RESUMO
INTRODUCTION: One of the major difficulties with respect to molar incisor hypomineralization (MIH) is its classification and differentiation from other enamel development defects (EDDs). The aim of this study was to evaluate diagnostic accuracy in dental students to classify MIH as well as its differentiation from other EDDs by combining conventional theoretical classes and e-learning-assisted pre-clinical practices. METHODS: In this one-group pre-test and post-test study, 59 second-year students assessed 115 validated photographs using the MIH Index on the Moodle learning platform. This index assesses the clinical features and extent of MIH, differentiating it from other EDDs. Students received automatic feedback after the pre-test. Two weeks later, students re-evaluated the same photographs. Both pairwise accuracy and overall diagnostic accuracy were estimated and compared for pre- and post-testing, with the area under the curve AUC, along with 95% confidence intervals (95% CI). RESULTS: The lowest diagnostic accuracy was for the ability to discriminate between white or cream-coloured demarcated opacities and hypomineralization-type defect that is not MIH. The overall pre-test accuracy was AUC = 0.83 and increased significantly post-test to AUC = 0.99 (p < .001). The overall accuracy to discriminate the extent of the lesion also increased significantly post-test (p < .001). CONCLUSION: Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.
Assuntos
Hipoplasia do Esmalte Dentário , Hipomineralização Molar , Humanos , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/patologia , Incisivo/patologia , Dente Molar/patologia , Prevalência , Educação em Odontologia , EstudantesRESUMO
ABSTRACT Objective: To assess the impact of Molar Incisor Hypomineralization (MIH) and confounding factors on oral health-related quality of life (OHRQoL) according to the perception of 8 to 10-year-old children and their parents/caregivers. Material and Methods: A cross-sectional study including 403 students aged 8-10 years was carried out, in which OHRQoL was measured using the Child Perceptions Questionnaire administered to both children and parents/caregivers. The diagnosis of MIH was performed according to the previously proposed index. Dental caries experience, malocclusion, and sociodemographic factors were evaluated as confounders. Cluster analysis and Poisson regression with robust variance (p<0.05) were performed. Results: The prevalence of MIH was 13.4%. Parents/caregivers of children with MIH in incisors showed a higher impact prevalence in the emotional well-being domain (PR=1.92; 95%CI=1.16-3.19). Children with hypoplasia had a higher prevalence of negative impact on OHRQoL in the oral symptoms domain (PR=1.51; 95%CI=1.03-2.23). According to the perception of parents/caregivers, dental caries experience had a negative impact on the quality of life of students in the emotional well-being domain (PR=4.19; 95%CI=1.06-16.49) and in the total questionnaire score (PR=3.21; 95%CI=1.06-9.71). Conclusion: According to the perception of parents/caregivers, children with MIH in incisors showed a greater impact on OHRQoL. Additionally, the presence of hypoplasia affected the self-perception of OHRQoL in children, and caries experience influenced the OHRQoL of children, as perceived by parents/caregivers.
Assuntos
Humanos , Masculino , Feminino , Criança , Qualidade de Vida/psicologia , Saúde Bucal , Desmineralização do Dente , Hipomineralização Molar , Autoimagem , Estudos Transversais/métodos , Análise Multivariada , Inquéritos e Questionários , Análise de Regressão , Cárie Dentária/epidemiologia , Hipoplasia do Esmalte Dentário/diagnóstico , Razão de Prevalências , Estudos Populacionais em Saúde Pública , Fatores SociodemográficosRESUMO
BACKGROUND: Molar-incisor hypomineralisation (MIH) is the most common developmental abnormality observed in teeth. Being a relatively new condition, its treatment can present a challenge for the dentist. There is currently no study available that has evaluated the knowledge of Mexican dental personnel. This study aimed to evaluate the knowledge, experience, and perceptions of dental surgeons regarding the detection, assessment, and treatment of MIH in the metropolitan area of Mexico City. METHODS: A cross-sectional study was designed. Dentists from Mexico City and its metropolitan area were invited through social networks to answer a questionnaire of 30 questions related to MIH. Participants were classified into general practice dentists, paediatric dentists, and other speciality dentists. Pearson's chi-square test was used for data analysis. RESULTS: The questionnaire was answered by 391 dentists. A total of 86% (338 out of 391) of them identified MIH lesions, while 84% of them reported having observed MIH lesions in their practice. The most frequently observed lesions were yellow-brown opacities which accounted for 47% of the lesions, 46% were white opacities, while only 7% were observed as post-eruptive fractures in the enamel as part of the manifestations of MIH. The most frequently reported problem in the management of teeth with MIH was insufficient training for treating children with MIH. A total of 84% of dentists stated that they would like more information on the treatment of MIH lesions. CONCLUSIONS: Most of the surveyed dentists recognised MIH and reported having observed MIH lesions in their practice. Most of the dentists indicated that the main problem for the management of the MIH is the lack of training.
