Developmental Defects Of Enamel Research Articles

Calidad de vida relacionada con salud bucal en niños y adolescentes con defectos del desarrollo del esmalte infiltrados con resina

Introduction: Developmental defects of enamel (DDE) can affect the aesthetic self-perception of children and adolescents. Among the minimal invasive therapeutic choices is infiltrant resin, which could better aesthetic problems. Objective: To evaluate the oral health-related quality of life (OHRQoL) in children and adolescents with resin-infiltrated developmental defects of enamel. Methodology: A longitudinal study was conducted in children and adolescents (n = 10) from 8 to 14 years old with DDE. The impact of resin infiltration on OHRQoL was evaluated utilizing CPQ 8-10 and CPQ 11-14 questionnaires. The total and dimensions scores “emotional well-being” and “social well-being”, of the complete sample, were re-scaleted. Descriptive statistics were calculated and the mean total and per dimensions scores were compared (Student-t test for paired samples; p < 0.05) with SPSS program v.25, IBM. Results: The OHRQoL improved significantly in both age groups after resin infiltration. “Social well-being” was the dimension of bigger impact in the 8 to 10 years age group, while “emotional well-being” dimension was in the 11 to 14 years age group (p = 0.016). Standardized scores analysis revealed statistically significant differences (p = 0.001). Conclusions: The OHRQoL in children and adolescents with DDE significantly improved after resin infiltration.

Predictive Value of Hypomineralization of Second Primary Molars for Molar Incisor Hypomineralization and Other Relationships between Both Developmental Defects of Dental Enamel.

Molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM) are dental enamel developmental defects with significant prevalence and psychophysical impact, posing a public health concern. We examined the relationship between HSPM and MIH in 426 children aged 7 to 10 years (213 with MIH, 213 without MIH). The frequency of HSPM was higher in children with MIH (37.1% vs. 11.3%, p < 0.001). However, there was no correlation between MIH severity and presence of HSPM (p = 0.296). In patients with both defects (n = 79), 90% of severe MIH cases were associated with severe HSPM, while 87.8% of mild MIH cases were associated with mild HSPM (p < 0.001). The involvement of permanent incisors by MIH was not influenced by the presence of HSPM or HSPM severity. HSPM exhibited a positive predictive value of 76.7, negative predictive value of 58.8, sensitivity of 37.1% (95% CI = 30.6-43.6%), and specificity of 88.7% (95% CI = 84.5-93%). The odds ratio for MIH based on HSPM was 4.64 (95% CI). HSPM may serve as a predictor of MIH, but its absence does not rule out the occurrence of MIH. The results highlight the need for surveillance programs in children presenting with HSPM to facilitate early diagnosis and preventive measures for MIH-related complications.

Comparison between intraoral scanning and direct visual analysis for the assessment of developmental defects of enamel

ObjectiveTo compare direct visual analysis (DVA) and intraoral scanning (IOS) for the assessment of developmental defects of the enamel (DDE). MethodsThirty-nine extracted permanent human teeth with DDE were selected by an experienced examiner and digitised using IOS. The scanning was recorded using the OBS Studio software parallel to the IOS software to obtain a coloured high-definition MP4 file of the process. Two other experienced, blinded, and calibrated examiners randomly analysed the same teeth through DVA and IOS. A third examiner resolved any disagreements between the two examiners. Descriptive statistics were used to analyse the frequencies of the scores. Cohen's kappa test was used to determine whether the DVA scores were different from those assigned using IOS. Spearman's test was used to verify non-random examiner errors. The Chi-square test was used to compare score frequencies. Statistical significance was set at p <0.05. ResultsScores indicating more severe and extended DDE (p <0.05) were more frequently assigned with IOS than with DVA (IOS: 25.64%, 25.64%, 38.46%, and 35.90% between one-third to two-third of the lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 10.26%, 7.69%, 15.38%, and 10.26% for the respective aforementioned tooth surfaces). Contrarily, ‘no visible enamel defect’ was significantly less assigned for IOS than for DVA (IOS: 15.38%, 43.59%, 35.90%, 15.38%, and 17.95% for buccal, lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 38.46%, 66.67%, 56.41%, 51.28%, and 43.59% for the respective aforementioned tooth surfaces). Kappa agreement ranged from fair to moderate when comparing DVA and IOS; the correlation between both methods was positive, indicating that the examiners assigned the scores properly and the differences arose from employing different methods. ConclusionThe assessment of DDE differed depending on the method used. IOS scores indicated more severe and extended DDE than DVA scores. Clinical investigation is the next step in validating the use of IOS for DDE diagnosis. Clinical SignificanceThis study showed that DDE can be assessed differently using IOS. It is clinically relevant as it directly affects the determination of the severity of the defect and dental treatment planning.

