PMC3789299_01
Preoperative radiograph showing overretained deciduous teeth and a few permanent teeth.
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Radiographic examination showed over retained deciduous teeth, 51, 52, 53, 64, 71, 72, 73, 81, 82 and 83, and few permanent teeth, 15, 16, 23, 24, 26, 35, 36, 45, and 46 (Figure 1).
Severely attritted mixed dentition resulting in a collapsed bite.
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On clinical examination intraorally the deciduous teeth (51, 52, 53, 64, 71, 72, 73, 81, 82, and 83) were showing grade I mobility and severe attrition resulting in reduced lower facial height and a collapsed bite (Figure 2).
The patient exhibiting prominent and protuberant lips, abnormal hair (trichodysplasia) (head and eyebrows) (a), dry wrinkled skin of the palm (b), and feet with abnormal nails (onychodysplasia) (c).
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A 14-year-old Asian female presented with having some phenotypic expressions with mild symptoms with prominent and protuberant lips, abnormal hair (trichodysplasia) (head and eyebrows), skin of hands, palm, and feetdry, wrinkled, and scaly with abnormal nails (onychodysplasia) (Figure 3), and hyperpyrexia due to reduced number of sweat glands (dyshidrosis).
Maxillary and mandibular arch after extraction of mobile deciduous teeth.
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Since the patient retained most of her deciduous teeth till the age of 14 there was no significant deficiency in the development of the alveolar process (Figure 4).
Conventional overdenture prosthesis inserted in the patient's mouth.
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After using interim removable partial dentures for 1 year she complained of poor retention of the prostheses. A conventional overdenture prosthesis was then planned and fabricated for the patient without preparing the existing permanent teeth (Figure 5).
Milling of wax pattern on the cast (a) and milled metallic framework cemented to the teeth intraorally (b).
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The patient agreed for minimal tooth preparation of the remaining permanent teeth to receive metal copings (Figure 6).
Implants in maxillary (12, 13, and 21 regions) (a) and mandibular (41, 43, and 32 regions) (b) with attached gingival formers.
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Ltd.) and mandibular 41, 43, and 32 regions (A-11, Ankylos, Dentsply) (Figure 7).
Occlusal view of the prosthesis, maxillary arch (mirror image) (a), mandibular arch (b) (mirror image), in occlusion (c), and patient's smile (d).
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Osseointegrated supported fixed prosthesis was cemented in occlusion (Figure 8).
Radiograph taken after 6 months of cementation of the prosthesis.
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A radiograph was taken after 6 months of cementation of the prosthesis (Figure 9).