Assuntos
Hipoplasia do Esmalte Dentário , Hipomineralização Molar , Criança , Humanos , Estudos Transversais , Hipoplasia do Esmalte Dentário/terapia , Hipoplasia do Esmalte Dentário/diagnóstico , México , Dente Molar/patologia , Odontólogos , Percepção , PrevalênciaRESUMO
PURPOSE: The objective of this study was to assess the impact on diagnostic accuracy and Kappa values improvement during the three-phase training and calibration process for MIH/HSPM. METHODS: Thirty dentists were calibrated as examiners for diagnosis of Molar Incisor Hypomineralization (MIH) using Ghanim's index. The whole process was divided into three phases. Phase 1: three meetings with the dentists for the first diagnosis training and calibration (sessions 1a and 1b); phase 2: for a period of 1 month, the dentists started practicing MIH/HSPM diagnosis in the Basic Health Units and an online follow-up group was created to discuss cases and resolve doubts; phase 3: two meetings with the dentists for the second calibration (sessions 2a and 2b). A webpage with educational material was prepared as support during the whole process to improve the dentists' skills in diagnosing MIH/HSPM. The examiners' responses were compared to a gold standard and the Kappa value was obtained. RESULTS: The average clinical criteria kappa value of the examiners was 0.76 ± 0.19 for the first calibration and 0.93 ± 0.07 (p < 0.05) for the second calibration. For the eruption criteria, the average kappa value was 0.89 ± 0.14 for the first calibration and 0.98 ± 0.08 for the second calibration. Extension criteria had an average kappa value of 0.59 ± 0.15 during the first calibration and 0.75 ± 0.14 during the second calibration. CONCLUSION: This study demonstrated that the methodology used was an effective tool for improving the diagnostic accuracy of MIH/HSPM.
Assuntos
Hipoplasia do Esmalte Dentário , Dente Molar , Calibragem , Estudos Transversais , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/epidemiologia , Estudos Epidemiológicos , Humanos , PrevalênciaRESUMO
Cleft lip with or without cleft palate (CLP) is considered the most frequent congenital malformations of the head and neck, with cleft individuals exhibiting more chances of presenting abnormalities such as developmental defects of enamel (DDE). Matrix metallopeptidase 2 (MMP2) is a membrane-bound protein with collagen-degrading ability and has important roles in tooth formation and mineralization. The aim of this study was to evaluate the frequency, location, severity and extent of DDE found in the maxillary incisors for groups of individuals born with CLP, as well as understanding their relationship with the cleft side. Besides, this study addresses the hypothesis that DDE can be influenced by variation in the MMP2 genes (rs9923304). Individual samples, clinical history, intraoral photographs and panoramic radiographs were obtained from 233 patients under treatment at the Cleft Lip and Palate Service of the University Hospital Lauro Wanderley at the Federal University of Paraíba. Digital images were examined by the same evaluator using the Classification of Defects According to the Modified DDE Index, and then loaded into the Image Tool software, where two measurements were made: total area of the buccal surface (SA) and the area of the DDE (DA), obtaining the percentage of the surface area affected (%SAD) (ICC = 0.99). Genomic DNA was extracted from saliva samples from 124 participants. Genotyping was carried out using TaqMan chemistry for one marker in MMP2 (rs9923304). Statistical analyses were performed by The Jamovi Project software. The Shapiro-Wilk test was applied, followed by the Student's t-test and the Mann-Whitney test. Chi-square and Fisher's exact tests, and odds ratio (OR) with 95% confidence interval (CI) calculations were used to determine Hardy-Weinberg equilibrium and statistically significant differences with an alpha of 0.05. No significant differences in the prevalence and extent of enamel defects were found between male and female individuals born with CLP (p = 0.058256). The frequency of individuals presenting teeth with DDE, in relation to the cleft and non-cleft side, was statistically different (p <0.001; OR = 7.15, CI: 4.674> 7.151> 10.942). However, the averages of %SAD were similar (p = 0.18). The highest means of the %SAD were found in individuals with bilateral cleft lip with or without cleft palate (BCLP) when compared to individuals with unilateral cleft lip with or without cleft palate (UCLP), for the teeth inside (IA) and outside the cleft area (OA) (p <0.001). Regardless of the cleft side, individuals with BCLP were 7.85 times more likely to have more than one third of the tooth surface affected, showing more frequently defects in the three thirds (OA: p <0.001) (IA: p = 0.03), as well as a higher frequency of more than one type of defect (OA: p = 0.000358) (IA: p = 0.008016), whereas in UCLP, defects were isolated and restricted to only one third, more frequently, the incisal third (OA: p = 0.009) (IA: p = 0.001), with greater frequency of milder defects, such as demarcated (p = 0.02) and diffuse (p = 0.008) opacities. A higher frequency of the T allele, less common, was observed in the group of CLP individuals who had all the affected teeth or at least two teeth with %SAD greater than 20% (p = 0.019843). Our results suggest that MMP2 may have a role in the cases that presented DDE and genotyping rs9923304 could serve as the basis for a genomic approach to define risks for individuals born with CLP. Frequency and severity of DDE is strongly related to the CLP phenotype, since the highest values were found for BCLP. However, the extent of the DDE is independent of its relationship with the side of the cleft.
