Implant-supported fixed prosthodontic treatment for ectodermal dysplasia: a case report

Ectodermal dysplasia (ED) often results in congenital tooth agenesis and severe developmental alveolar ridge defects, leading to functional impairments, reduced masticatory efficiency, and psychosocial challenges. Limited local blood supply and rapid bone resorption in ED patients pose significant challenges for predictable implant rehabilitation, highlighting the need for biologically guided, long-term restorative strategies. An 18-year-old male patient with hypohidrotic ED (HED) presented with multiple congenitally missing teeth (FDI 12–16, 22–26, 34–35, 42, 44–46) and knife-edge alveolar ridges. Following two years of fixed orthodontic treatment and maxillary sinus augmentation at an external clinic, the patient underwent simultaneous alveolar ridge augmentation with implant placement at our institution. Subsequently, implant-supported fixed prostheses were delivered. Multidisciplinary sequential treatment achieved favorable clinical outcomes (Table 1). At one-year follow-up after final prosthesis placement, all implants demonstrated stable osseointegration, marginal bone loss < 0.5 mm, probing depths < 3 mm, and bleeding on probing < 15%. Masticatory function improved significantly, and PES/WES scores reached clinically acceptable aesthetic levels. This case illustrates the feasibility of a prosthetically guided implant-supported rehabilitation for severe ED-related alveolar ridge defects, using site-specific differential treatment (simultaneous anterior ridge augmentation, delayed posterior implant placement), dual L-PRF-assisted bone and soft tissue healing, and a prosthetic strategy involving reducing the buccolingual width and occlusal contact points of the implant-supported prostheses combined with light occlusal loading, emphasizing the value of individualized treatment planning in patients with developmental alveolar bone deficiency.