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.