Dentofacial Pattern in Patients with Severe Congenital Absence of Teeth

Patients with Multiple Congenitally Missing Teeth (MCMT) have a characteristic skeletodental pattern and present a challenge to the dental profession. Objective: To describe the dentofacial pattern of those patients with severe congenital absence, posing the most difficult orthodontic and prosthetic problems, and to compare it with normals. Material and methods: The parent sample comprised of 115 individuals with at least 3 missing teeth. From this, a group of 29 patients with 10 or more congenitally missing teeth (third molars excluded) were examined cephalometrically for the present study. Eleven angular and ratio cephalometric parameters were compared with the classical straight profile and Israeli more convex face. Results: Statistically significant differences were observed between the study groups and the classical norms indicating that the MCMT group has a retrognathic position of the maxilla and mandible (p=0.001), decreased chin angle (p=0.000), reduced lower anterior facial height (p=0.041) and retroclined maxillary incisors (p=0.000). Comparison with the Israeli norms (Gleis et al., 1989) showed that the MCMT group exhibited a retrognathic position of the maxilla (p=0.003), decreased ANB angle (p=0.008) and FMA (p=0.000), increased interincisal angle (p=0.000) and a very straight profile (N-A-Pog, p=0.000). The range of most of these measurements was wider in the affected group than in the normal population pointing to a wide variability in the facial pattern of these patients. Conclusion: Patients with severe absence of congenitally missing teeth (MCMT) present extreme dentofacial patterns which require far reaching dental (orthodontic and or prosthetic) compensations in their rehabilitation. Supported by a joint research fund of the HU-Hadassah SDM founded by the Alpha omega fraternity and the Hadassah Medical Organization