Assuntos
Fenda Labial/complicações , Fissura Palatina/complicações , Hipoplasia do Esmalte Dentário/epidemiologia , Esmalte Dentário/anormalidades , Incisivo/anormalidades , Adolescente , Adulto , Biomarcadores , Criança , Fenda Labial/genética , Fissura Palatina/genética , Estudos de Coortes , Estudos Transversais , Esmalte Dentário/diagnóstico por imagem , Esmalte Dentário/crescimento & desenvolvimento , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/genética , Feminino , Humanos , Incisivo/diagnóstico por imagem , Incisivo/crescimento & desenvolvimento , Masculino , Metaloproteinase 2 da Matriz/genética , Maxila , Fotografação , Polimorfismo de Nucleotídeo Único , Radiografia Panorâmica , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND: Little information is available on the trends over time of the prevalence of molar incisor hypomineralization (MIH). This condition may be preventing dental caries decline. AIM: (a) To compare the prevalence of MIH, in Mexico City schoolchildren, evaluated in 2008 with a group evaluated in 2017, (b) to identify the association of MIH with dental caries, and (c) to assess the mother's perception of her child's oral health status. DESIGN: Two cross-sectional studies performed in 2008 and in 2017 were compared. The oral examiner and the selected schools were the same in both surveys. RESULTS: A total of 549 schoolchildren were evaluated. The prevalence of MIH in the first survey was 20.3%, and 31.9 % in the second survey, (p = .002). Children with MIH were more likely to have dental caries. The odds ratio was 2.24 (p = .036) and 4.18 (p Ë .001) in the first and second surveys, respectively. Mothers of children with MIH perceived worse oral health status of their children than the mothers whose children did not have MIH (odds ratio = 4.47, p Ë .001). CONCLUSION: The findings portray a clear increase in prevalence of MIH and highlight the need for increased awareness about this condition among dentists and the general population.
Assuntos
Cárie Dentária/epidemiologia , Hipoplasia do Esmalte Dentário/epidemiologia , Incisivo/patologia , Instituições Acadêmicas/estatística & dados numéricos , Criança , Cidades/epidemiologia , Estudos Transversais , Cárie Dentária/etiologia , Cárie Dentária/prevenção & controle , Hipoplasia do Esmalte Dentário/complicações , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/patologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , México/epidemiologia , Mães/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Prevalência , Inquéritos e Questionários/estatística & dados numéricosRESUMO
The aim of this study was to assess the impact of Molar-Incisor Hypomineralization (MIH) on Oral Health-Related Quality of Life (OHRQoL) in schoolchildren from a public educational institution in Bucaramanga, Colombia. Eighty-eight 7- to 10-year-olds took part in the study; of whom half had MIH. The translated and adapted version of the Child Perceptions Questionnaire (CPQ 8-10) was applied by means of an interview. The dependent variable was OHRQoL and explanatory variables were presence and severity of MIH, sex, age, socioeconomic status and social security. Frequencies and proportions were calculated for qualitative variables, and measures of central tendency, dispersion and position were calculated for quantitative variables. Chi-square, Fisher's Exact Test, Mann-Whitney U Test and Kruskal-Wallis tests were used, as appropriate. A p-value <0. 05 was considered statistically significant. Parents or caregivers of participating children signed informed consent, and children signed an assent. A statistically significant difference was found for age groups (p<0. 001), socioeconomic status (p=0. 015) and social security (p=0. 045) according to the presence of MIH. Likewise, statistically significant differences were found for each of the four domains of the questionnaire and for the overall CPQ 810 score (p<0. 0001) according to the presence of MIH. The presence of the Molar-Incisor Hypomineralization may have negative impact on the Oral Health-Related Quality of Life of the participating children.
