Elastodontic therapy in a growing patient affected by dentinogenesis imperfecta

Aim. Dentinogenesis imperfecta (DI) is an autosomal dominant disorder of tooth development. This clinic condition can be associated with osteogenesis imperfecta. At first clinical examination, these patients have short roots and crowns, hypoplastic dentin, sane enamel which tends to deteriorate due to supporting lack and a larger breadth of the pulp chamber with respect to average. Moreover, the Dentinogenesis imperfecta (DI) is also associated with different degrees of discoloration, on a color spectrum from gray to yellow-brown. From a radiographic point of view, teeth affected from DI are called “specter teeth” because of the emptiness appeareance, as it is possible to observe only the polished outlines. We used an elastodontic therapy along patient growth from the deciduous dentition to permanent one, with second class malocclusion, deep bite and lower arch crowding. Materials and methods. Elastodontic braces are devices which allow through light forces use to carry out an eruptive guide for dental elements, improve deep bite and second class malocclusion through a preformed bite construction based on a mandibular advancement. Eventually, performing the so-called “lip bumper effect”. Initially, the patient, who was five and a half years old, was treated with an elastodontic brace “Nite-Guide”, which was carried both at night and on daylight (two hours per day) performing exercises aimed to activate facial muscles and facilitate the deep bite reopening. At a later stage, when the patient was 7 years old, during her first permanent molars and incisors eruption, following best practices, it has been placed a cloggedo- Guide Series G, which is usually utilized as a brace in case of mixed dentition. At 9 years with deep bite resolution, it was reported to the patient to use the occluded-o-Guide only at night to hold down previous results and sustain patient’s dental growth. At 11 years old, after successful teeth switching, it was prescribed an occluded-o-Guide Series N, which is functional for permanent dentition and guaranteed an eruptive guide for last dental elements. Results. The patient has corrected optimally her second class malocclusion, deep bite, and dental misalignment. The elastodontic devices have allowed a proper eruptive guide for all teeth in various commuting stages. Conclusion. This clinic case could be considered an exemplificative approach for all those patients with systemic and/or dental diseases that disallow adequate dental retention, which is necessary for most orthodontic appliances, whereas elastodontic devices do not require adequate dental retention thus result as the proper solution.