Prosthetic rehabilitation of hypophosphatasia with precision attachment retained unconventional partial denture: a case report

Abstract

Deficiency of the alkaline phosphatase isoenzyme can lead to a rare hereditary disorder called Hypophosphatasia. It is characterized by defective mineralization of the skeletal and dental structures of the body. Hypophophatasia is classified into six clinical forms namely, perinatal lethal, perinatal benign, infantile, childhood, adult and odontohypophosphatasia. This clinical report describes the prosthetic rehabilitation of an 18-year-old girl with Hypophosphatasia with partial anodontia and no occlusion. A precision attachment retained unconventional removable partial denture in the maxillary arch and conventional removable partial denture in the mandibular were fabricated to establish an acceptable masticatory function, speech, occlusion and aesthetics for the patient.

Keywords: Hypophosphatasia; Odontohypophosphatasia; Precision attachment; Removable partial denture.

[Table/Fig-1]:

Pre-treatment extra-oral view

[Table/Fig-2]:

Pre-treatment intraoral view of maxillary arch

[Table/Fig-3]:

Pre-treatment intraoral view of mandibular arch

[Table/Fig-4]:

Intraoral periapical radiograph of maxillary central incisors showing enlarged pulp chambers

[Table/Fig-5]:

Tooth preparation for a porcelain fused to metal bridge with 11, 13 and 21

[Table/Fig-6]:

Wax pattern for fabrication of porcelain fused to metal bridge on abutments 11, 13 and 21 with extracoronal precision attachment

[Table/Fig-7]:

Finished porcelain fused to metal bridge with extracoronal precision attachment incorporated

[Table/Fig-8]:

Intraoral view of cemented porcelain fused to metal bridge with extracoronal precision attachment incorporated

[Table/Fig-9]:

O-ring incorporated upper partial denture and lower conventional removable partial denture,

[Table/Fig-10]:

Post insertion Intra-oral view,

[Table/Fig-11]:

Post insertion Extra-oral view