A histological study of enamel developmental defects in a chacma baboon (Papio ursinus) incisor

Physiological stress disrupts normal growth creating visible grooves on the enamel surface (i.e., linear enamel hypoplasia or LEH). Hypoplastic defects often, but not always, co-occur with internal accentuated lines (AL). Monkeys reportedly exhibit fewer enamel defects than hominoids as their presumably faster-growing teeth produce shallower LEH defects that are harder to macroscopically identify. In this case study of a chacma baboon (Papio ursinus) incisor, we assessed whether AL are matched by LEH defects; how enamel extension rates and striae angles relate to the surface distribution of LEH defects; and whether striae angles are shallow and rates of enamel extension fast compared to hominoid anterior teeth. We found a higher prevalence of internal AL (N = 48) compared to external LEH defects (N = 10), which co-occurred in all instances of LEH. However, 79.2% of AL defects do not co-occur with LEH defects. The spatial distribution of AL is more consistent, ranging from 3-10/decile, while LEH defects occur mainly in the midcrown and cervical regions. This incisor exhibits faster extension rates (mean = 23.6 µm/day) and shallower striae angles (11-16°) compared to hominoids, likely creating shallower LEH defects and contributing to the discrepancy between AL and LEH defects.

A clinical and statistical study on enamel hypomineralization of the first permanent molar in the period of mixed dentition.

The first permanent molar (FPM) is the first tooth in the permanent dentition that emerges in the oral cavity, at around the age of six and behind the deciduous teeth, thus converting the primary dentition into a mixed dentition. Its early formation represents a risk factor for the onset of hard dental tissues disorders, the most common being the molar incisor hypomineralization (MIH). The aim of the study was to assess the hypomineralization type of developmental defects of enamel at FPM level during the mixed dentition stage, in a group of Romanian children. The research was conducted on 87 patients, 44 females and 43 males, divided into the following age groups: 5-6 years, 6-7 years, 7-8 years, 8-9 years, 9-10 years, 10-11 years, 11-12 years and older than 12 years. All children were examined in the dental office by a pediatric dentist. Of the subjects, 40.2% presented hypomineralization lesions on the FPM. Among the affected children, 62.9% were girls and 37.1% were boys. Mild forms were the most prevalent, being found in 71.4% of the affected subjects. Moderate forms were present in 22.9% and severe forms in 5.7% of the affected children. MIH prevalence significantly decreased with increasing age. Only two children belonging to the group 8-9 years and 10-11 years, respectively, showed severe MIH lesions. Statistically significant differences were determined in what regards the distribution of MIH children according to the severity of the lesions in relation to age (p=0.007). Children 6- to 7-year-old have been the most affected by FPM hypomineralization, which indicates the need for early management of the disease, through a thorough diagnosis, and preventive and interceptive therapeutic approaches.

RANTES and developmental defects of enamel in children: A Brazilian prenatal cohort (BRISA).