El objetivo de este trabajo fue evaluar el impacto de la Hipomineralización Inciso Molar sobre la Calidad de Vida Relacionada con la Salud Oral (CVRSO) en escolares vinculados con una institución educativa pública de Bucaramanga, Colombia. Ochenta y ocho menores de 7 a 10 años hicieron parte del estudio, la mitad presentaba HIM; a todos se les aplicó la versión traducida y adaptada del Child Perceptions Questionnaire (CPQ 8-10) mediante entrevista. La variable de salida fue la CVRSO y las variables explicatorias, la presencia y severidad de HIM, el género, la edad, el estrato socioeconómico y la seguridad social. Se calcularon frecuencias y proporciones para las variables cualitativas, y medidas de tendencia central, dispersión y posición para las cuantitativas. Se utilizaron las pruebas Chi2, Test Exacto de Fisher, U. de Mann Whitney y Kruskal-Wallis según fuera apropiado. Un valor de p<0,05 fue considerado estadísticamente significativo. Los padres o cuidadores de los menores participantes firmaron un consentimiento informado y los niños y niñas, un asentimiento. Se encontró una diferencia estadísticamente significativa en los grupos de edad (p<0,001), el estrato socioeconómico (p=0,015), y la seguridad social (p=0,045) según la presencia de HIM. Así mismo, se obtuvo una diferencia estadísticamente significativa en cada uno de los cuatro dominios del cuestionario y en el puntaje global del CPQ 8-10 (p<0,0001) de acuerdo con la presencia de HIM. Según las percepciones de los participantes al responder al CPQ 8-10, se podría sugerir la presencia de la Hipomineralización Inciso Molar influye de forma negativa sobre la Calidad de Vida Relacionada con la Salud Oral en los niños participantes.
Assuntos
Hipoplasia do Esmalte Dentário , Autoavaliação Diagnóstica , Saúde Bucal , Qualidade de Vida , Criança , Colômbia , Estudos Transversais , Hipoplasia do Esmalte Dentário/diagnóstico , Feminino , Humanos , MasculinoRESUMO
Objective: To evaluate systemic factors those are related to molar incisor hypomineralization (MIH), its association with dental caries, and the impact on oral health-related quality of life (OHRQoL) in Brazilian children. Material and Methods: This case-control study was conducted at the Pediatric Dentistry Clinic, Federal University of Parana, Brazil. Patients with MIH who were assisted from 2014 to 2015 were included in the study, for a total of 31 children, 6-13 years of age. The control group consisted of 62 children who were matched by sex and age. European Academy of Pediatric Dentistry criteria were used for MIH diagnosis. The children's mothers answered a questionnaire regarding the children's history of health intercurrences in the pre-, peri-, and postnatal periods. The Decayed, Missing, or Filled Teeth indices for permanent and primary teeth (dmft index and DMFT index, respectively) were used for dental caries examination by two calibrated examiners. Child Perceptions Questionnaires for 8- to 10-year-old children and 11- to 14-year-old children (CPQ8-10 and CPQ11-14) were used to assess OHRQoL. Results: Prematurity and prolonged delivery were significantly associated with the occurrence of MIH. In the postnatal period, recurrent fevers in the first 3 years of life were associated with MIH. Of the 339 incisors and first permanent molars that were examined, 178 presented MIH, of which 116 (65%) were demarcated opacities. A significant difference was found in the mean DMFT index between groups. No impact of MIH on OHRQoL was observed. Conclusion: The present results suggest higher intercurrences during the perinatal period and a higher incidence of caries among children with MIH.
Assuntos
Humanos , Masculino , Feminino , Criança , Estudos de Casos e Controles , Criança , Desmineralização do Dente/etiologia , Cárie Dentária , Hipoplasia do Esmalte Dentário/diagnóstico , Dente Molar/anatomia & histologia , Qualidade de Vida , Brasil , Índice CPO , Saúde Bucal , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Dental enamel defects (DEDs) are faulty or deficient enamel formations of primary and permanent teeth. Changes during tooth development result in hypoplasia (a quantitative defect) and/or hypomineralisation (a qualitative defect). OBJECTIVE: To compare technology-based diagnostic methods for detecting DEDs. MATERIAL AND METHODS: Two-hundred and nine dental surfaces of anterior permanent teeth were selected in patients, 6-11 years of age, with cleft lip with/without cleft palate. First, a conventional clinical examination was conducted according to the modified Developmental Defects of Enamel Index (DDE Index). Dental surfaces were evaluated using an operating microscope and a fluorescence-based device. Interexaminer reproducibility was determined using the kappa test. To compare groups, McNemar's test was used. Cramer's V test was used for comparing the distribution of index codes obtained after classification of all dental surfaces. RESULTS: Cramer's V test revealed statistically significant differences (P < .0001) in the distribution of index codes obtained using the different methods; the coefficients were 0.365 for conventional clinical examination versus fluorescence, 0.961 for conventional clinical examination versus operating microscope and 0.358 for operating microscope versus fluorescence. The sensitivity of the operating microscope and fluorescence method was statistically significant (P = .008 and P < .0001, respectively). Otherwise, the results did not show statistically significant differences in accuracy and specificity for either the operating microscope or the fluorescence methods. CONCLUSION: This study suggests that the operating microscope performed better than the fluorescence-based device and could be an auxiliary method for the detection of DEDs.
