Hypodontia and its impact on a young person's quality of life, esthetics, and self-esteem.

INTRODUCTION: The impact of hypodontia on quality of life is a relatively unexplored area. The limited research shows that the issues of importance for people with hypodontia can vary from those of patients undergoing routine orthodontic treatment. This research aimed to use generic and condition-specific scales to evaluate the impact of hypodontia on a young person's oral health-related quality of life, self-esteem, and aesthetics. METHODS: This prospective cross-sectional hospital-based study recruited 97 participants with hypodontia, aged 11-18 years. The following questionnaires were completed before the start of any planned treatment: child perception questionnaire, Bristol condition-specific questionnaire for hypodontia, child health questionnaire, and Oral Aesthetic Subjective Impact Scale. A priori sample size calculation determined a minimum of 65 participants were required, at the 5% level of significance, and with a power of 80%. The number was inflated to allow for dropouts/loss to follow-up by 30%. RESULTS: A total of 323 teeth were missing; 58 subjects (36 female) showed mild (2 absent teeth), and 39 subjects (25 female) showed moderate to severe (>2 absent teeth) hypodontia. Forty-one (42%) patients were missing anterior teeth, with absent maxillary lateral incisors predominating. Significant differences were found for the overall child perception questionnaire (P = 0.01), emotional (P = 0.005), and social (P = 0.003) well-being; scores were highest in the moderate to severe hypodontia group, revealing the greatest negative impact. Similarly, overall Bristol condition-specific questionnaire for hypodontia (P <0.001), treatment (P = 0.001), appearance (P = 0.013), and other people's reaction (P <0.001) domains were all significant, with the moderate to severe group reporting higher levels of negative impact. No significant differences were observed in self-esteem or esthetics. CONCLUSIONS: Hypodontia in young people appear to have a negative psychosocial impact, both in terms of its presentation and planned care.

Duane retraction syndrome mimicking orbital fracture.

We describe the case of a 20-year-old patient who presented at the accident and emergency department with symptoms and signs of fractures of the zygomatic complex and orbit following an assault. He was later discovered to have Duane retraction syndrome, a rare congenital disorder of eye movement that has some of the clinical characteristics of fractures of the zygomatic complex and orbit. The fracture was not displaced, and without knowledge of the syndrome a surgeon might have been forced to investigate further.