[THE EFFECT OF DOWN SYNDROME ON TEETH AND JAWS DEVELOPMENT - THE FIRST CASE REPORT ON DENTAL IMPLANTS WITH 15 YEARS FOLLOW-UP].

INTRODUCTION: Down syndrome presents dentists with several treatment problems due to hereditary olygodontia of permanent teeth, abnormal development of the midface causing small maxilla and class III occlusion, abnormal mineralization of teeth, reduced bone density and hypotony. The challenge of replacing missing permanent teeth was the trigger for the development of dental implants some 30 years ago. However, the abnormal development of jaw bones and the reverse occlusion caused concerns in the dental community regarding the possibility of using dental implants in Down syndrome patients. In 1999 the dental team of Barzilai Medical Center was the first to insert dental implants in a Down syndrome adolescent in order to replace 4 missing premolars. One implant was lost during the healing process, and the other 3 were followed for 15 years. One of the most important factors affecting implant success is gingival health. Periodontitis affects bone height and retention of the implant. Our patient was observed in the dental clinic every 3 months for the last 15 years for plaque and calculus control. The close follow-up and treatment kept the alveolar bone healthy and at the same height as at the beginning. This case report is unique since it is the first of its kind with a 15 year follow-up. Furthermore, it showed that frequent visits and control of gingival health keeps the bone healthy and at the same height as at the beginning.