Multidisciplinary Oral Rehabilitation in Osteogenesis Imperfecta: 18-Year-Old Case Report.

Osteogenesis imperfecta (OI) is a hereditary connective tissue disorder characterized by bone fragility and Type I collagen defects. Although dentinogenesis imperfecta (DI) is a classic manifestation, patients with OI may experience significant dental deterioration even in its absence due to inherent dentinal weakness. This report describes the multidisciplinary full-mouth rehabilitation of a 18-year-old male with OI and a complex medical history including autoimmune hepatitis and seizure disorder. The patient presented with extensive caries, failure of previous restorations, multiple impacted teeth, and radiographic evidence of preeruptive intracoronal resorption (PEIR) as well as open apices in permanent second molars. Severe microstomia, joint laxity, high risk of iatrogenic jaw fracture, and limited cooperation necessitated treatment under general anesthesia. Management included vital pulp therapy to promote apexogenesis in immature teeth, stainless steel crowns for posterior rehabilitation, and composite restorations using universal adhesive systems containing 10-MDP. A conservative, non-extraction strategy was adopted to minimize mandibular fracture risk. This case highlights that dental pathology in OI may originate within bone prior to eruption and emphasizes the importance of biologically driven and fracture-conscious treatment planning in medically complex patients.