Assuntos
Esmalte Dentário/patologia , Anormalidades Dentárias/diagnóstico , Criança , Hipoplasia do Esmalte Dentário/diagnóstico , Fluorescência , Humanos , Microscopia , Sensibilidade e Especificidade , Anormalidades Dentárias/patologiaRESUMO
A hemofilia é uma coagulopatia congênita autossômica recessiva ligada ao cromossomo X, isso é devido à deficiência do fator VIII (hemofilia A) ou do fator IX (hemofilia B) afetando apenas os homens.Os transtornos hemorrágicos constituem um dos problemas de maior interesse a serem considerados pelo cirurgião-dentista na prática odontológica. O tratamento odontológico de pacientes com hemofilia deve ser realizado sob cuidados especiais com uma equipe multidisciplinar, nos quais os profissionais da saúde devem ter experiência médica e apoio hematológico adequados. O Objetivo deste trabalho foi relatar a reabilitação odontológica de maneira multidisciplinar de um paciente pediátrico com diagnóstico de hemofilia B grave, a qual é tratada e controlada por médicos hematologos do Hospital Geral de Zona (HGZ). O diagnóstico odontológico foi de acúmulo de placa bacteriana nas superfícies dentais por má higiene bucal, lesões de cárie e hipoplasia de esmalte. Para reabilitação bucal foram realizadas extrações de alguns elementos dentais, profilaxia, flúor terapia, orientação emotivação de higiene bucal, remoção de tecido cariado com auxílio de ultrassom, restaurações com resina composta, ionômero de vidro e restaurações indiretas cerômeros. Concluiu-se que para um adequado manejo odontológico é imprescindível o conhecimento de diversas patologias sistêmicas como a hemofilia, o atendimento multidisciplinar, além do conhecimento de técnicas de mínima intervenção em Odontopediatria para assim poder oferecer ao paciente melhores alternativas de tratamento com a mínima invasão e resultados favoráveis.
Hemophilia is an autosomal recessive congenital blood coagulation desorder to X chromosome, this is due to deficiency of factor VIII (hemophilia A) or factor IX (hemophilia B) affects only men. Bleeding disorders are one of the issues of greatest interest to be considered by the dentist in the dental practice. Dental treatment of patients with hemophilia should be done under special care bya multidisciplinary team in which health professionals must have medical experience and adequate hematologic support. The objective of this study was to report the dental rehabilitation in a multidisciplinary team to a pediatric patient with severe haemophilia B, which is treated and controlled by medical hematologists in Zone General Hospital (HGZ). The dental diagnosis was accumulation ofplaque on dental surfaces by poor oral hygiene, dental caries and enamel hypoplasia. For oral rehabilitation extractions were performed in some dental elements, prophylaxis, fluoride therapy, guidance and motivation of oral hygiene, caries removal with ultrasound assistance restorations with compositeres in, glass ionomer and indirect restorations with cerômics. It was concluded that for properdental management is essential knowledge of various systemic diseases such as hemophilia, multidisciplinary care, in addition to knowledge of minimal intervention techniques in pediatric dentistry so as to offer the best treatment alternatives patient with minimal invasion and favorable results.
