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OBJECTIVES: The decision to preserve or to extract a deciduous tooth without a successor hinges upon whether it can be expected to be stable over time. This study aimed to record the number and location of deciduous teeth and to examine the condition of deciduous canines and molars in a group of patients with severe hypodontia, both at baseline and at follow-up. MATERIAL AND METHODS: A total of 50 patients participated in a follow-up study. The average age was 13.9 years (range 7-25 years) at baseline and 25.6 years (range 18-38 years) at follow-up. Of the 50 subjects, 44 had at least one persisting deciduous tooth at follow-up and 42 had at least one deciduous canine or molar at baseline. The presence of persisting deciduous teeth was identified on panoramic radiographs. Deciduous canines and second molars were classified as good or poor based on infraocclusion, root resorption, and restorations. RESULTS: The mean number of persisting deciduous teeth per patient was 6.3 (range 1-16) at baseline and 2.6 (range 0-9) at follow-up. The tooth types with the highest tendency to remain were canines and second molars, and in particular canines in the mandible. Among the 42 participants with a deciduous canine or molar, 183 teeth were present at baseline, of which 112 were classified as good. At follow-up, 86 (77 per cent) of these were still present, with 65 (58 per cent) classified as good. The number of teeth classified as poor due to infraocclusion decreased much more from baseline to follow-up than those classified as poor due to root resorptions and restorations, indicating that infraoccluded teeth were lost during the observation period. CONCLUSIONS: Preserving deciduous canines and molars in good condition is often a dependable choice. Early infraocclusion is detrimental to the prognosis and often leads to tooth loss. Teeth with short roots proved to be more stable over time.

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INTRODUCTION: Children with severe hypodontia have a substantial impairment of their dental health starting early in life. The purpose of this study was to describe types and locations of substitutes for missing teeth in patients with severe hypodontia and to compare the crown and soft tissue morphologies of orthodontic space closure, dental implants, and tooth-supported fixed dental prostheses for replacing teeth in the anterior region. METHODS: Fifty patients missing 6 or more teeth and aged 18 years or older (mean age, 25.6 years) took part in a follow-up study. The patients were examined clinically with panoramic radiographs and clinical photographs. Crown and soft tissue variables (mucosal discoloration, crown morphology, color, and papilla index) were compared for orthodontic space closure, dental implant fixtures, and fixed dental prostheses. RESULTS: Dental implants, orthodontic space closure, and retaining deciduous teeth were the most commonly prescribed treatments. Persisting deciduous teeth showed a good survival rate at the follow-up examination. Mucosal discoloration was seen only for implant fixtures and was evident for almost all fixtures in the anterior mandible and two thirds of those in the anterior maxilla. The papilla index scored poorer for both implant fixtures and fixed dental prostheses compared with orthodontic space closure. CONCLUSIONS: Dental implants in the anterior region proved to be an inadequate treatment modality in patients with severe hypodontia because of pronounced mucosal discoloration.

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BACKGROUND: The aims of this study were to (1) investigate to what extent the generic and condition specific (CS) forms of the oral impact of daily performance (OIDP) inventory discriminate between a group of patients with hypodontia and a group of patients having malocclusion, (2) assess the association of the generic and CS OIDP with severity and localisation of hypodontia, whilst adjusting for patients' age and sex. METHODS: A total of 163 patients aged 10-17 years were included in a cross-sectional study. Two groups were investigated: 62 patients with non-syndromic hypodontia and 101 non-hypodontia patients. Both groups had a malocclusion of similar treatment need. All patients underwent a clinical and radiographic examination and completed a Norwegian version of the generic and the CS OIDP inventory. CS scores were established for impacts attributed to hypodontia. RESULTS: The mean number of missing teeth in the hypodontia group was 6.2. The prevalence of generic and CS oral impacts in the hypodontia group were 64% and 30%, and the corresponding rates in the non-hypodontia group were 62% and 10%. The generic OIDP did not discriminate between the two groups with respect to overall scores. The CS OIDP discriminated strongly between patients with and without hypodontia regarding problems with emotional status, showing teeth, social contact, speaking and carrying out work. Compared to the non-hypodontia group, patients with hypodontia, with severe hypodontia (≥ 6 missing teeth) and upper anterior hypodontia were respectively 3.4, 2.5 and 7.0 times more likely to report any oral impact attributed to small teeth, gaps between teeth and missing teeth. CONCLUSIONS: Hypodontia and malocclusion patients report a considerable burden of oral impacts. The CS-OIDP measure discriminated most effectively between patients with and without hypodontia and was related to severity and upper anterior localisation of hypodontia.

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This study aimed to assess infraocclusion, root resorption and restorations and their importance for the prognosis of retained primary mandibular molars lacking successors. The sample comprised 188 persisting primary mandibular second molars in 111 subjects, 48 males and 63 females, with a mean age of 12.6 years. The patients had been referred to an interdisciplinary clinic because of extensive hypodontia, missing 8.4 teeth on average. All persisting primary mandibular molars were included in the study, as no decision had been made as to whether they should be kept or extracted. Panoramic radiographs were used to assess infraocclusion, resorption of the mesial and distal roots and whether restorations were present. Clinically significant infraocclusion was observed in 43.6 per cent of the patients and classified as severe in 18.8 per cent. The mesial and distal root exhibited no resorption in 18.9 and 33.3 per cent, respectively (P = 0.01). Most primary molars had no restorations (78.4 per cent). A significant correlation was found between root resorption and infraocclusion. Age was found to be weakly but significantly correlated with root resorption and infraocclusion. No significant relationship was observed between gender and either infraocclusion or root resorption. In conclusion, infraocclusion was estimated to be a more critical factor for the prognosis of retained primary molars than root resorption.

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