Osteogenesis imperfecta

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1.5. Odontological considerations

Considering the variable and early dental impact in OI, these patients must undergo evaluation and regular monitoring by a dentist starting 6 months after the eruption of their first teeth or from the time of diagnosis if it occurs later in life. Maintaining good oral hygiene from the outset is of utmost importance to control dental plaque and prevent the development of cavities. This preventive approach is particularly vital as it can help avoid exacerbating the fragility and wear of their teeth. The dentist will guide measures to prevent dental erosion and consider protective interventions such as preformed crowns.

When discolouration resulting from dentinogenesis imperfecta becomes a matter of aesthetics, veneers (thin coverings for the visible surface of incisors or canines) or crowns (caps) can be used. The decision to employ these restorative options will be assessed on an individual basis, taking into consideration the extent of the condition and the patient's age.

Starting from around the age of 6-7, the dentist will monitor the transition of the dentition, the emergence of eruption irregularities, and the presence of malocclusion and/or an open bite. If corrective measures are deemed necessary, the specialist will contemplate orthodontic treatment (braces) while considering the challenges associated with bonding devices to brittle enamel.

Regarding affected teeth, the dentist will evaluate whether it is preferable to leave them in place, extract them, or attempt repositioning. Conversely, when teeth are missing, the feasibility of dental implants will be examined. Dental implants are secured in the bone; hence, the dentist must be well-versed in the bone characteristics of OI and assess whether adequate bone structure is present for successful implantation. Partial or complete dentures may be considered in cases involving multiple missing teeth.

 

Last modified
14 July 2023