Assuntos
Humanos , Masculino , Feminino , Cárie Dentária/classificação , Cárie Dentária/complicações , Cárie Dentária/diagnóstico , Hemofilia B/complicações , Hemofilia B/sangue , Hipoplasia do Esmalte Dentário/complicações , Hipoplasia do Esmalte Dentário/diagnóstico , Reabilitação Bucal/efeitos adversos , Reabilitação Bucal , Reabilitação BucalRESUMO
Aim: To determine if the prevalence of enamel hypoplasia, molar-incisor hypomineralisation(MIH) and deciduous molar hypomineralisation (DMH) is associated with the socioeconomicstatus of the child and to determine the prevalence of enamel hypoplasia and MIH/DMH comorbidityin the study population. Methods: Information was collected on the sex andsocioeconomic status of the 1,169 study participants resident in Ile-Ife, Nigeria, recruited througha household survey. The children were clinically examined to assess for the presence of enamelhypoplasia, MIH and DMH. Associations between sex, socioeconomic status and the prevalenceof enamel hypoplasia, MIH and DMH were determined. The proportion of children with enamelhypoplasia and MIH/DMH co-morbidity was also determined. Results: Among the 1,169 studyparticipants, 47(4.0%) had MIH, 15 (1.3%) had DMH and 161 (13.8%) had enamel hypoplasia. One (0.09%) study participant had MIH/DMH co-morbidity, 12 (1.0%) had DMH/enamel hypoplasiaco-morbidity, and 9 (0.8%) had MIH/hypoplasia co-morbidity. There was no significant associationbetween the socioeconomic status and presence of enamel hypoplasia (p=0.22), MIH (p=0.78) orDMH (p=1.00). Conclusions: The socioeconomic status cannot be used as a distinguishing factorfor enamel hypoplasia, MIH and DMH. The possibility of co-existence of enamel hypoplasia andMIH/DMH makes it imperative to find ways to distinguish between the lesions.
Assuntos
Humanos , Masculino , Feminino , Cárie Dentária/epidemiologia , Desmineralização do Dente/diagnóstico , Desmineralização do Dente/epidemiologia , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/epidemiologia , Morbidade , Condições Sociais , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Introdução: Hipomineralização molar incisivo (HMI) é a displasia do esmalte dos dentes que afeta um ou mais primeiros molares permanentes frequentemente associados aos incisivos permanentes. Pacientes com essa alteração apresentam vários problemas clínicos, que podem incluir um desgaste dentário acentuado, perda do esmalte, aumento da suscetibilidade à cárie e sensibilidade dentária. O tratamento da hipomineralização molar-incisivo dependerá da gravidade do dente afetado, abrangendo desde medidas preventivas até procedimentos restauradores complexos. Objetivos: Relatar um caso de um paciente infantil, 7 anos, gênero feminino, diagnosticada com HMI. Além, disso, descrever a abordagem terapêutica, tratamento restaurador e acompanhamento de 28 meses. Conclusão: Pacientes com hipomineralização molar-incisivo necessitam de acompanhamento longitudinal para prevenir perda de estrutura dentária e manutenção do tratamento restaurador.
Introduction: Molar incisor hypomineralization (MIH) is defined as the enamel dysplasia that affects one or more first permanent molars and frequently permanent incisors. These patients have several oral health problems that may include increased tooth wear, loss of enamel, higher susceptibility to dental caries and tooth sensitivity. The treatment of molar incisor hypomine-ralization depends on the severity of the affected teeth, including preventive measures as well as extensive restorative procedures. Objectives: To present a case report of a patient, female, diagnosed at 7 years old with MIH and to describe restorative procedures with a 28-months follow-up period. Conclusion: MIH Patients require longitudinal follow-up to prevent loss of tooth structure and maintenance of restorative treatment.
Assuntos
Humanos , Feminino , Criança , Hipoplasia do Esmalte Dentário/diagnóstico , Odontopediatria , Tratamento Dentário Restaurador sem Trauma/métodosRESUMO
In some patients with labial white stains involving the enamel and dentin, bleaching associated with a restorative procedure using composites may be an appropriate treatment alternative. Although bleaching makes the teeth and the stain whiter, the staining is less evident and easier to restore. Restorative procedures using adequate composites may then recover the natural optical properties while also providing appropriate mechanical properties, thereby ensuring the longevity of the treatment. In this article, the clinical case of a 9-year-old patient who reported dissatisfaction with her smile because of the presence of hypoplastic enamel staining at the central superior and inferior incisors is reported. The treatment consisted of a bleaching protocol followed by composite resin restorations using the stratification technique. The final esthetic result demonstrated the possibility of obtaining a natural smile with an adequate color and natural-looking restorations, thereby ensuring the esthetics and the patient's functional satisfaction.
Assuntos
Hipoplasia do Esmalte Dentário/terapia , Incisivo/patologia , Peróxido de Carbamida , Criança , Cor , Resinas Compostas/química , Esmalte Dentário/patologia , Hipoplasia do Esmalte Dentário/diagnóstico , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Dentina/patologia , Estética Dentária , Feminino , Humanos , Peróxidos/uso terapêutico , Sorriso , Clareamento Dental/métodos , Clareadores Dentários/uso terapêutico , Preparo do Dente/métodos , Transiluminação/métodos , Ureia/análogos & derivados , Ureia/uso terapêuticoRESUMO
Quando as manchas e os defeitos no esmalte são nominados incorretamente, significa que as verdadeiras causas e mecanismos foram ignorados e uma abordagem terapêutica inadequada pode ser aplicada4. A formação do esmalte, ou amelogênese, é executada exclusivamente pelos ameloblastos, células altamente especializadas, que: produzem a matriz orgânica adamantina; mineralizam-o de uma forma muito específica, para resultar nos prismas; proporcionam uma estrutura altamente cristalina, ao reabsorverem as proteínas anteriormente incorporadas. A atividade do ameloblasto exige um grande refinamento metabólico, estrutural e organizacional, a ponto de ser considerado uma das células mais sensíveis frente aos agentes externos.
