Schnabl D, Grunert I, Schmuth M, Kapferer-Seebacher I
University Hospital for Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, Austria.
Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria.
J Oral Rehabil. 2018 Jul;45(7):555-570. doi: 10.1111/joor.12638. Epub 2018 May 9.
Hypohidrotic ectodermal dysplasia (HED) comprises a large group of inherited disorders of ectodermal structures, characterised by hypo- or anhidrosis, hypotrichosis and hypo- or oligo- or anodontia. We aimed to systematically assess the spectrum of prosthodontic approaches with regard to the patients' age and to provide clinical implications for practicing dentists. An electronic and manual search was conducted in four databases (Medline, LIVIVO, Cochrane Library, Web of Science Core Collection). Publications of multiple study designs written in English or German without data restrictions, reporting on prosthodontic treatment of patients diagnosed with HED and afflicted with oligo- or anodontia, were included. In total, 75 articles on 146 patients were analysed according to the patients' age. In children aged 2-17 years, removable full or partial (over)dentures represented standard treatment. In the mandible, implant-supported removable dentures on two interforaminal implants presented an alternative, already in young childhood. In cases with more than six teeth per jaw, also fixed (resin) bridges were used, frequently after orthodontic treatment. In adults, fixed or removable reconstructions with the help of up to eight implants per jaw, usually placed after bone augmentation procedures, were standard. Ten case reports/series with long-term follow-up illustrated the need for consistent maintenance including denture renewals. Prosthodontic rehabilitation should start in early childhood and needs to be revised in accordance with the patients' growth. Treatment should be carried out by a multidisciplinary team addressing variable demands in different age groups.
少汗型外胚层发育不良(HED)是一大类外胚层结构的遗传性疾病,其特征为少汗或无汗、毛发稀少以及牙齿发育不全、牙齿缺失或无牙。我们旨在系统评估针对患者年龄的口腔修复方法,并为执业牙医提供临床指导。我们在四个数据库(Medline、LIVIVO、Cochrane图书馆、科学网核心合集)中进行了电子检索和人工检索。纳入了以英文或德文撰写、无数据限制、报告诊断为HED且患有牙齿缺失或无牙的患者的口腔修复治疗的多种研究设计的出版物。总共根据患者年龄分析了75篇关于146例患者的文章。在2至17岁的儿童中,可摘全口或局部(覆盖)义齿是标准治疗方法。在下颌骨中,在两个下颌孔间植入物上支持的种植体支持可摘义齿在幼儿期就是一种替代方法。在每侧颌骨有超过六颗牙齿的情况下,通常在正畸治疗后也会使用固定(树脂)桥。在成年人中,每侧颌骨使用多达八颗种植体进行固定或可摘修复,通常在骨增量手术后进行,这是标准做法。十篇长期随访的病例报告/系列说明了持续维护的必要性,包括义齿更新。口腔修复康复应在幼儿期开始,并需要根据患者的生长情况进行调整。治疗应由多学科团队进行,以满足不同年龄组的各种需求。
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