Tooth replacements in young adults with severe hypodontia: Orthodontic space closure, dental implants, and tooth-supported fixed dental prostheses. A follow-up study

•Fifty children missing 6 or more teeth were surveyed after age 18.•Implants, space closure, and retaining deciduous teeth were the treatments of choice.•Implants in the anterior region were inadequate in patients with severe hypodontia.•Mucosal discoloration or visible metal were most pronounced in the anterior mandible.•Persisting deciduous teeth showed a good survival rate.

IntroductionChildren with severe hypodontia have a substantial impairment of their dental health starting early in life. The purpose of this study was to describe types and locations of substitutes for missing teeth in patients with severe hypodontia and to compare the crown and soft tissue morphologies of orthodontic space closure, dental implants, and tooth-supported fixed dental prostheses for replacing teeth in the anterior region.MethodsFifty patients missing 6 or more teeth and aged 18 years or older (mean age, 25.6 years) took part in a follow-up study. The patients were examined clinically with panoramic radiographs and clinical photographs. Crown and soft tissue variables (mucosal discoloration, crown morphology, color, and papilla index) were compared for orthodontic space closure, dental implant fixtures, and fixed dental prostheses.ResultsDental implants, orthodontic space closure, and retaining deciduous teeth were the most commonly prescribed treatments. Persisting deciduous teeth showed a good survival rate at the follow-up examination. Mucosal discoloration was seen only for implant fixtures and was evident for almost all fixtures in the anterior mandible and two thirds of those in the anterior maxilla. The papilla index scored poorer for both implant fixtures and fixed dental prostheses compared with orthodontic space closure.ConclusionsDental implants in the anterior region proved to be an inadequate treatment modality in patients with severe hypodontia because of pronounced mucosal discoloration.