Assuntos
Anodontia/etiologia , Hipoplasia do Esmalte Dentário , Hipoplasia do Esmalte Dentário/classificação , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/etiologia , Hipoplasia do Esmalte Dentário/etnologiaRESUMO
O objetivo deste trabalho é relatar o caso clínico de gêmeos bivitelinos que apresentaram alterações semelhantes nas estruturas do sistema estomatognático. Os pacientes, com 3 anos e 6 meses de idade, foram atendidos na Clínica de Odontopediatria da UFSC, devido a traumatismos nos dentes 51 e 61 no menino e primeira consulta odontológica da menina. A mãe relatou que as crianças nunca haviam ido ao dentista antes e que os dois tinham o hábito de sucção de chupeta. Os irmãos apresentavam mordida aberta anterior e alterações generalizadas nas estruturas dentárias, diagnosticadas como hipoplasia de esmalte. Já na primeira consulta, foram repassadas orientações quanto às consequências do hábito no desenvolvimento craniofacial, bem como quanto à importância da sua interrupção. Em quinze dias foi realizada a exodontia dos elementos 51 e 61 do menino, e nessa consulta, a mãe relatou que ambos já haviam abandonado o hábito. Dois meses após a consulta inicial, foi possível observar redução significante da mordida aberta anterior, nas duas crianças. Os pacientes foram incluídos em um esquema de proservação, com consultas periódicas para acompanhar o fechamento da mordida e a troca dentária para a dentadura permanente, a qual também pode vir a apresentar comprometimento por alterações no esmalte.Conclui-se tratar de um caso de combinação de alterações morfológicas por influência do meio (uso de chupeta) e de alterações estruturais por influência genética (hipoplasia de esmalte).
The aim of this article is to report the case of dizygotic twins who presented similar alterations in their oral cavity. Patients were 3 years and 6 months old and attended the Pediatric Dentistry Clinic at UFSC because of dental trauma on 51 and 61 in the boy and for first visit to the dentists for the girl. Their mother reported the children had never visited the dentists before and that both had the habit of sucking pacifiers. The siblings presented anterior open bite and alterations in the dental structures diagnosed as enamel hypoplasia. During the first visit, orientations were given regarding the consequences of the use of pacifiers on the craniofacial development and it was recommended its interruption. Fifteen days after, it was performed the extraction of teeth 51 and 61 from the boy. In this same visit, the mother reported that both children had abandoned the sucking habit. Two months later, it was possible to observe a significant reduction in the open bite, on both children. The patients were included in a follow-up scheme, with regular and programmed visits, in order to evaluate the closing of their open bite and follow the eruption of the permanent teeth in the future, as it is known that the enamel alterations may show the same characteristics on the succedaneum teeth. It may be concluded that the cases reported here are combinations of morphological alterations as consequence of environmental factors (use of pacifiers) and structural alterations as genetic influence (enamel hypoplasia).
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Chupetas , Crânio/crescimento & desenvolvimento , Ossos Faciais , Hipoplasia do Esmalte Dentário/diagnóstico , Mordida Aberta/diagnóstico , Sistema Estomatognático , Comportamento de Sucção , Gêmeos , Traumatismos Dentários/diagnósticoRESUMO
Focal dermal hypoplasia (FDH), also known as Goltz-Gorlin syndrome, is an autosomal dominant disease affecting tissues derived from the ectoderm and mesoderm. Knowledge and early diagnosis of the craniofacial alterations commonly found in patients with FDH provide oral health care professionals with effective preventive and therapeutic tools. This article aims to review the craniofacial characteristics present in FDH and the main systemic manifestations that have implications for dental management, while presenting a new case of the syndrome with novel oral findings.
