Yoshihiro Goto: Oral rehabilitation of amelogenesis imperfecta

Amelogenesis imperfecta (AI) represents a very challenging situation for both patient and clinician. Besides malformation of the enamel layer and tooth discoloration, AI often shows other severe symptoms such as teeth impaction, root malformation and severy malocclusion. For the patient AI usually means a compromised appearance, unesthetic smile and therefore has a considerable psychosocial impact. For the clinician AI is difficult to treat, diagnosis and treatment planning are of key importance. Dr Goto reviews treatment options and their advantages and disadvantages. Treatment options include for example forced eruption of impacted teeth and restoration, or extraction and implant based tooth replacement. Dr Goto leads through a patient treatment example, with extraction of all impacted permanent teeth and implant based full rehabilitation. A long term temporary denture was supported by the deciduous teeth, which also served as surgical guide support during implant surgery and in turn were extracted after implant placement. The treatment was started, when the patient was 16 year old, and was finished and restored with 6 segmented fixed implant supported bridges, when she was 21 year old. Impant based restoration is a very helpful treatment alternative in AI situations and can considerably increase patient's confidence and quality of life.