Restoration of Oral Function for Adult Edentulous Patients with Ectodermal Dysplasia: A Prospective Preliminary Clinical Study.

BACKGROUND Therapy with zygomatic implants (ZIs) or conventional implants (CIs) has proven to be an effective method to restore oral function for systemically healthy patients. However, it is still a major challenge to fully restore oral function to edentulous adult patients with ectodermal dysplasia (ED). PURPOSE The aim of this study was to determine an effective treatment protocol for restoring oral function using ZIs and CIs to edentulous adult ED patients. MATERIALS AND METHODS Ten edentulous adult ED patients were treated in this study. The treatment protocol involved the following: (1) bone augmentation in the region of the anterior teeth; (2) placement of two ZIs and four CIs in the maxilla, and four CIs in the mandible; (3) fabrication of dental prosthesis; and (4) psychological and oral education. Following treatment of these patients, implant success rates, biological complications, patient satisfaction, and psychological changes were recorded. RESULTS Although there was evidence of bone graft resorption in the maxilla, bone augmentation of the mandible was successful in all patients. Nine CIs in the maxilla failed and were removed. All ZIs were successful, and the CIs success rates were 77.50% in the maxilla and 100% in the mandible, with a mean of 88.75%. The mean peri-implant bone resorption for the CIs ranged from 1.3 ± 0.4 mm to 1.8 ± 0.6 mm, and four cases exhibited gingival hyperplasia in the maxilla and mandible. One hundred percent of the patients were satisfied with the restoration of their oral function, and >50% of the patients exhibited enhanced self-confidence and self-esteem. CONCLUSIONS This study demonstrates that oral function can be restored in edentulous adult ED patients using a comprehensive and systematic treatment protocol involving psychological and oral education, bone augmentation, implant placement, and denture fabrication. Despite these positive outcomes, bone augmentation remains challenging in the anterior region of the maxilla for edentulous adult ED patients.

[1]  Wei Huang,et al.  A retrospective 3- to 5-year study of the reconstruction of oral function using implant-supported prostheses in patients with hypohidrotic ectodermal dysplasia. , 2014, The Journal of oral implantology.

[2]  Jian Sun,et al.  Long-term results for maxillary rehabilitation with dental implants after tumor resection. , 2014, Clinical implant dentistry and related research.

[3]  M. Dhima,et al.  Rehabilitation of medically complex ectodermal dysplasia with novel surgical and prosthodontic protocols. , 2014, International journal of oral and maxillofacial surgery.

[4]  U. Santana-Mora,et al.  Prosthodontic Rehabilitation in Patient With Ectodermal Dysplasia Combining Preprosthetic Techniques: A Case Report , 2013, Implant dentistry.

[5]  P. Henry,et al.  Long-term follow-up of implant treatment for oligodontia in an actively growing individual: a clinical report. , 2012, The Journal of prosthetic dentistry.

[6]  Allan S. Jones,et al.  Bone microarchitecture at oral implant sites in ectodermal dysplasia (ED): a comparison between males and females. , 2012, Clinical oral implants research.

[7]  Changzheng Huang,et al.  Mutation p.Leu354Pro in EDA causes severe hypohidrotic ectodermal dysplasia in a Chinese family. , 2012, Gene.

[8]  Wei Ma,et al.  Review of Ectodermal Dysplasia: Case Report on Treatment Planning and Surgical Management of Oligodontia With Implant Restorations , 2011, Implant dentistry.

[9]  L. Cheung,et al.  Alveolar distraction osteogenesis for oral rehabilitation in reconstructed jaws , 2011, Current Opinion in Otolaryngology & Head and Neck Surgery.

[10]  F. Momen-Heravi,et al.  Full mouth implant rehabilitation of a patient with ectodermal dysplasia after orthognathic surgery, sinus and ridge augmentation: a clinical report , 2011, The journal of advanced prosthodontics.

[11]  B. Neville,et al.  Multifocal lateral periodontal cysts: a report of 4 cases and review of the literature. , 2011, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[12]  F. Carinci,et al.  Implant Treatment in Grafted and Native Bone in Patients Affected by Ectodermal Dysplasia , 2010, The Journal of craniofacial surgery.

[13]  J. V. Van Sickels,et al.  Interdisciplinary management of patients with ectodermal dysplasia. , 2010, The Journal of oral implantology.

[14]  D. Mitchell,et al.  Strategies for Avoiding Complications with Vascularized Bone Flaps in Head and Neck Microvascular Reconstruction , 2008, Seminars in plastic surgery.

