Restorative Management of Dentinogenesis Imperfecta in an adult - A case report

Dentinogenesis Imperfecta is a localized mesodermal dysplasia affecting both the primary and permanent dentition. First described in the late 19th century, it is characterized by discolored and translucent teeth ranging from grey to brownish-blue or amber. Dentinogenesis Imperfecta, type II (DGI-2) is rare and it is a severe form of the condition. Radiographically, the crowns of the teeth are bulbous with marked cervical constrictions, and the pulp chambers become obliterated over a period of time. Sensori-neural hearing loss has also been reported in some patients. This case report presents the restorative management of DGI-2 in a 44year old clergy woman whose primary complaints were poor aesthetics and lack of social acceptance. The case was managed with consideration of the patient's limited financial resources at the Lagos State University Teaching Hospital,Ikeja (LASUTH). The objective of the management of this condition was to open the bite of the patient using maxillary posterior bite plane followed by intermediate restoration of worn teeth using composite resin for the newly established occlusion. The patient used the restorations for a while before definitive restorations, using ceramo-metal crowns as well as over dentures, were carried out. The restorative treatments corrected the patient´s vertical dimension of occlusion with resultant acceptable aesthetics and function. The patient was satisfied with maxillary anterior ceramo-metal crowns and a posterior removable over denture as well as a complete mandibular over denture. Key words: Dentinogenesis imperfecta; Restorative treatment; Over-denture