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Case Reports
. 2021 Sep 8;9(9):1180.
doi: 10.3390/healthcare9091180.

From Child to Adulthood, a Multidisciplinary Approach of Multiple Microdontia Associated with Hypodontia: Case Report Relating a 15 Year-Long Management and Follow-Up

Charlotte Thomas  1   2   3 , Frédéric Vaysse  2   4   5 , Teva Courset  2   3 , Karim Nasr  2   6 , Bruno Courtois  2   3   7 , Arnaud L'Homme  3   6 , Nicolas Chassaing  5   8 , Alexia Vinel  1   2   3 , Isabelle Bailleul-Forestier  2   4   5 , Luc Raynaldy  3   5   9 , Sara Laurencin-Dalicieux  1   2   3   5
Affiliations
Case Reports

From Child to Adulthood, a Multidisciplinary Approach of Multiple Microdontia Associated with Hypodontia: Case Report Relating a 15 Year-Long Management and Follow-Up

Charlotte Thomas et al. Healthcare (Basel). .

Abstract

Oral rehabilitation of patients presenting multiple microdontia is a real therapeutic challenge. These alterations in size, often associated with other dental anomalies, have aesthetic and functional repercussions for patients and can lead to significant psycho-social consequences. We report here the case of an 11-year-old patient with bilateral sectorial microdontia and agenesis of teeth numbers 13 and 23. She also presented staturo-ponderal delay and a history of acute coronary syndrome with a lower coronary occlusion of unknown aetiology. At first, additive coronoplasties and an orthodontically retained interim prosthesis answered the aesthetic and functional need during childhood and adolescence. Once she reached adulthood, a multidisciplinary meeting was conducted and a treatment plan was established. The decision was made to rehabilitate the upper arch with a permanent bridge and the lower arch with indirect adhesive restorations. This solution solved the problem of the bilateral lateral infraocclusions and tooth agenesis, restoring both aesthetics and function. This paper presents 15 years of management and treatment of a patient presenting multiple microdontia associated with hypodontia. Both the multidisciplinary approach and coordination between the different medical team members was essential to maintain the existing dentition while preparing, planning, and carrying out a personalized treatment plan once maxillofacial growth was complete.

Keywords: hypodontia; microdontia; multidisciplinary treatment; oral rehabilitation; prosthetics.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Situation and care provided during childhood. (a,b) Initial intraoral lateral views; (c) endobuccal view after additive coronoplasties and orthodontically retained interim prosthesis; and (d) panoramic X-ray of the situation.
Figure 2
Figure 2
Clinical situation 10 years later (early adulthood). (a,b) Intraoral lateral views; (c) panoramic X-ray of the situation; (d) retro-alveolar X-ray of tooth number 45 showing atypical corono-radicular morphology; (e) CBCT-scan of the right maxilla canine region; and (f) CBCT-scan of the left premolar region.
Figure 3
Figure 3
Endodontic treatment of teeth numbers 32 and 46. Retro-alveolar X-rays before and after endodontic therapy of tooth number 32 (a,b) and number 46 (c,d).
Figure 4
Figure 4
Temporary treatment of the maxilla with a fixed tooth supported prosthesis. (a–c) Prosthetic project defined by the wax-up and set-up (frontal and occlusal views); (d) mock-up from the wax-set-up; and (e) 1st generation temporary bridge made from the wax-up and set-up.
Figure 5
Figure 5
Mandibular rehabilitation in the posterior region and lateral infraocclusion correction. (a–c) Preparations of the lateral mandibular premolar and molar regions before optical impression; (d–f) digital modelling of prosthetic parts; and (g,h) final bonded restorations (intraoral frontal view before (i) and after (j) correction of lateral infraocclusions).
Figure 6
Figure 6
Final maxilla and mandibula rehabilitation. (a–e) Final clinical frontal, lateral views; (f) initial occlusal view of the mandibular arch; (g) final occlusal view of the mandibular arch; and (h) final panoramic X-ray.
Figure 7
Figure 7
18-month follow-up. (a–d) 18 month clinical and radiographic follow-up.
Figure 8
Figure 8
Timeline and summary of management and follow-up over 15 years.
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