Little is known about the effect of maternal immunological factors on the etiology of developmental defects of enamel (DDE). RANTES (Regulated on Activation Normal T Cell Expressed and Secreted) is a chemokine produced by fibroblasts, lymphoid and epithelial mucosa cells in response to various external stimuli. Despite its importance for embryogenesis, RANTES expression has been demonstrated in multiple diseases characterized by inflammation, tumor and immune response, and wound healing. We hypothesized that altered levels of RANTES during pregnancy are associated with the immune and inflammatory response in women, which could lead to the occurrence of DDE in utero (DDE-iu), directly or mediated by preterm birth. Therefore, this study aimed to evaluate the direct and indirect effects of serum levels of RANTES in pregnant women in the occurrence of DDE-iu in children. This is a longitudinal case-control study. The mothers and their children (327) were evaluated in three moments: prenatal care, post childbirth, and when the child was between 12.3 and 36 months of age. The analysis was performed with structural equation modeling, estimating the standardized coefficient (SC), adopting α = 5%. There was a direct and negative effect of RANTES on the outcome (SC = -0.137; p = 0.022). This association was not mediated by preterm birth (SC = 0.007; P = 0.551). When considering the specific types of DDE-iu, RANTES had a direct effect on hypoplasia (SC = -0.190; p = 0.007), but not on opacity (SC = 0.343; p = 0.074). Lower serum levels of RANTES may contribute to a higher number of teeth with DDE-iu, specifically hypoplasia. However, more evidence supported by clinical, laboratory and epidemiological studies is still needed.

Penyakit pada anak sebagai salah satu faktor etiologi molar incisor hypomineralization : scoping review

Background: Molar incisor hypomineralization is one of the major developmental defects of enamel affecting one or more first permanent molars and is often associated with incisor involvement. MIH is thought to be idiopathic, but the etiology is not yet known. Objective: The aim of this study was to determine the relationship between postnatal factors, namely the disease suffered by children aged 0-3 years and MIH in the group of children aged 6-15 years. Methods: The study was conducted using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram through databases such as Google Scholar, PubMed, Wiley, and Science Direct using keywords of ((molar incisor hypomineralization) AND (permanent molar)) AND (etiology). Results: 32 articles that fits the criteria were found and were divided into 2 categories, namely: disease in children as a factor for MIH and disease in children associated with MIH. Conclusion: Based on the results of the study, it can be concluded that there is a relationship between disease in children aged 0-3 years and the occurrence of MIH in children aged 6-15 years. Respiratory disease at an early age was associated with the occurrence of MIH most frequently.

Prevalence and risk factors of molar incisor hypomineralization in school children: A cross-sectional study in North Kerala, India

Introduction: Molar incisor hypomineralization (MIH) is a developmental enamel defect affecting permanent molars and incisors, leading to dental challenges. The prevalence and associated risk factors of MIH vary globally, highlighting the need for region-specific studies. The primary objectives of this cross-sectional study were to determine the prevalence of MIH in 7- to 11-year-old school children, investigate associated risk factors, and analyze the clinical manifestations. Materials and methods: A random sample of 10,000 children aged 7 to 11 years from 10 primary schools in North Kerala underwent oral examinations. The study utilized a two-part proforma, including demographic details, parental interviews, and clinical assessments using a modified developmental defect of enamel index. The data were analyzed using the chi-square test and SPSS software. Ethical approval and parental consent were obtained. Results: Out of 2170 children examined, the prevalence of MIH was 8.2%. Males showed a higher prevalence (62.92%), with maxillary molars being predominantly affected. The study revealed significant associations between MIH and antenatal factors, antibiotic usage, and maternal illnesses. Maxillary molars were more frequently affected than mandibular molars, with specific teeth showing varying degrees of susceptibility. Conclusion: As children’s age increased, the severity of MIH defects in the first permanent molars escalated, indicating progressive enamel defects. The prevalence of MIH was more pronounced in the upper arch, with both maxillary and mandibular first permanent molars being equally affected. The study identified factors such as polychlorinated biphenyls (PCBs)/dioxins, medical illness problems, malnutrition, fluoride exposure, common medical diseases, and genetic disorders as potential contributors to MIH defects. Early diagnosis and intervention are crucial for managing the challenges posed by MIH-affected teeth.

