Prosthetic treatment outcome in patients with severe hypodontia: a systematic review

Abstract

Severe hypodontia (≥6 missing teeth) is associated with aesthetic and functional problems. Its presentation is heterogenic, and a variety of treatment modalities are used resulting in different treatment outcomes. As there is currently no standard treatment approach for patients with severe hypodontia, the literature was systematically reviewed with the focus on treatment outcomes. Medline, Embase and The Cochrane Central Register of Controlled Trials were searched (last search 24 August 2015). This was completed with a manual search of the reference lists of the selected studies. To be included, studies had to describe dental treatment outcome measure(s) in patients with severe hypodontia; there were no language restrictions. The methodological quality was assessed using MINORS criteria. Twenty-one studies were eligible, but the diversity in type and quality did not allow for a meta-analysis; seventeen studies had a retrospective design; sixteen studies described the results of implant treatment. Treatment with (partial) dentures, orthodontics, fixed crowns or bridges was sparsely presented in the eligible studies. Implant survival, the most frequently reported treatment outcome, ranging from 35·7% to 98·7%, was influenced by 'location' and 'bone volume'. The results of implant treatment in severe hypodontia patients are promising, but due to its heterogenic presentation, its low prevalence and the poor quality of the studies, evidence-based decision-making in the treatment of severe hypodontia is not yet feasible, thus prompting further research.

A systematic review: the prevelance of partial edentulourism in patients with ectodermal dysplasia

“…In a nutshell, the capability of deciding on a treatment for patients that have hypodontia in accordance to the evidence is not yet possible [30] . Although implant therapy for hypodontia patients have a better outcome, when dealing with children, removable partial denture is the most suitable choice.…”

“…The main reason behind this is because an ongoing eruption of teeth will result in the implant submerging; similar to that of secondary retention of teeth [32] . Children on the other hand, are more easily adapted to removable partial dentures; as it can be known as their 'interim phase' [30] .…”

“…Since this review is more focused on children that are affected with severe hypodontia, generally, removable dentures are more targeted towards them. One reason being that implants require more bone availability in the jaws and another reason being that it is a much more lower cost treatment option [30] . Generally, it is not recommended for growing children to have implants except for the interforaminal area of the mandible [31,32] .…”

Effect of implant therapy on oral health‐related quality of life (OHIP‐49), health status (SF‐36), and satisfaction of patients with several agenetic teeth: Prospective cohort study

“…A wide range of prosthetic treatment options are available to improve function and dental appearance in hypodontia patients, of which fixed prosthodontics on dental implants is currently the preferred treatment 9, 10. However, the effect of such treatment on patients with more than 4 agenetic teeth (third molars excluded) is not well understood as it has only been assessed in patients with more than 1 agenetic teeth 11, 12, 13, 14.…”

Three-dimensional computer-guided implant placement in oligodontia

“…The need for oral rehabilitation in patients with oligodontia is high as they often suffer from functional and aesthetic problems due to a high number of missing teeth. Implant-based prosthodontics seem to be favourable to improve oral function and aesthetics in oligodontia [2]. …”