Postępowanie kliniczne w amelogenesis imperfecta w wieku rozwojowym – przypadki kliniczne

Abstract

Amelogenesis imperfecta is a hereditary defect of enamel. It can affect both the primary and permanent dentition. It manifests as: change in enamel structure, shape of teeth, severe malocclusion and can also co-occur with changes in other tissues derived from the ectoderm. In the literature there are several classifications of this disease, the two main ones are the four-stage classification according to Witkop (1988) and the two-stage classification according to Sundell, distinguishing the form associated with enamel hypoplasia and enamel hypomineralization. The aim of this paper is to present the diagnostic and therapeutic management of patients with amelogenesis imperfecta at the developmental age, based on three clinical cases. Three cases were chosen to represent patients with AI: 1) hypoplastic type of AI in 14-year-old girl, 2) hypoplastic type of AI in 12-year-old girl with distoocclusion and retrusion of upper incisors, 3) hypoplastic type of AI in 13-year-old boy with deep overbite and functional retrognathia. Presented methods of treatment were selected depending on the form of lesions, patient’s age and coexisting malocclusion. Direct reconstruction with composite materials was used – free-hand, as well as the technique of indirect reconstruction with steel crowns combined with use of functional orthodontic appliances. Dental treatment in patients with AI should be interdisciplinary. The choice of treatment method depends on the coexisting disorders. It aims to eliminate caries associated with enamel development defects and to correct occlusal conditions, as well as to improve the psychosocial functioning of patients by improving the aesthetics of the teeth.