Complete Dental Restoration in Osteopetrosis: A Case Study
Successful complete oral rehabilitation of a patient with osteopetrosis with extensive pre-treatments, bone grafts, dental implants and fixed bridges: a multidisciplinary case report
Key Terms
Västerbotten form of autosomal recessive osteopetrosis (ARO): A rare inherited bone disease found in some people from Västerbotten, Sweden, where bones become too dense and can cause problems like weak teeth and nerve pressure.
Iliac crest bone grafting: A procedure where a small piece of bone is taken from the hip (the iliac crest) and used to help rebuild or support bones in another part of the body, like the jaw.
Titanium implants: Strong, metal posts (made of titanium) that are placed in the jawbone to act like roots for fake teeth.
Screw-retained ceramic bridges: A set of fake teeth made from tooth-colored ceramic that are held in place by screws attached to implants in the mouth.
Bone grafting: A medical procedure where a small piece of bone is added to another area of the body that needs more bone support.
Hematopoietic stem cell transplantation (HSCT): A treatment where healthy blood-forming stem cells are given to replace damaged or diseased bone marrow.
TMJ (temporomandibular joint): The joint that connects your lower jaw to your skull, which helps you open and close your mouth to talk or chew.
Simplified Case Study
This study involves a young male patient with Västerbotten form of autosomal recessive osteopetrosis (ARO), undergoes many oral treatments, including tooth extractions, temporary dentures, iliac crest bone grafting, titanium implants, and screw-retained ceramic bridges (Kelk et al., 2023).
For background, ARO causes very dense and brittle bones, resulting in severe dental problems (may include delayed tooth eruption and malformed teeth). Those with ARO often require early (before the age of 3) hematopoietic stem cell transplantation (HSCT) to prevent complications and ensure normal bone development (Kelk et al., 2023). In steps, this is how they go about with the procedure.
1. Assessment & Planning: The patient’s dental and bone conditions were evaluated to create a detailed treatment plan.
2. Tooth Removal: Malformed or misaligned teeth were extracted to prepare for restoration.
3. Bone Grafting: Bone from the hip was used to strengthen the jaw for implant placement.
4. Dental Implants: Titanium implants were placed to act as roots for new teeth.
5. Temporary Bridges: Temporary teeth were added to restore function during healing.
6. Final Restoration: Permanent screw-retained ceramic bridges were placed for a lasting, natural look.
After three years of all of these treatments, the patient is reported to have stable bone levels, no TMJ issues, and overall excellent esthetics and function with the additional 3-4 professional maintenances throughout the year (Kelk et al., 2023).
Although this case study was more general with the different treatments, we get the message that different conditions of patients will require different variations of treatments to maintain a healthy lifestyle.
Images corresponding to case study
Figure 1: A look at the patient's teeth before any dental treatment at ages 5, 8, and 9.
a shows a full-mouth X-ray at age 5.
b and c show X-ray images of the upper and lower jaws at age 8.
d shows a regular photo of the teeth at age 9.
Figure 2: First treatment of the upper jaw using a temporary removable denture at age 11:
a, b show photos of the patient’s face.
c, d show models of the teeth.
e shows a photo of the upper jaw with missing teeth, and f shows the temporary denture used to replace them.
g and h show the teeth before and after putting in the temporary denture.
Figure 3: Absence of posterior occlusion at the age of 13 years that initiated treatment planning:
a-c Facial/extra oral photograph overviews.
d-f Photographs of the dentition and lack of posterior occlusion
official case study link:
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-023-03707-3
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