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Introduction: Ectodermal dysplasia (ED) is an inherited disruption of two or more tissues and structures of ectodermal origin during their embryonal development. Hypodontia or anodontia of the primary and permanent teeth, poorly developed alveolar ridges and inappropriate мaxillo-mandibular relations are the most common oral manifestations. Management of patients with ED (depending on the phenotypic characteristics) needs a multidisciplinary team approach that involves maxillo-facial surgeon, pedodontist, orthodontist and prosthodontist. Case report: A 6-year-old girl with ectodermal dysplasia having a normal intellectual development has typical facial expresion: square forehead, prominent ears and supraorbital ridges, pigmented and wrinkled eyelids, nose with anteverted nostrils, thin inward lips, and pointed chin. Hypotrichosis is characterized by almost no eyebrows, eyelashes and skin hairs; the sculp is covered with a wig. The skin is dry, thin and rough as a result of decreased function of the sweat glands. Finger and toe nails are short, thick and striated. Decreased lower facial height, together with deep mentolabial and nasolabial folds contributed to an old-looking facial expression. Complete bilateral cleft palate was partially solved on 1.5 year of age, with remained oro-nasal communication and a presence of soft palate only. An alveolar ridge in the mandible is rather atrophic with deciduous canines destroyed by caries and and carious permanent molar teeth in both jaws (severe hypodontia). The gingiva is rather swollen, with dark-red color especially around the teeth. Treatment procedure: Taking into consideration the patient’s age and clinical findings, removable complete over-denture prosthesis was the treatment of choice. The preliminary impressions were taken with stock trays and irreversible hydrocolloid material, while the functional impressions were taken using custom trays and thermoplastic material for border molding and polyvinyl siloxane impression material. Maxillo-mandibular relations were determined using temporary bases with wax rims. The final trial with artificial teeth arranged according to a balanced occlusion was conducted to verify horizontal and vertical relations, phonetics and esthetics. The maxillar and mandibular prosthesis were produced in the heat cure acrylic resin. Disrupted functions of the oro-facial system such as mastication, swallowing and phonetics are improved significantly with complete dentures. Conclusion: Correct maxillo - mandibular relations and normal function of the dentofacial system in patients with ED, can be achieved by the acrylic dentures. Prosthodontic treatment has a major impact not only on the functions and esthetics, but on the psychological development and emotional state as well. Keywords Cleft palate, Ectodermal Dysplasia, Hypodontia, Removable dentures. |