Development of undergraduate students' diagnostic accuracy for the classification of molar incisor hypomineralization.

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. 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). 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). Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.

Oral and craniofacial research in the Generation R study: an executive summary

ObjectivesOral conditions are of high prevalence and chronic character within the general population. Identifying the risk factors and determinants of oral disease is important, not only to reduce the burden of oral diseases, but also to improve (equal access to) oral health care systems, and to develop effective oral health promotion programs. Longitudinal population-based (birth-)cohort studies are very suitable to study risk factors on common oral diseases and have the potential to emphasize the importance of a healthy start for oral health. In this paper, we provide an overview of the comprehensive oral and craniofacial dataset that has been collected in the Generation R study: a population-based prospective birth cohort in the Netherlands that was designed to identify causes of health from fetal life until adulthood.MethodsWithin the multidisciplinary context of the Generation R study, oral and craniofacial data has been collected from the age of 3 years onwards, and continued at the age of six, nine, and thirteen. Data collection is continuing in 17-year-old participants.Research outcomesIn total, the cohort population comprised 9749 children at birth, and 7405 eligible participants at the age of seventeen. Based on questionnaires, the dataset contains information on oral hygiene, dental visits, oral habits, oral health–related quality of life, orthodontic treatment, and obstructive sleep apnea. Based on direct measurements, the dataset contains information on dental caries, developmental defects of enamel, objective orthodontic treatment need, dental development, craniofacial characteristics, mandibular cortical thickness, and 3D facial measurements.ConclusionsSeveral research lines have been set up using the oral and craniofacial data linked with the extensive data collection that exists within the Generation R study.Clinical relevanceBeing embedded in a multidisciplinary and longitudinal birth cohort study allows researchers to study several determinants of oral and craniofacial health, and to provide answers and insight into unknown etiologies and oral health problems in the general population.

Antibiotic Exposure and Dental Health: A Systematic Review.

The use of antibiotics in young children is widespread and may lead to adverse effects on dental health, including staining, developmental defects, and dental caries. To systematically review the effects of early childhood antibiotic exposure on dental health. Medline (Ovid/PubMed), Embase (Ovid) and Cochrane databases. Study bias was assessed using the Newcastle-Ottawa Scale. English language articles that reported antibiotic exposure before 8 years of age and 1 or more of the relevant outcomes (dental caries, intrinsic tooth staining, or developmental defects of enamel) were included. Data on study population, design, type of antibiotic, outcome measurement, and results were extracted from the identified studies. The initial search yielded 1003 articles of which 34 studies were included. Five of the 18 studies on tetracycline described a dose response relationship between exposure to tetracycline doses of > 20 mg/kg per day and dental staining. Early childhood exposure to doxycycline (at any dose) was not associated with dental staining. There was no clear association between any early childhood antibiotic exposure and dental caries or enamel defects. In all included studies, the main limitations and sources of bias were the lack of comparison groups, inconsistent outcome measures, and lack of adjustment for relevant confounders. There was no evidence that newer tetracycline formulations (doxycycline and minocycline) at currently recommended dosages led to adverse effects on dental health. Findings regarding antibiotic exposure and developmental defects of enamel or dental caries were inconsistent. Further prospective studies are warranted.

Assessment of Risk Factors for Developmental Defects of the Enamel in Preterm

This study aimed to determine the criteria for quantifying developmental defects of enamel in primary teeth in premature babies and to investigate the severity of developmental defects according to the gestational age, birth weight, systemic complications, and treatments received after preterm birth. Birth information, a history of complications, the duration of parenteral nutrition, and endotracheal intubation were investigated by retrospectively reviewing the admission and discharge records of premature babies in the neonatal intensive care unit. The Preterm Developmental Defects of Enamel (PDDE) index was designed by modifying the existing developmental defects of enamel index. