Biomimetic hydroxyapatite paste for molar-incisor hypomineralization: A randomized clinical trial.

OBJECTIVES: The aim of this randomized clinical trial was to evaluate the desensitizing and remineralizing effect of a new zinc-hydroxyapatite-based paste in sites affected by molar-incisor hypomineralization (MIH), by assessing dental sensitivity, tooth wear, and periodontal indexes. MATERIALS AND METHODS: Twenty-five patients with presence of 1 enamel demineralization of permanent molars and incisors in two different quadrants were recruited. After professional dental hygiene, a domiciliary hydroxyapatite-based paste was assigned and recommended to be applied on 2 MIH teeth in one random quadrant (test group), while the 2 contralateral MIH teeth did not undergo paste application (control group). The following primary outcomes were assessed: Plaque Control Record (PCR), Bleeding Index (BI), MIH Treatment Need Index (MIH-TNI), and Schiff Air Index (SAI). RESULTS: No significant inter- and intragroup differences were found for PI and BI, except for both intragroup T0-T1. For MIH-TNI, significant intergroup differences were detectable in the test group after 9 months of treatment. For SAI values, no significant differences were found in the control group, while in the test group, significant lower values were found after 1 and 3 months since baseline, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Biomimetic zinc-hydroxyapatite showed a desensitizing effect when used to treat MIH.

Preventive efficacy of 38% silver diamine fluoride and CPP-ACP fluoride varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial.

Background: This randomized controlled trial aimed to compare the efficacy of silver diamine fluoride (SDF) and Casein Phosphopeptide-Amorphous Calcium Phosphate fluoride Varnish (CPP-ACPFV) in preventing caries development, enamel breakdown, and sensitivity on molars affected by molar incisor hypomineralization (MIH) in children. Methods: A total of 100 children aged 6 to 9 years were enrolled in the study with two contralateral permanent molars mildly affected by MIH. Affected molars were randomly and equally assigned to receive either SDF or CPP-ACPFV treatment. The interventions were applied at four different time points (baseline, 3, 6, 9 months), and the incidence of caries, caries progression, enamel breakdown, and sensitivity were assessed. Results: The findings of this study revealed significant differences in the incidence of caries between the groups treated with SDF and CPP-ACPFV ( P-value < 0.05). Similarly, there was a significant difference in caries progression between the two groups ( P-value < 0.05). However, no significant differences were observed in enamel breakdown scores between the treatment groups, as the majority of teeth in both groups exhibited a score of 0. Furthermore, there were no significant differences in sensitivity between the treatment groups throughout the study period. Conclusions: In conclusion, the results of this study provide evidence that molars treated with SDF demonstrated a lower incidence of caries and a higher rate of caries arrest compared to those treated with CPP-ACPFV. Both interventions showed promise in preventing enamel breakdown and improving sensitivity. These findings highlight the potential of SDF and CPP-ACPFV as effective treatments for caries prevention and management, emphasizing the importance of early intervention and appropriate dental care strategies in maintaining oral health. Trial registration: ISRCTN54243749 (13/01/2022).

Enamel Developmental Defect Masking on Central Incisor with Infiltrant Resin.

The aim of this paper is to present a case of masking of a hypoplastic lesion using the infiltrating resin technique, without use of drilling or any loss of tooth structure. A 22-year-old female patient complained of a noncarious white spot on the buccal surface of the upper right central incisor which affected the esthetics of her smile. Despite the tooth discoloration, the tooth structure was intact, with no depressions, cracks, or grooves. During the anamnesis, she reported that the white spot had been present since childhood. On the basis of the information provided by the patient and collected during intraoral clinical examination, it was determined that the stain was suggestive of enamel hypoplasia. The treatment proposed to the patient was the application of infiltrating resin to mask the hypoplasia on the surface of the tooth enamel without any loss of tooth structure. In this case, Icon infiltrating resin proved to be efficient in masking the hypoplastic lesion. The final appearance of the treated tooth was satisfactory, with homogeneity and gloss on the surface, which minimized the characteristics of an unpleasant smile.

Effect of Remineralization Agents on Molar-Incisor Hypomineralization-Affected Incisors: A Randomized Controlled Clinical Trial.

