Based on case history, clinical assessment, and radiological findings, the diagnosis was confirmed as ectodermal dysplasia (ED) of the hypohydrotic variant.

After careful patient assessment, a detailed, comprehensive treatment plan for corrective rehabilitation was planned out. The patient and his father were given two options:

First prosthetic implant-supported prosthesis.

Second, removable dentures for maxillary and mandibular arches.

The Patient and his family discussed the pros and cons of each treatment option, and it was decided to proceed with removable dentures for the maxillary and mandibular arches. The patient was informed about the future implant-supported prosthesis in the upper and lower arches.

Before the commencement of treatment, consent was obtained from the patient. He was given the option of reshaping 11, which he declined. A frenectomy was done for the maxillary labial frenum, which was necessary to provide a better fit for the prosthesis. Irreversible hydrocolloid impressions (Tropicalgin, Zhermack S.P.A, Italy) were made for maxillary and mandibular arches, and casts were poured using dental stone (Kalabhai Kalstone, Kalabhai Karson Pvt Ltd, India). Special trays were fabricated, and border moulding was done with a thermoplastic material (DPI^® Pinnacle, Dental Products of India, India) for a better marginal seal and fit. Functional wash impressions were made using light body polyvinyl siloxane impression material (Aquail^® Ultra⁺ Dentsply, Milford, DE, USA), impressions were poured with dental stone, and casts were obtained. Maxillo mandibular relationships were established, followed by a recording of the vertical dimension of occlusion and centric relation. This was followed by mounting the cast on a semi-adjustable articulator setting of the teeth and clinical trial. The final trial also allows the clinician to verify centric and vertical facial relations, occlusion, phonetics, and retention of the plates. Maxillary and mandibular dentures were fabricated using a cross-linked heat cure acrylic resin (DPI^® Heat Cure, Dental Products of India, India). The denture was placed inside the patient’s mouth and adjusted (Fig. 3). There was an immediate improvement in the patient’s vertical facial profile, thus improving his facial profile (Fig. 4). The Patient was provided information on how to insert and remove the dentures, maintenance of hygiene, and usage.

Follow-up was done after one week to check the fit of the maxillary and mandibular dentures. This was followed by a three-month follow-up for the next two visits and 6 months after. The Patient is motivated to maintain good oral and denture hygiene at each follow-up appointment. Regular follow-up visits and check-ups have been emphasized at each appointment to ensure the success of the treatment.

The patient was successfully rehabilitated with maxillary and mandibular removable dentures. He was happy and satisfied with his improved facial aesthetic and oral functions. This has increased his self-esteem and confidence.

The case under discussion was diagnosed with ED based on distinctive clinical features and radiological findings. One of the most important intra-oral findings was multiple clinically missing permanent teeth; the teeth that were present exhibited abnormal shape, making oral rehabilitation challenging. Oral rehabilitation of ED patients is demanding and requires a multidisciplinary approach. The primary goal of such an approach is the combination of active preventive measures and prosthodontic interventions. Preventive measures include reinforcement of oral hygiene instructions and oral health education. To achieve the patient’s aesthetic, speech and masticatory functionality as far as the treatment modality is concerned is based on age, skeletal growth, development of the stomatognathic system, degree of malformation, dental agenesis, and patient motivation.

Prosthetic implant is the treatment of choice for adult patients with ED.¹⁸ Studies have suggested an increase in the prevalence of failure of prosthetic implants in the maxillary anterior.¹⁹ In partial or complete anodontia of the maxillary and/or mandibular arch, the height of the alveolar bone is compromised, further complicating the rehabilitation. Further, such approaches are contraindicated in growing patients. Oral rehabilitation with removable partial and/ or complete prostheses and composite resin restorations is the treatment of choice in growing or young adult patients. Removable prostheses fabricated with cross-linked heat-cured acrylic resin are frequently reported in the literature due to their ease of fabrication and cost-effectiveness. After considering all the limiting factors, such as biological and economic factors, a removable prosthesis for the maxillary and mandibular arches is needed. Patients are usually advised to be on regular follow-up appointments to adjust the appliance and its maintenance for optimal function.

Marked improvement in the facial aesthetic was evident following the insertion of the removable prostheses; apart from this, the patient noted an improvement in the form and functions, such as speech and masticatory efficiency.

The comprehensive and holistic oral rehabilitation of ED patients is challenging and requires a multidisciplinary approach. Conventional maxillary and mandibular removable dentures effectively rehabilitate the patient by improving the patient’s stomatognathic function, aesthetics, and self-confidence.