ABSTRACT
ABSTRACT The aim of this study was to report the clinical case of an 8-year-old male patient seen at the Pediatric Dentistry outpatient clinic at the Universidade Federal do Paraná, Brazil, diagnosed with molar-incisor hypomineralization (MIH) after presenting with pain in teeth 16, 36, and 46, which had extensive atypical cavities and opacities on the adjacent enamel. A diagnostic wax-up of affected teeth was performed for manufacture of silicone occlusal matrix. Encapsulated high-viscosity glass ionomer cement was handled and inserted into the occlusal matrix which was fitted onto the teeth by slight finger pressure. After setting time, excess of material was removed, and occlusion was checked. A flowable resin coating material was applied, and the restorations were finished. Six months later, the restorations performed for treatment of the severe MIH lesions proved to be efficient, lowering the sensitivity reported by the patient, reshaping the teeth, improving their function, and refining dental esthetics.
RESUMO O objetivo deste estudo foi relatar um caso clínico de um paciente com diagnóstico de Hipomineralização de Molares e Incisivos (HMI). Paciente do sexo masculino, de 8 anos de idade, compareceu à clínica de Odontopediatria da Universidade Federal do Paraná com queixa de dor nos dentes 16, 36 e 46 - os quais apresentavam extensas cavitações atípicas com opacidades no esmalte adjacente. O enceramento diagnóstico dos dentes afetados foi realizado para a confecção das matrizes oclusais de silicone. Cimento ionômero de vidro de alta viscosidade encapsulado foi manipulado e inserido na matriz oclusal, a qual foi encaixada sobre os dentes, exercendo-se leve pressão digital. Após a presa do material os excessos foram removidos e a oclusão foi checada. Aplicou-se uma camada de resina fluída de cobertura e as restaurações foram finalizadas. Após seis meses, as restaurações realizadas para tratar as lesões severas de HMI mostraram-se eficazes, reduzindo a sensibilidade relatada pelo paciente, além de reestabelecerem a anatomia, função e estética dentária.
ABSTRACT
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.