An interesting case of Hypohidrotic Ectodermal Dysplasia was seen at our clinic recently. The patient was a 6 year old child with congenital HED and only a single upper rudimentary tooth in the central incisor area. Dr. Reshma Gidwani has fabricated a full denture for the child and has presented this interesting case very adroitly.

Introduction
Hereditary hypohidrotic (anhidrotic) ectodermal dysplasia is a specific syndrome characterized by a congenital dysplasia of one or more ectodermal structures and their accessory appendages, manifested primarily by hypohidrosis, hypotrichosis and hypodontia. Hereditary hypohidrotic (anhidrotic) ectodermal dysplasia is an X linked recessive mendelian character. Males are affected more frequently than females.

Clinical Features
Patients usually exhibit a soft, smooth, thin dry skin with partial or complete absence of sweat glands.
The oral findings are of interest since patients manifest anodontia or oligodontia, complete or partial absence of teeth, with frequent malformation of any teeth present, both deciduous and permanent dentitions. Where some teeth are present they are commonly truncated or cone shape. Even when complete anodontia exists, the growth of the jaw is not impaired.

Case report
A seven year old boy with ectodermal dysplasia was referred to Sanjeevni dental clinic by a private practitioner. He is the second child with normal sibling born to healthy parents with no family history of ectodermal dysplasia. This was discovered when the child was 2-3 months old.

On intra oral examination
The teeth present are 16,26 & a conical mesiodens. The lower jaw is edentulous. Roentgenographic examination was done & the orthopanthomogram revealed permanent tooth buds of 11,21,36,46.The root formation is still incomplete.

Management
The aim of treatment is to improve the patient's masticatory function as the overall health of the patient is affected because of his inability to eat. Also the appearance of the child is an important feature as the child could be psycologically affected because of the absence of teeth. The treatment plan was explained to the parents. Upper & Lower dentures were constructed. The parents were made aware that the child would have to visit the dentist regularly & have the dentures adjusted to compensate for the jaw growth.

On the first day , the patient was explained the nature of the procedures that were going to be carried out. Primary impressions of the upper & lower jaw was taken using sodium alginate impression material on perforated stock trays. The models were sent to the laboratory and special trays were made in cold cure acrylic . On the second visit the final impression was taken.Border moulding was done using green stick compound & rubber base wash impression was made.

The next step was to record the jaw relation of the patient. Vertical & Centric relation was established. After the wax bite registration the Try-in was performed & finally the denture was delivered. Patient was asked to report back after two days for a recall visit. On the recall visits it was noticed that the patient is now comfortable with the dentures. The future plan is to change the dentures on a 6 to 8 monthly basis to take into account the growth of the jaws.