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The prosthodontic pathway for patients with anomalies affecting tooth structure

From Volume 43, Issue 4, May 2016 | Pages 356-374

Authors

Dominic P Laverty

ACF/StR in Restorative Dentistry, Birmingham Dental Hospital

Articles by Dominic P Laverty

Matthew BM Thomas

BDS(Hons), MFDS, MPhil, MRDRCS(Ed), FDS RCS(Eng), FDS RCS(Ed), FDTFEd

Specialist Registrar in Restorative Dentistry, Cardiff University School of Dentistry, Heath Park, Cardiff, UK

Articles by Matthew BM Thomas

Abstract

There are a number of anomalies that affect the structure of the dental hard tissues which impact upon the form, function and aesthetics of the dentition. Understanding the challenges these conditions pose will enable dentists to manage the functional and aesthetic problems with restorative techniques better. This article will present cases that demonstrate the different conditions, the restorative challenges experienced and a variety of restorative treatments in the management of these conditions.

CPD/Clinical Relevance: Awareness of different anomalies affecting tooth structure that may present to the dental practitioner is necessary. Clinicians should appreciate the specific restorative challenges that may arise in treating such patients and the possible treatment options that may be available.

Article

There are a number of local and systemic conditions that affect the structure of the dental hard tissues that the GDP may come across in practice. This includes anomalies such as amelogenesis imperfecta and dentinogenesis imperfecta, which are well known to those specialists who work in secondary care environments.

These conditions are developmental abnormalities and can affect the form, function and aesthetics of the whole dentition, which can potentially have a psychological impact on the patient. Other anomalies that affect one or two teeth, such as dens invaginatus or fusion, are no less important simply because they are more localized.

These conditions often appear early in life and require immediate management and treatment where necessary. As patients get older they may be referred for restorative specialist advice and treatment. Treatment can be challenging, complex and prolonged. Even when treatment is complete the patient will require long-term review and maintenance.

Although several conditions can affect tooth structure, the aim of this article is to provide an overview of selected anomalies that affect the dental hard tissues and to present case examples of the range of restorative treatment performed on this patient group. Many of these patients are treated in specialist settings; however, it is likely that general dental practitioners will come into contact with these patients before, during or after treatment phases. This paper will highlight strategies to overcome specific challenges with the restorative aspect of their dental care.

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