ABSTRACT
La hipomineralización de primeros molares frecuentemente es acompañada con una hipomineralización de incisivos (HIM - Hipomineralización Incisivo y Molar) esto es comúnmente encontrado en la práctica clínica. El esmalte hipomineralizado es frágil, puede fracturarse y dejar expuesta la dentina, causando sensibilidad dental y aumento del riesgo de caries. La prevalencia de HIM varía de 3,6 a 25% en el norte de Europa, siendo considerada un problema de salud pública. En cuanto a los factores etiológicos los datos no son definidos, por lo cual causas sistémicas parecen importantes. Los posibles factores etiológicos de este cambio son a menudo relacionados con problemas en el embarazo y enfermedades de la infancia en los tres primeros años de vida. El HIM es frecuentemente confundido con otros defectos del esmalte como amelogénesis imperfecta, la fluorosis y la hipoplasia, sin embargo, detalles sobre las características clínicas de esta condición pueden diferenciarlo de otros defectos del esmalt
Hypomineralized first molar often in combination with hypomineralized incisors (MIH - molar incisor hypomineralization) is a common finding in everyday practice. In this condition, hypomineralized dental enamel is fragile and soft, and it can break easily leading to an exposed dentin, and causing dental sensitivity and progression of caries lesions. The prevalence of MIH range from 3.6 to 25% in North of Europe that consider this condition a public health problem. No conclusive information was reported about the etiologic factors of MIH, however, systemic causes seem to be of importance. Several aetiological factors are mentioned as the cause of this condition and they are frequently associated with complications during pregnancy and childhood diseases during the first three years of life. MIH is frequently misinterpreted as fluorosis, hypoplasia or amelogénesis imperfect, however, this condition presents defined clinical aspects that can distinct it from the other defects
Subject(s)
Humans , Dental Enamel Hypoplasia , Tooth Demineralization/diagnosis , Dental EnamelABSTRACT
Background Enamel hypoplasia occurs due to inherent and non-inherent factors. Researchers noted occurrence of non-inherent based enamel hypoplasia happens due to malnutrition of children or foreign infl uence to teeth while they are on their formation stage (Groshikov 1985). According to studies of N.A. Belova, a researcher, in 1976, an examination conducted on 200 children between the ages of 2.5-3 in Moscow area and resulted 20.5% of the children were affected with EH. Results from Asian countries such as in Beijing, China the prevalence rate was 22.5% (Lee et all, 1995) among 1344 children who were 8-15 years of age and had premature weight at birth, and in Deli, India 30% (Agarwal K.N et aii, 1999-2001) among 280 children who were 0-1 year of age and had substitute provision. Prevalence rate was 32.7% in Iranian cities of Yazd and Hadi among 1223 elementary school children (A.R.Daneshkazemi, DDS, MS; A. Davari, DDS, MS). Inherent based EH or Amelogenesis Imperfecta is an abnormal development of enamel. It is formed due to genetic mutation (Aldred, 2003). Prevalence of inherent EH differs from countries to countries and the variation was 1:718-1:14000 (Seow, 1993). Its genetic inheritance pattern can be autosomal dominant, autosomal recessive or XLinked (Shafer, 1987, Seow, 1993). The basis for this study work on risk factors of EH was due to lack of similar studies among the youth of our county. Objective The aim of the research work was to study the pathogenesis and etiology of enamel hypoplasia, Methodology We have conducted clinical examination up among 296 (12-year-old) children, and surveyed with a specially designed questionnaire those who are affected with enamel hypoplasia followed illustrations of their genetic chart. Result Of those who were involved in the research, 11.8% were affected with EH, and 10.4% had non-genetic infl uence factors, 1.01% had genetic infl uence factors and 0.34% had genetic syndrome. Statistical analysis was conducted to determine non-genetic infl uence factors among 62 children were free of EH (DMFT 1.70.14) and 31 children who had genetically infl uenced EH. While, 71% of the children who had EH had normal birth weight and 29% had miniature weight, 87% of the healthy children had normal birth weight and 13% had miniature birth weight (OR = 2.761 [CI 95percentage 