OBJECTIVE: The objective of this study was to evaluate the remineralization effect of two different mineral containing agents on white/creamy and yellow/brown demarcated opacities in incisors in children with molar-incisor hypomineralization (MIH) by using laser fluoresence (LF). STUDY DESIGN: Fifty-three children (n=401 lesions) with MIH were randomly divided into three groups: (1)calcium glycerophosphate (CaGP), (2)casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) and, (3)control (1450 ppm fluoride toothpaste). Remineralization was evaluated by means of LF, at baseline, after one and threemonths. Anova Test for Repeated Measurements in intra-group comparisons in evaluating the effectiveness of remineralization agents. One-way Variance Analysis (ANOVA) and Tukey-Kramer Multiple Comparison test were used in the comparisons between groups and, Student Newman Keuls Multpile Comparison Test was used to determine the differences between the measurement averages in case of p<0.05. RESULTS: There was a significant improvement in MIH-lesions over time in all groups (p<0.001), with no differences between groups. The highest percentage of change was observed in CPP-ACFP in lesions LF≤20 scores and the mean percentage of change LF>20 scores, the highest percentage changes in CaGP. There was no significant difference between the groups over the time for all the used outcome measures (p>0.05). CONCLUSION: The additional use of both mineral containing agents in MIH-affected teeth improved these hypomineralized lesions with mineral deposition. Even if both agents could be used in the hypomineralized teeth with demarcated opacities, future studies are recommended the long-term effect of these mineral containing agents with longer observation and a larger sample size.

Structural integrity of MIH-affected teeth after treatment with fluoride varnish or resin infiltration: An 18-Month randomized clinical trial.

OBJECTIVE: To evaluate the influence of fluoride varnish (FV) therapies or resin infiltration (RI) to maintain the structural integrity of Molar Incisor Hypomineralization (MIH) -affected teeth. METHODS: Fifty-one children aged 6-12 years with at least one incisor and one first permanent molar with yellow/brown MIH opacities were included. Patients were randomly allocated into three groups: FV - Fluoride Varnish (Duraphat); FV+etch - Fluoride Varnish (Duraphat) after enamel etching with 37% phosphoric acid; or RI - Resin Infiltration system (Icon). Opacities were monitored for 18 months. The primary outcome was the loss of integrity due to post-eruptive enamel breakdown (PEB). Covariables included sex, age, DMFT index, opacity colour, plaque index, number of MIH-affected teeth, and number of MIH-affected surfaces. Fisher's Exact was used to test the association of treatments with PEB, the Kaplan-Meyer method analysed the survival rates and Cox-regression determined which covariables would predict failure (α=0.05). RESULTS: From a total of 235 teeth, the PEB rate for RI (6.1%) was significantly lower (p<0.05) than FV (17.9%; OR 3.0, 95%CI 1.07, 8.48) and FV+etch (17.3%; OR 3.1, 95%CI 1.13, 8.73). DMFT index >3, brown opacities, cusp involvement, and age between 6-8 years predicted PEB (p<0.05). CONCLUSIONS: Resin infiltration positively influenced the structural integrity maintenance of MIH-affected teeth by decreasing the risk of enamel breakdown over18 months follow-up. Registry of Clinical Trials (RBR-8wwk3n). CLINICAL RELEVANCE: Resin infiltration proved to be a more efficacious intervention to maintain the structural integrity of MIH-affected teeth than fluoride varnish therapies.

Toward a better understanding of type I interferonopathies: a brief summary, update and beyond.

BACKGROUNDS: Type I interferonopathy is a group of autoinflammatory disorders associated with prominent enhanced type I interferon signaling. The mechanisms are complex, and the clinical phenotypes are diverse. This review briefly summarized the recent progresses of type I interferonopathy focusing on the clinical and molecular features, pathogeneses, diagnoses and potential therapies. DATA SOURCES: Original research articles and literature reviews published in PubMed-indexed journals. RESULTS: Type I interferonopathies include Aicardi-Goutières syndrome, spondyloenchondro-dysplasia with immune dysregulation, stimulator of interferon genes-associated vasculopathy with onset in infancy, X-linked reticulate pigmentary disorder, ubiquitin-specific peptidase 18 deficiency, chronic atypical neutrophilic dermatitis with lipodystrophy, and Singleton-Merten syndrome originally. Other disorders including interferon-stimulated gene 15 deficiency and DNAse II deficiency are believed to be interferonopathies as well. Intracranial calcification, skin vasculopathy, interstitial lung disease, failure to thrive, skeletal development problems and autoimmune features are common. Abnormal responses to nucleic acid stimuli and defective regulation of protein degradation are main mechanisms in disease pathogenesis. First generation Janus kinase inhibitors including baricitinib, tofacitinib and ruxolitinib are useful for disease control. Reverse transcriptase inhibitors seem to be another option for Aicardi-Goutières syndrome. CONCLUSIONS: Tremendous progress has been made for the discovery of type I interferonopathies and responsible genes. Janus kinase inhibitors and other agents have potential therapeutic roles. Future basic, translational and clinical studies towards disease monitoring and powerful therapies are warranted.

Antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization-controlled clinical trial.

BACKGROUND: Molar incisor hypomineralization (MIH) is a change in the formation of dental enamel of systemic origin that affects at least one of the first 4 permanent molars and usually affects incisors. During the eruption, the affected surfaces tend to fracture, exposing the dentin, which causes excessive sensitivity in addition to making the region very susceptible to the appearance of carious lesions. The objective of this research will be to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in permanent teeth with severe and sensitive MIH. METHODS: The methodology will be based on the selection of patients from 6 to 12 years of age with permanent molar teeth, randomly divided in 2 groups. The selected teeth should have MIH on the occlusal surface, indicated for clinical restorative treatment. In Group 1, aPDT will be applied for the treatment of infected dentin. Afterward, the teeth will be restored with high viscosity glass ionomer cement. In Group 2, the removal of the softened dentin around the side walls of the cavity with sharp dentine curettes and posterior restoration with high viscosity glass ionomer cement will be performed. All patients will have clinical and radiographic follow-up with a time interval of 6 and 12 months. The data obtained will be submitted to descriptive statistical analysis to evaluate the association of categorical variables. Chi-square test and Fisher exact test will be applied, to analyze the correlation between the continuous variables, Pearson correlation test will be applied. For the analysis of dentin density in the scanned radiographic images and the microbiological results for colony-forming units, ANOVA and Kruskal-Wallis will be applied. DISCUSSION: Often in the presence of severe MIH, the presence of dentin sensitivity is also associated with caries lesion, making it even more necessary to respect the principles of minimal intervention. TRIAL REGISTRATION: NCT03904641.

JAK-inhibitors. New players in the field of immune-mediated diseases, beyond rheumatoid arthritis.

Janus kinase (JAK)/signal transducers and activators of transcription (STATs) are a group of molecules associated with one of the major pathways through which many cytokines exert and integrate their function, and as such they are increasingly recognized as playing critical role in the pathogenesis subserving various immune-mediated diseases, including RA, PsA, SpAs, IBD, skin disorders (e.g. alopecia areata, atopic dermatitis), single-gene disorders like interferonopathies, and others. JAKs are the key initiating players of the JAK/STAT pathway. Upon binding of their respective effector molecules (cytokines, IFNs, growth factors and others) to type I and type II receptors, JAKs are activated, and through phosphorylation of themselves and of other molecules (including STATs), they mediate signal transduction to the nucleus. A class of drugs-called JAK inhibitors or JAKinibs-that block one or more JAKs has been developed in the last decade, and now numbers >20 members. Although, so far, JAK inhibitors have been marketed only for RA and PsA, these drugs have been tested in phase 2 and phase 3 clinical trials for other inflammatory conditions and beyond. In this review, we summarize the clinical data, including efficacy and safety, available for JAK inhibitors used in some immune-mediated conditions other than RA.

Molar incisor hypomineralization treatment with casein phosphopeptide and amorphous calcium phosphate in children.

BACKGROUND: The purpose of this study was to evaluate the sensitivity of teeth with MIH in children before and after the use of a tooth mousse containing casein phosphopeptide and amorphous calcium phosphate (CPP-ACP). METHODS: Forty patients, both males and females, aged from 8 to 13 years old that had a molar with MIH hypersensitivity were included in this study. In the test group (20 subjects), a tooth mousse with CPP-ACP was used while fluoride toothpaste was used in the control group. Dental sensitivity to mechanical and thermal stimuli was evaluated before (T0) and 120 days after the beginning of the treatment (T1). RESULTS: In the test group, the thermal sensitivity decreased significantly (P<0.05) from T0 to T1 (2.4±0.6 to 1.1±0.4) while in the control group resulted very similar (from 2.3±0.5 to 2.2±0.4). Similarly, mechanical sensitivity decreased significantly (P<0.05) from 7.8±1 to 3.8±0.6 while in the control group decreased not significantly (from 7.5±1.3 to 7.2±0.8). No significant difference (P>0.05) was observed by comparing males with females. CONCLUSIONS: The use of the remineralizing agent containing CPP-ACP resulted in a significant improvement in dental sensitivity in patients with MIH.

