Stunted growth, concave profile, unilateral posterior crossbite, open bite of 4mm, no enamel, clinically visible dentin, enlarged pulp chambers, open root apex (evident on OPG) and on oral bisphosphonates.
The first thing to mention is the fact that bisphosphonates are contra-indicated for patients with hypophosphatasia. So this treatment might influence any other measures. The second point is that tooth loss is always possible in hypophosphatasia (HPP) due to the defective dentin and the enlarged pulp chambers. So any movement of teeth should be performed as slowly and carefully as possible. Probably the most experience in this field can be found at the university dental clinic in Wurzburg, Germany, in the person of Ulrich Schlagenhauf. He might have some further advice, so feel free to contact him.
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