Assuntos
Anormalidades Craniofaciais/diagnóstico , Hipoplasia Dérmica Focal/diagnóstico , Anormalidades Dentárias/diagnóstico , Anodontia/diagnóstico , Pré-Escolar , Dente Canino/anormalidades , Assistência Odontológica para Doentes Crônicos , Hipoplasia do Esmalte Dentário/diagnóstico , Diagnóstico Precoce , Assimetria Facial/diagnóstico , Feminino , Seguimentos , Humanos , Incisivo/anormalidades , Freio Labial/anormalidades , Dente Molar/anormalidades , Palato Duro/anormalidades , Erupção Ectópica de Dente/diagnósticoRESUMO
El síndrome de Prune Belly es una alteración congénita que puede conducir a insuficiencia renal crónica y alteraciones metabólicas como hiperparatiroidismo secundario. El presente caso describe un individuo masculino que padece insuficiencia renal crónica debido al síndrome de Prune Belly y presenta hallazgos estomatológicos como hipoplasia de esmalte, signos radiográficos de osteopenia a nivel de los maxilares y ausencia de lesiones de caries. Los exámenes radiográficos demostraron retardo de edad biológica en el paciente. Se brindó tratamiento odontológico preventivo.
Prune Belly's syndrome is a congenital alteration that can lead to chronic renal failure and metabolic alterations as secondary hyperparathyroidism. The present case describes a male who suffers chronic renal failure due to Prune Belly's syndrome and presents oral findings like hipoplasia of enamel, radiographic signs of osteopenia in the upper maxilla and absence of carious lesions. Radiographic analyses showed a delay in the biological age in the patient. Preventive treatment was offered to the patient.
Assuntos
Humanos , Masculino , Adolescente , Abdome/anormalidades , Hipoplasia do Esmalte Dentário/diagnóstico , Insuficiência Renal , Síndrome do Abdome em Ameixa SecaRESUMO
Objetivo: Fazer um levantamento, frente aos odontopediatras e clínicos gerais, quanto ao conhecimento do diagnóstico e tratamento dos defeitos do esmalte em pacientes na cidade de João Pessoa, Paraíba. Métodos: Foram entrevistados 25 odontopediatras e 56 clínicos gerais inscritos no Conselho Regional de Odontologia de João Pessoa, onde foram apresentados dois casos clínicos para serem relatados o diagnóstico e o tratamento dos mesmos. Resultados: Ao se observar a relação entre os diagnósticos corretos nos referidos casos clínicos, verificou-se que apenas 4,9% dos entrevistados acertaram o diagnóstico da opacidade e 19,8% o da hipoplasia (p>0.05). Com relação ao tratamento indicado, em cada caso, pelos profissionais, observou-se que 4,07% acertaram o da opacidade e 87,7% o da hipoplasia (p>0.05). Conclusão: Os conceitos de diagnóstico e tratamento dos defeitos do esmalte necessitam ser atualizados entre os profissionais da odontologia que lidam com crianças, em virtude de representarem fatores de grande relevância na predisposição ao desenvolvimento da cárie precoce na infância.
Objective: The objective of this study was to determine the knowledge of pediatric dentists and general practitioners on the diagnosis and treatment of enamel defects in patients from the city of João Pessoa, state of Paraíba. Methods: A total of 25 pediatric dentists and 56 general dentists registered at the Regional Dental Council of João Pessoa were interviewed. Two clinical cases were presented to them for them to diagnose and suggest treatment. Results: The percentage of correct diagnoses for the clinical cases presented to the dentists was low: only 4.9% of the dentists correctly diagnosed opacity and 19.8% correctly diagnosed hypoplasia (p>0.05). As for treatment, only 4.07% of the interviewed dentists proposed a correct treatment for opacity and 87.7% proposed a correct treatment for hypoplasia (p>0.05). Conclusion: Dental care professionals that work with children need to update their knowledge on the diagnosis and treatment of enamel defects because these are very relevant factors that predispose the child early to caries lesions.
Assuntos
Humanos , Competência Clínica , Descoloração de Dente/diagnóstico , Descoloração de Dente/terapia , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/terapia , OdontólogosRESUMO
AIM: This was to review the literature published, to point out shortcomings and to suggest areas in need of improvement concerning the diagnosis and prevalence of MIH. METHODS: A broad search of the PubMed database was conducted. Relevant papers published in English were identified after a review of their titles, abstracts or full reading of the papers. Papers were selected if the number of children with at least one first permanent molar affected by demarcated opacities could be deciphered. Targeted publications were critically assessed by the author concerning examination criteria, selection and character of the study groups, examiners' calibration and result presentation. RESULTS: The initial search revealed 414 papers of which 24 met the inclusion criteria. A wide variation in defect prevalence (2.4 - 40.2 %) was reported. Cross comparison of the results of the various studies were difficult because of use of different indices and criteria, examination variability, methods of recording and different age groups. CONCLUSIONS: Further standardization of study design and methods is needed to make the results comparable.