Inherited Arterial Calcification Syndromes: Etiologies and Treatment Concepts.

PURPOSE OF REVIEW: We give an update on the etiology and potential treatment options of rare inherited monogenic disorders associated with arterial calcification and calcific cardiac valve disease. RECENT FINDINGS: Genetic studies of rare inherited syndromes have identified key regulators of ectopic calcification. Based on the pathogenic principles causing the diseases, these can be classified into three groups: (1) disorders of an increased extracellular inorganic phosphate/inorganic pyrophosphate ratio (generalized arterial calcification of infancy, pseudoxanthoma elasticum, arterial calcification and distal joint calcification, progeria, idiopathic basal ganglia calcification, and hyperphosphatemic familial tumoral calcinosis; (2) interferonopathies (Singleton-Merten syndrome); and (3) others, including Keutel syndrome and Gaucher disease type IIIC. Although some of the identified causative mechanisms are not easy to target for treatment, it has become clear that a disturbed serum phosphate/pyrophosphate ratio is a major force triggering arterial and cardiac valve calcification. Further studies will focus on targeting the phosphate/pyrophosphate ratio to effectively prevent and treat these calcific disease phenotypes.

The Effect of Casein Phosphopeptide-Amorphous Calcium Phosphate on Molar-Incisor Hypomineralisation: A Pilot Study.

PURPOSE: To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) application on noncarious MIH (molar-incisor hypomineralisation) lesions using a DIAGNOdent device (KaVo), which measures laser fluorescence within the mineral structure of the tooth. MATERIALS AND METHODS: A total of 461 subjects age 7-12 (mean ±â€¯SD was 9.9 ±â€¯1.6) years were examined. Fifty- four children were diagnosed with MIH and divided into 2 groups. A total of 38 teeth met the inclusion criteria and were included in the study. Group 1 subjects (n = 15) used a paste containing 10% CPP-ACP, and group 2 subjects (n = 23) used a paste containing 10% CPP-ACP with 0.2% NaF (CPP-ACFP) for one month. RESULTS: After the application of the pastes for one month, significant decreases were found in the mean DIAGNOdent readings for both groups (CPP-ACP p = 0.0015 and CPP-ACFP p = 0.0001). However, the percentage decreases in both groups were not significantly different from each other (60.4% and 45.5% in CPP-ACP and CPP-ACFP groups, respectively). CONCLUSION: This pilot study shows that using CPP-ACP and CPP-ACFP had a positive effect in reducing hypomineralisation on enamel surfaces of MIH-diagnosed teeth for a one month period. It is important to diagnose molar-incisor hypomineralisation at an early stage to prevent excessive caries develeopment. Therefore, further clinical studies are necessary on the long-term application of these kinds of nanocomplexes.

Comparison of Mineral Density in Molar Incisor Hypomineralization applying fluoride varnishes and casein phosphopeptide-amorphous calcium phosphate.

The aim of the present work was to evaluate and compare variations in mineral density (MD) using laser-induced fluorescence (LF) after applying 5% Sodium Fluoride Varnish (Duraphat®), 5% Sodium Fluoride Varnish with Tricalcium Phosphate (Clinpro®) or Casein phosphopeptide-amorphous calcium phosphate (Recaldent®) on teeth with Molar Incisor Hypomineralization (MIH). Mineral density of 92 MIH teeth with mild (Mi) and moderate (Mo) lesions was assessed using a DIAGNOdent device (KaVo, Biberach, Germany). LF values were recorded on day 0 (baseline) and on days 15, 30 and 45; the remineralizing agents were applied immediately after LF readings at baseline and on days 15 and 30. Data corresponding to Mi and Mo lesions were analyzed separately. Significant differences were observed both in mild (p<0.01) and moderate (p<0.000005) lesions. Differences between Recaldent® and Clinpro®, and between Duraphat® and Clinpro® (global level 0.10) were found in Mi lesions. All 3 pairs ofproducts differed significantly in Mo lesions (global level 0.05). The results obtained under the conditions used here allow concluding that Clinpro® was more effective in mild lesions whereas Duraphat® was more effective in moderate lesions.

