Clinical Findings and Observation
The clinical manifestations presented by the Patient were suggestive of hypohydrotic ectodermal dysplasia. The patient appears nervous and lacks confidence; his father mentioned the same. He also mentioned psychological and emotional issues he faced during his childhood at school and in the neighborhood. This has affected his performance through low grades and his reluctance to attend school.
A clinical extra and intra-oral evaluation was done, supplemented by extra-oral radiographic assessment. The extra-oral assessment suggested sparse hair of the scalp, characterized by fragile, hypochromic, and fragile hair, a prominent forehead, sparse eyelashes and eyebrows, pigmented and altered texture of the skin over the face and neck, protrusive and prominent lips contributed to a senile appearance of the face (Fig. 1). Apart from these findings, the skin over the upper and lower limbs was dry, rough, and scaly. Finger and toenails were brittle and thick and short.
The clinical intra-oral evaluation showed multiple clinically missing permanent teeth, leading to the maxilla and mandible’s underdeveloped alveolar ridges (atrophic) (Fig.1). Mandibular teeth were absent, and four maxillary teeth were present (i.e., 11,16, 26, and 27) with peg-shaped 11 (Fig.1). Panoramic radiograph confirms the clinical findings; apart from that, it also showed incomplete formation of the roots of 16 and 26, peg-shaped 11; and associated atrophy of the alveolar ridges in the maxillary and mandibular arches secondary to congenital absence of teeth (Fig.2). The upper and lower alveolar ridges were thin. The oral mucosa appeared pale pink with rough texture.
Differential Diagnosis
The following medical disorders were considered as differential diagnoses for the medical and dental conditions of this patient (Table. 1):
Table 1. Medical conditions as a differential diagnosis for ectodermal dysplasia.