ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Early Dental Management of Pediatric Patients with Ectodermal Dysplasia with Removable Partial and Complete Prosthesis Can Restore Orofacial Function, Development, and Esthetics
Clinical Question In a pediatric patient with ectodermal dysplasia-associated hypodontia, will removable partial and/or complete prosthesis provide improved facial esthetics and masticatory function well into adolescence?
Clinical Bottom Line The early use of removable partial and/or complete prosthesis in a pediatric patient presenting with ectodermal dysplasia-associated hypodontia provides successful orofacial development, masticatory function, and esthetics.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 25206194Trivedi/20131 pediatric patient with ectodermal dysplasiaCase report
Key resultsThe use of removable partial and complete acrylic prostheses provided successful oral rehabilitation by restoring oral function.
#2) 15867750Tarjan/20052 pediatric patients with ectodermal dysplasiaCase report
Key resultsThe use of age-appropriate removable partial and complete prostheses provided successful dental treatment by improving oral facial functions in speech, mastication, and facial esthetics.
#3) 8933447Pigno/1996Pediatric patients with Ectodermal DysplasiaNarrative review of non-randomized trials
Key resultsRemovable partial and complete prosthesis are both acceptable forms of dental treatment for ectodermal dysplasia. Removable partial dentures allow preservation of the alveolar ridge. Overdentures and implant-supported prostheses can also improve oral function; however, implant placement is only indicated after careful consideration due to the potential to interfere with alveolar vertical growth.
Evidence Search ((removable prosthesis) AND complete prosthesis) AND ectodermal dysplasia) AND child.
Comments on
The Evidence
Validity: Case reports and narrative reviews provide minimal evidence supporting the use of removable partial and complete prosthesis in the treatment of hypodontia related to ectodermal dysplasia. The combined case reports provide consistent results that support the conclusion of the narrative review. According to the National Foundation for Ectodermal Dysplasia, only 7 out of 10,000 births are affected by ectodermal dysplasia. More studies with better methodology are needed to provide stronger evidence that can guide the clinician’s decision on treating children with E.D. in their practice. However, because of the low prevalence of ectodermal dysplasia, clinical trials or cohorts studies providing higher levels of evidence are unlikely. Perspective: The studies listed provide weak scientific evidence on the use of removable partial and complete prosthesis as successful dental treatment of ectodermal dysplasia associated hypodontia in pediatric patients. However, according to the National Foundation for Ectodermal Dysplasia, most children affected by E.D. will need some form of dental prosthesis by age 2. The information presented consistently determined that treatment using removable partial or complete prostheses for hypodontia provided significant improvement in mastication, speech, and facial esthetics and has psychosocial benefits at a young age. Additional research and evidence is warranted reflecting dental management of hypodontia in a pediatric patient diagnosed with ectodermal dysplasia.
Applicability Pediatric patients with hypodontia will need a dental prosthesis at a very young age. The evidence provided shows that removable partial and complete prostheses are the elected form of treatment for pediatric patients with hypodontia linked to ectodermal dysplasia. Dental treatment for children affected by E.D. will require multiple denture replacements throughout their childhood into their adolescent years. A close collaboration with the patient’s physician and other dental specialists such as a pedodontist, orthodontist, and prosthodontist may be required to adequately provide comprehensive dental care. Good patient rapport and rapport with the patient's guardian will also take part in the ability to provide comprehensive care. It is imperative for the dentist to educate the guardian about the dental needs of the patient and the importance of adequately providing prosthodontic treatment for the restoration of mastication, speech, and facial esthetics. For the general practitioner, referral to a prosthodontist may be warranted due to the young age of the patient and the level of expertise needed.
Specialty/Discipline (General Dentistry) (Pediatric Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords hypodontia, ectodermal dysplasia, pediatric patient, removable partial prosthesis, removable complete prosthesis
ID# 2868
Date of submission: 04/01/2015spacer
E-mail lunaal@livemail.uthscsa.edu
Author Angeline Luna
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Maria Cervantes Mendez, DDS
Faculty mentor/Co-author e-mail cervantesmen@uthscsa.edu
Basic Science Rationale
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