Use of Dental Implants in the Management of Dental Malformations

Amelogenesis imperfecta

Amelogenesis imperfecta (AI) is a heterogeneous group of hereditary disorders that adversely affects enamel development and causes abnormalities in the amount, structure, and composition of enamel without evidence of systemic disease. Winter and Witkop and coworkers have delineated at least 12 distinct types of AI using a combination of clinical, radiographic, histologic, and genetic criteria.

Transmission of the responsible gene may take place by autosomal dominant, autosomal recessive,

Enamel aplasia

Enamel aplasia may appear at first glance to be clinically similar to AI but close clinical and radiographic examination will reveal total absence of enamel, and as a result will be characterized by extreme dental sensitivity to cold and pain. Teeth with enamel aplasia, for example in generalized odontodysplasia, may not erupt normally so tend to lie ectopically in the jaws. The reasons for treating patients who have enamel aplasia by edentulation and implant placement may be even more

Epidermolysis bullosa

Patients who have epidermolysis bullosa have dentitions grossly similar to enamel aplasia. The reconstruction of patients who have epidermolysis bullosa is difficult (Figs. 4A–4F). They have fragile skin and mucosa that must be protected during treatment to minimize bulla formation (see Fig. 4C). These bullae are painful and may lead to scarring. Moreover, these patients often have severe trismus which severely limits the access for reconstruction. To make matters worse, at least in our

Dentinogenesis imperfecta

Dentinogenesis imperfecta (DI) is an inherited malformation of the dentin. The teeth appear blue-gray or amber brown and opalescent. Radiographically, the roots are narrow with little or no evidence of a pulp chamber or root canal. The crowns are “bell shaped” and bulbous with a wide emergence profile. The enamel may shear from the dentin when subjected to occlusal forces. There are three types of DI, all with an autosomal dominant pattern of inheritance. Types I and II are distinct from each