El objetivo del trabajo fue evaluar y comparar la variación de la densidad mineral (MD) registrada con láser de fluorescencia (LF), posteriormente a la aplicación de barniz fluorado al 5% (Duraphat®), barniz fluorado al 5% con fosfato tricálcico (Clinpro®) y fosfopéptidos de caseína-fosfato de calcio amorfo (Recaldent®) en piezas con Hipomineralización Molar Incisiva (MIH). La MD de 92piezas dentarias con MIH con lesiones leves (Mi) y moderadas (Mo) fue registrada utilizando el equipo DIAGNOdent (KaVo, Biberach, Germany). Los valores de LF fueron registrados en el día 0 (condiciones basales) y en los días 15, 30 y 45. Los agentes remineralizantes fueron aplicados inmediatamente luego de los registros de LF en condiciones basales y en los días 15 y 30. A los 45 días se observaron diferencias significativas tanto en las lesiones leves (p<0,01) como en las moderadas (p<0,000005). En las lesiones leves se detectaron diferencias significativas entre los productos Recaldent® y Clinpro® y entre Duraphat® y Clinpro® a nivel global 0,10. En las lesiones moderadas los tres pares de productos resultaron significativamente diferentes a nivel global 0,05. Los resultados obtenidos permiten concluir que, en las condiciones de este estudio, Clinpro® resultó más efectivo en lesiones leves, mientras que Duraphat® lo fue en lesiones moderadas.

Effect of Fluoride Varnish on Enamel Remineralization in Anterior Teeth with Molar Incisor Hypomineralization.

OBJECTIVE: The objective of this study was to investigate the effect of fluoride varnish on remineralization of anterior teeth affected by Molar-Incisor Hypomineralization (MIH) by means of Quantitative Light-Induced Fluorescence- QLF. STUDY DESIGN: Fifty-one healthy 9 - 12- year-old children were selected according to different clinically diagnosed levels of MIH, proposed by the European Academy of Pediatric Dentistry (2003) (considering the most severe lesion per patient, n= 51 lesions), and randomly divided into two groups: (1) four applications of 5% NaF varnish, with one-week interval, and (2) usual home care- control. At each visit, the mean change in fluorescence and area of lesion were measured by QLF. The data were analyzed by repeated measures ANOVA and Tukey's test. RESULTS: All patients showed enamel alterations in first permanent molars and incisors, frequently with two molars affected by MIH (41.1%). There was no statically significant difference in the mean of fluorescence and area of lesion between groups over the studied time. CONCLUSION: We observed no favorable effect on the remineralization of MIH lesions in anterior teeth after four applications of fluoride varnish.

MIH supplementation strategies: prospective clinical and laboratory trial.

The use of calcium-phosphate casein on hypomineralized molars (molar incisor hypomineralization, MIH) has been proposed but not clinically investigated. Qualitative and quantitative effects of supplementation with a calcium-phosphate casein product on MIH molars were monitored over a period of three years. Molar replicas, minimally invasive biopsies and their SEM microphotographs, plus ESEM/EDX semi-quantitative peaks of elements present in affected enamel were evaluated. Mineralization, morphology, and porosity appeared markedly improved, with calcium and phosphate levels reaching almost normal levels at three years' follow-up. The hypothesis tested was rejected, since calcium-phosphate casein improved enamel morphology in vivo.

Prevalence of developmental defects of enamel in children and adolescents with asthma.

OBJECTIVE: This study aimed to evaluate the prevalence of developmental defects of enamel (DDEs) in relation to asthma severity, symptom onset and pharmacological treatment in pediatric asthma patients. METHODS: Children and adolescents (68 asthma patients and 68 controls), 5-15 years of age and residents of the city of Londrina, Brazil, were enrolled in the study. Medical and dental histories were collected through the use of a structured questionnaire. Each participant underwent a dental examination in which the examiner employed the DDE index. RESULTS: Of the 68 asthma group subjects, 61 (89.7%) presented dental enamel defects, compared with only 26 (38.2%) of those in the control group. Using multivariate logistic regression analysis, we estimated the risk of DDEs in permanent dentition to be 11 times higher in pediatric subjects with asthma than in those without (OR = 11.88, p = 0.0001). The occurrence of dental enamel defects correlated with greater asthma severity (p = 0.0001) and earlier symptom onset (p = 0.0001). However, dental enamel defects did not correlate with the initiation of treatment (p = 0.08) or the frequency of medication use (p = 0.93). CONCLUSIONS: Pediatric patients with severe, early-onset asthma are at increased risk of dental enamel defects and therefore require priority dental care.