[15]  C. Marchetti,et al.  Gingival hyperplasia around implants in the maxilla and jaw reconstructed by fibula free flap. , 2008, International journal of oral and maxillofacial surgery.

[16]  M. Peñarrocha,et al.  Rehabilitation of severely atrophic maxillae with fixed implant-supported prostheses using zygomatic implants placed using the sinus slot technique: clinical report on a series of 21 patients. , 2007, The International journal of oral & maxillofacial implants.

[17]  A. Monzavi,et al.  Full mouth rehabilitation of a hypohidrotic ectodermal dysplasia patient with dental implants: a clinical report. , 2007, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[18]  M. Salter,et al.  Prosthodontic and psychological factors in treating patients with congenital and craniofacial defects. , 2006, The Journal of prosthetic dentistry.

[19]  B. Kargül,et al.  Growth analysis of a patient with ectodermal dysplasia treated with endosseous implants: 6-year follow-up. , 2006, Journal of oral rehabilitation.

[20]  L. Cooper,et al.  Facial distortion secondary to idiopathic gingival hyperplasia: surgical management and oral reconstruction with endosseous implants. , 2005, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[21]  R. Carmichael,et al.  Simultaneous functional and fixed appliance therapy for growth modification and dental alignment prior to prosthetic habilitation in hypohidrotic ectodermal dysplasia: a clinical report. , 2004, The Journal of prosthetic dentistry.

[22]  M. Peñarrocha-Diago,et al.  Fixed rehabilitation of a patient with hypohidrotic ectodermal dysplasia using zygomatic implants. , 2004, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[23]  M. Yenísey,et al.  Orthodontic and prosthodontic treatment of ectodermal dysplasia — a case report , 2004, British Dental Journal.

[24]  B. Rashedi Prosthodontic treatment with implant fixed prosthesis for a patient with ectodermal dysplasia: a clinical report. , 2003, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[25]  Tonya S. King,et al.  Prospective clinical trial of dental implants in persons with ectodermal dysplasia. , 2002, The Journal of prosthetic dentistry.

[26]  C. Vergani,et al.  Overlay removable partial dentures for a patient with ectodermal dysplasia: a clinical report. , 2001, The Journal of prosthetic dentistry.

[27]  B. Bergendal Prosthetic habilitation of a young patient with hypohidrotic ectodermal dysplasia and oligodontia: a case report of 20 years of treatment. , 2001, The International journal of prosthodontics.

[28]  D. NaBadalung Prosthodontic rehabilitation of an anhidrotic ectodermal dysplasia patient: a clinical report. , 1999, The Journal of prosthetic dentistry.

[29]  A. Pope,et al.  Factors associated with peer social competence in preadolescents with craniofacial anomalies. , 1997, Journal of pediatric psychology.

[30]  R. Cronin,et al.  Prosthodontic management of ectodermal dysplasia: a review of the literature. , 1996, The Journal of prosthetic dentistry.

[31]  P. Fodor Facial disfigurement: Problems and management of social interaction and implications for mental health , 1991 .

[32]  P. Maló,et al.  Extramaxillary surgical technique: clinical outcome of 352 patients rehabilitated with 747 zygomatic implants with a follow-up between 6 months and 7 years. , 2015, Clinical implant dentistry and related research.

[33]  Wei-Shao Lin,et al.  Use of digital data acquisition and CAD/CAM technology for the fabrication of a fixed complete dental prosthesis on dental implants. , 2014, The Journal of prosthetic dentistry.

[34]  T. Abduljabbar,et al.  Surgical and implant-supported fixed prosthetic treatment of a patient with ectodermal dysplasia: a case report. , 2012, Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry.

[35]  S. Wallet,et al.  Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: microbiological and immunological results , 2012, Clinical Oral Investigations.

[36]  B. Bergendal Oligodontia ectodermal dysplasia--on signs, symptoms, genetics, and outcomes of dental treatment. , 2010, Swedish dental journal. Supplement.

[37]  R. Kirmeier,et al.  Oral rehabilitation of adult twins with severe lack of bone due to hypohidrotic ectodermal dysplasia--a 12-month follow-up. , 2009, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[38]  J. Cano,et al.  Osteogenic alveolar distraction: a review of the literature. , 2006, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[39]  J. McCarthy Distraction osteogenesis in maxillofacial surgery using internal devices: Review of five cases , 1996 .