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Aesthetic composite veneers for an adult patient with amelogenesis imperfecta: a case report Ian Brignall Shamir B Mehta Subir Banerji Brian J Millar Dental Update 2024 38:9, 707-709.
Authors
IanBrignall
BDS, DPDS
Senior Clinical Teacher, King's College Dental Institute, London, UK
This case has been presented as part of the continual assessment requirement for the MSc in Aesthetic Dentistry, King's College Dental Institute. Amelogenesis imperfecta (AI) is a hereditary disorder of enamel formation, affecting both the permanent and deciduous dentitions. It can be classified into hypoplastic, hypomaturation and hypocalcified types and presents with different hereditary patterns. The aim of this article is to provide an overview of amelogenesis imperfecta, including a detailed case report for an aesthetically concerned adult patient presenting in general practice with a Witkop's Type IA defect managed with the placement of direct, layered resin composite veneers.
Clinical Relevance: Amelogenesis imperfecta patients are susceptible to the restorative cycle of replacement restorations like any other patient, but start with a distinct disadvantage. This case report demonstrates a minimally invasive, relatively simple and cost-effective option for the aesthetic correction of a case of hypoplastic amelogenesis imperfecta with layered composite veneers.
Article
The condition ‘amelogenesis imperfecta’ (AI) represents a rare but diverse group of hereditary disorders affecting the formation of enamel in both the deciduous and permanent dentitions. The prevalence of AI has been found to vary from 1:718 in a northern Swedish population¹ to 1:14,000 in the USA.² Since being first described by Weinmann et al in 1945,³ varying classifications have been proposed as more information has been acquired about this condition.
Witkop's most recent classification,4 as depicted by Figure 1, modifies his earlier versions and segregates AI into four groups based primarily on phenotype:
Each group has been subsequently subdivided into further categories according to the appearance and inheritance pattern of the pathology observed: autosomal dominant, autosomal recessive and X-linked dominant and recessive, thereby creating 15 subtypes.
Phenotypic variability, however, often occurs between individuals within the same family.5 Occasionally, cases can occur spontaneously,5,6 with no previous family history, however, meticulous patient assessment is paramount in view of recessive inheritance and incomplete penetrance of a dominant gene.5
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