Oral rehabilitation of tooth agenesis frequently starts in paediatric dentistry. A retrospective analysis of 625 patients

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ABSTRACT

Aim

As oral rehabilitation of tooth agenesis usually begins at a very young age, it is important to plan the therapy in advance in order to prepare the patient for the final treatment after the end of skeletal and dental growth. The diverse patterns of tooth agenesis require interdisciplinary oral rehabilitation adapted to individual factors like patient’s age, number of missing teeth, and alveolar-bone development. The aim of the present high volume single-center study was to provide an overview of the management of patients with tooth agenesis, in terms of treatment approaches, associations, and long-term implant survival, over a period of 30 years.

Methods

Descriptive analyses were performed to analyse treatment approaches and and how they reated to severity of agenesis as well as patients’ gender and age. Kaplan–Meier survival curves and log-rank-tests were used to investigate implant survival over time.

Results

Children and adolescents were the majority of patients treated for tooth agenesis (66%) at our clinic. A total of 625 patients underwent orthodontic therapy (89%); mainly combined with dental implants (41%). Kaplan-Meier-analysis for 1105 placed implants showed a survival rate of 98% over an observation period of up to 22 years. Slightly more than half of the patients received their implants before the age of 18 years (55.0%). Implant survival differed significantly between patients with hypodontia and oligodontia (p=0.002). Other treatments included prostheses (56% including 52% fixed conventional prosthesis on teeth or implants and 4% removable overdentures), tooth transplantations (8%), onplants (1%), and preservation of deciduous teeth. Significant associations between some treatment approaches and severity of agenesis, gender, and age were analysed.

Conclusion

Treatment starts usually in childhood or adolescence; orthodontic therapy was the most common treatment. All treatment options showed similar high survival rates. External bone augmentation might be a risk-factor for implant loss.

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