Contributor

Dr. E. Kotsiomiti

Country - Institution

Department of Removable Prosthodontics, The Dental School, Aristotle University of Thessaloniki, Greece

Title

Prosthodontic management for children and adolescents with lack of multiple teeth: Aims, planning and delivery of treatment

Summary

The lack of multiple teeth in the early years of life may be congenital or acquired. Failure of development of the teeth germs (teeth agenesis) is the usual cause of the absence of many (oligodontia) or all (anodontia) teeth in children and adolescents. Oligodontia or anodontia are met either as a symptom of a syndrome or as an isolated entity. Normally developed teeth may also be lost because of trauma, caries, surgery or syndromes affecting periodontal health. The origin of teeth lack is related to the clinical presentation, accompanying symptoms and signs, craniofacial growth, pattern of heredity and genetic identity.

Although the prevalence of oligodontia is small, the affected children constitute a special edentulous population with severe needs which have to be addressed. Early prosthodontic intervention offers functional and aesthetic improvement and contributes to the psychosocial maturation. The established prosthodontic means and methods form the basis of the treatment protocol. The prosthodontic intervention aims in immediate and long-term restoration, as well as craniofacial growth support. The treatment plan is set up from the beginning of the treatment, provides for the multi-faced long-term follow up and includes the definite restoration to be placed on adulthood. Simple procedures and devices are employed and the protocol is kept minimally invasive and flexible, in order to respond to the changing background and evolving needs. Regular follow-up as well as coordination with the preventive and therapeutic treatments provided by the multidisciplinary team are necessary.

The treatment protocol applied for children with lack of multiple teeth in the Clinic of the Department of Removable Prosthodontics has been formed according the above guidelines and effectively serves the needs of the young patients throughout their growing years. The prosthodontic treatment is planned in response to the special characteristics and difficulties, which are dictated by the acquired or congenital nature of the defect, as well as its length and location. The treatment objectives are constantly re-evaluated to accommodate the oral, craniofacial and psychological growth changes. The prosthodontic treatment during growth is delivered by successive removable interim prostheses, which can be readily repaired and replaced. Simple and resourceful interim devices, exploiting the modern prosthodontic materials and procedures and preserving the integrity of the intraoral tissues, are an effective instrument for the delivery of the prosthodontic treatment until the completion of growth.