0.944-8.08]).While 58% of the children with EH were breastfed, 16% had mixed milk, 8% had substitute milk only, 87% of the healthy children were breastfed, 8% had mixed milk, and 5% had substitute milk only(OR=5.0 [CI 95% 1.085-23.034]). Where as 31% of the healthy children had vitamin D defi ciency, 46% percent had digestion problems, 8% had some type of infectious disease, and 58% had respiratory infection while they were 0-1 year old, 25% of the children with EH had vitamin D defi ciency, 25% had digestion problems, 13% had some type infectious disease, and 58% had respiratory infection while they were 0-1 year old. Looking at the result digestion illness raises (OR = 5.895 [CI 95percentage 1.944-17.879]) the risk of having EH than any other infectious diseases (OR=1.356 [CI 95percentage 0.215-8.571]). 19% of the mother of the 31 children who had EH had early pregnancy sickness, 26% had late pregnancy sickness. However, 10% of the healthy 62 children had early, and 16% had late pregnancy sickness (OR=2.761 [CI 95percentage 0.944-8.08]). While 74% of the mothers of the children with EH were delivered on time and 26% premature delivery, 86% of the mothers of the healthy children were delivered on time and 11% had premature delivery(OR=2.733; CI95% 0.887-8.419). Genetic factor infl uence is due to X linked dominant chromosome on two occurrences, and one occurrence is due to Y chromosome. One occurrence of genetic syndrome has been diagnosed as Acrofacial syndrome Nagera. Conclusion. Late pregnancy sickness among other had the highest probability of causing EH. Premature delivery, miniature weight had the highest probability of causing EH. Babies breastfed mixed milk for age 0-1 had the highest probability of causing EH among other illnesses that causes EH. Digestion illness had the highest probability of causing EH among other illnesses that causes EH. Infectious diseases had relevant risk factor. Genetic factor infl uence on EH is due to X linked dominant chromosome, and Y chromosome. One sign of genetic syndrome has been detected as due to Acrofacial syndrome Nagera.
ABSTRACT
Purpose: To present a case report of a patient with amelogenesis imperfecta rehabilitated with 26 CAD-CAM all-ceramic fully sintered zirconia crowns.Case description: A male subject, 28 year-old, sought dental treatment presenting a clinical condition compatible with amelogenesis imperfecta. All teeth had yellow, brown, and white areas of weak enamel. Composite restorations were present on teeth 14, 16, 24, 25, 26, 27, and 46; dental caries were shown on teeth 36, 37, and 47. Hipersensitivity was reported. The treatment included fully sintered zirconia crowns for all teeth, using a CAD-CAM system. No problems of marginal adaptation of the crowns were detected, and the final results were satisfactory for both the patient and the clinician. Conclusion: The clinical rehabilitation of an amelogenesis imperfecta case is a challenge, and a multidisciplinary approach is required. Zirconia all-ceramics crowns are an excellent option to restore dental aesthetics as the opaque zirconia coping can mask dischromic abutments, and the crowns have biocompatibility and improved physical properties.
Objetivo: Apresentar o caso clínico de um paciente com amelogenesis imperfecta, que foi reabilitado com 26 coroas CAD-CAM de zircônia totalmente sinterizada. Descrição do caso: Um sujeito do sexo masculino, 28 anos, procurou tratamento odontológico apresentando uma condição clínica compatível com amelogenesis imperfecta. Todos os dentes tinham áreas amarelas, marrons e brancas de esmalte enfraquecido. Havia restaurações de resina composta nos dentes 14, 16, 24, 25, 26, 27 e 46; cárie dentária estava presente nos dentes 36, 37 e 47. Relatou-se hipersensibilidade dentária. O tratamento incluiu coroas de zircônia totalmente sinterizada para todos os dentes, usando um sistema CAD-CAM. Nenhum problema de adaptação marginal das coroas foi detectado e os resultados finais foram satisfatórios para ambos o paciente e o clínico. Conclusão: A reabilitação clínica de amelogenesis imperfecta é um desafio e a abordagem multidisciplinar deve ser mandatória. As coroas de zircônia são uma excelente opção para a reabilitação de pacientes com esta anomalia, pois o opaco dos copings de zircônia pode mascarar as diferentes cores dos pilares e o resultado final é esteticamente aceitável, com biocompatibilidade e propriedades físicas superiores.