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Chapter 33
Oral-Facial Aspects of Osteogenesis
Imperfecta
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FIGURE 33.1 Typical shade of gray as seen in the dentition of a 13-year-old patient with OI. Notice the negative
anterior overjet indicative of a Class III malocclusion. This fi gure is reproduced in color in
the color plate section.
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FIGURE 33.2 Spontaneous fracture of a permanent molar with DI. Notice the color of the underlying dentin.
This figure is reproduced in color in the color plate section.
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FIGURE 33.3 The primary incisor on the left belongs to a child with OI. The primary incisor on the right
belongs to a healthy child. However, not all OI patients have teeth that are smaller than normal. This figure is
reproduced in color in the color plate section.
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FIGURE 33.4 The pan-oral radiograph shows the bulbous crowns of the teeth with calcified canals. The child
is 14 years old. The mandibular second molars have just erupted and have large pulpal spaces. Pulpal
spaces calcify very quickly once they erupt. The pulpal spaces of the maxillary second and third molars are
wide and the molars are impacted.
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FIGURE 33.5 There is an evident lack of eruption of the posterior teeth. The second primary molars are
retained with full roots and the permanent bicuspids below show their twisted roots.
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FIGURE 33.6 Retained primary teeth and underlying succedaneous teeth in an OI patient who received IV
bisphosphonates.
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FIGURE 33.7 Lateral cephalometric radiograph and tracing of an OI type III patient presenting with severe
lateral open-bite and retrusive maxilla.
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FIGURE 33.8 Adolescent with type I OI with agenesis of the permanent maxillary right canine, but no DI. This
fi gure is reproduced in color in the color plate section. (From ref. 48 )
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FIGURE 33.9 Same individual as in Figure 33.8 post-orthodontic treatment. This figure is reproduced in color in
the color plate section. (From ref. 48 )
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FIGURE 33.10 Young OI type 1 patient presenting with a moderate malocclusion and DI. This figure is
reproduced in color in the color plate section.
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FIGURE 33.11 Lateral cephalometric radiograph and tracing of a patient with type I OI showing moderately
abnormal findings in the anteroposterior plane. Vertical plane measurements are within normal
limits. The tendency towards a Class III skeletal malocclusion is present with compensation of the incisor
angulations to have a positive anterior overjet. This figure is reproduced in color in the color plate section.
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FIGURE 33.12 Intra-oral photo showing retrusion of the maxilla, forwards rotation of the mandible, anterior
cross-bite (negative anterior overjet), and DI. This figure is reproduced in color in the color plate section.
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FIGURE 33.13 Eight-year-old male patient presenting with the typical facial pattern associated with OI type
III. Triangular face, bossing of the forehead, low-set ears and maxillary retrusion. This figure is reproduced in
color in the color plate section.
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FIGURE 33.14 Adult with type IV OI with mandibular prognathism (Angle Class III malocclusion), and DI. This
figure is reproduced in color in the color plate section. (From ref. 48 )
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FIGURE 33.15 Same individual as in Figure 33.14 post-orthodontic treatment and orthognathic surgery of the
maxilla and mandible. This figure is reproduced in color in the color plate section. (From ref. 48 )
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FIGURE 33.16 Mandibular arch of a 13-year-old OI type III female showing an enlarged intermolar distance
resulting in a posterior cross-bite. This figure is reproduced in color in the color plate section.
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FIGURE 33.17 Craniofacial reconstruction from a cone-beam CT scan of a type III OI patient following
orthodontic and prosthetic treatment. This figure is reproduced in color in the color plate section.
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FIGURE 33.18 Lateral cephalometric radiograph and tracing of an OI type III patient presenting with severe
lateral open-bite and retrusive maxilla. Cephalometric measurements are markedly abnormal horizontally and
vertically. This figure is reproduced in color in the color plate section.
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FIGURE 33.19 Periapical radiographs of an OI type III patient. After 18 months of treatment and slow
orthodontic movement, no evidence of root resorption is evident. This figure is reproduced in color in the color
plate section.
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