Title: The restorative management of an adolescent patient with severe hypodontia utilising a digital workflow
Abstract:
Introduction: Hypodontia in adolescent patients presents significant functional and aesthetic challenges, often requiring coordinated multidisciplinary management. Restorative Dentistry input before and after orthodontic treatment is essential to guide treatment planning, optimise aesthetic outcomes, and facilitate predictable prosthetic rehabilitation. In the replacement of congenitally missing teeth, digital workflows are increasingly being adopted, with intraoral scanning supporting prosthesis design and the production of 3D-printed study models for diagnosis, treatment planning, and restoration fabrication.
Case Presentation: A 19-year-old male patient was referred to the Restorative Dentistry clinic following orthodontic correction of a Class III malocclusion on a Class I skeletal base with reduced vertical proportions and severe hypodontia involving nine missing teeth. Multidisciplinary treatment planning was undertaken within a joint hypodontia clinic before debonding of the fixed orthodontic appliances to confirm optimal space distribution and establish the restorative treatment objectives. Given the patient's age and the risks associated with dental implant placement in a growing individual, including continued craniofacial growth and the potential for infraocclusion, a conservative restorative approach was adopted. This comprised of direct composite build-ups to optimise the proportions of the existing dentition, combined with resin-bonded bridges to replace the missing teeth. Following completion of orthodontic treatment, the patient returned to the Restorative clinic to commence prosthetic rehabilitation. A fully digital workflow was utilised, beginning with intraoral scanning to generate 3D-printed study models for treatment planning, followed by a CAD-designed diagnostic wax-up.
Conclusion: This case emphasises the importance of early multidisciplinary planning and restorative input in the management of hypodontia. In young patients, treatment should prioritise prosthesis longevity to reduce the need for repeated intervention over the course of the patient's lifetime, whilst providing an optimal aesthetic outcome.