Prevalence of developmental defects of enamel in children and adolescents with asthma / Prevalência de defeitos do desenvolvimento do esmalte dentário em crianças e adolescentes com asma

OBJECTIVE: This study aimed to evaluate the prevalence of developmental defects of enamel (DDEs) in relation to asthma severity, symptom onset and pharmacological treatment in pediatric asthma patients. METHODS: Children and adolescents (68 asthma patients and 68 controls), 5-15 years of age and residents of the city of Londrina, Brazil, were enrolled in the study. Medical and dental histories were collected through the use of a structured questionnaire. Each participant underwent a dental examination in which the examiner employed the DDE index. RESULTS: Of the 68 asthma group subjects, 61 (89.7 percent) presented dental enamel defects, compared with only 26 (38.2 percent) of those in the control group. Using multivariate logistic regression analysis, we estimated the risk of DDEs in permanent dentition to be 11 times higher in pediatric subjects with asthma than in those without (OR = 11.88, p = 0.0001). The occurrence of dental enamel defects correlated with greater asthma severity (p = 0.0001) and earlier symptom onset (p = 0.0001). However, dental enamel defects did not correlate with the initiation of treatment (p = 0.08) or the frequency of medication use (p = 0.93). CONCLUSIONS: Pediatric patients with severe, early-onset asthma are at increased risk of dental enamel defects and therefore require priority dental care.

OBJETIVO: Avaliou-se a prevalência de developmental defects of enamel (DDEs, defeitos de desenvolvimento do esmalte dentário) em pacientes pediátricos com asma e sua relação com a severidade da asma, o início dos sintomas e o tratamento medicamentoso. MÉTODOS: Os participantes do estudo eram residentes do município de Londrina (PR), com 5 a 15 anos, sendo 68 asmáticos e 68 controles. Foram levantados dados retrospectivos da história médica e de saúde bucal da população do estudo através de um questionário estruturado. Todos os participantes foram submetidos a um exame dental. Para a avaliação dos defeitos de desenvolvimento do esmalte dentário, utilizou-se o Índice DDE. RESULTADOS: Neste estudo, foi observado que 61 (89,7 por cento) dos 68 pacientes asmáticos apresentavam defeitos de desenvolvimento do esmalte dentário quando comparado à ocorrência em 26 (38,2 por cento) dos no grupo controle. Através da análise multivariada por regressão logística, foi observado que um paciente pediátrico com asma apresenta risco aumentado em 11 vezes para o aparecimento de defeitos de desenvolvimento do esmalte em dentes permanentes (OR = 11,88, p = 0,0001). Além disso, foi observado uma associação entre defeitos do esmalte dentário e maior severidade da asma (p = 0,0001) e início dos sintomas mais precoce (p = 0,0001). Não se observou associação entre o início do tratamento (p = 0,08) ou frequência de uso da medicação (p = 0,93) com o aparecimento de defeitos de desenvolvimento do esmalte dentário. CONCLUSÕES: Pacientes pediátricos com asma apresentam risco aumentado para a ocorrência de defeitos de desenvolvimento do esmalte dentário relacionado à severidade da asma e início dos sintomas e, portanto, necessitam de atenção odontológica prioritária.

The application of synthetic hydroxyapatite in children and adolescents in various clinical cases.

The possibility of application of HA-BIOCER synthetic hydroxyapatite in the treatment of enamel hypoplasia in children and adolescents manifested by mineralisation disorders, enamel underdevelopment, enamel deficiency and oversensitivity to mechanical, thermal and chemical stimuli was evaluated. The possibility of applying the same preparation in case of enamel fractures and teeth injuries type I according to Ellis was also examined. It was found that the application of hydroxyapatite stimulates processes of remineralization in decalcified places. It also causes removal of tooth oversensitivity to thermal and mechanical stimuli by closing open dentinal tubules or decrease in their size. HA-BIOCER preparation brings about smoothing and lighting of hypoplastic foci, improves aesthetic appearance and is not toxic to patients.