Hvaring CL, Ogaard B, Stenvik A, Birkeland K. The prognosis of retained primary molars without successors: infraocclusion, root resorption and restorations in 111 patients. Eur J Orthod. 2014;36:26-30. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1093/ejo/cjs105|
|Paper II: Hvaring CL, Birkeland K, Astrom AN. Discriminative ability of the generic and condition specific Oral Impact on Daily Performance (OIDP) among adolescents with and without hypodontia. BMC Oral Health. 2014;14:57. The article is available in DUO: http://urn.nb.no/URN:NBN:no-47220|
|Paper III: Hvaring CL, Ogaard B, Birkeland K. Tooth replacements in young adults with severe hypodontia: Orthodontic space closure, dental implants, and tooth-supported fixed dental prostheses. A follow-up study. Am J Orthod Dentofacial Orthop. 2016;150:620-6. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1016/j.ajodo.2016.03.023|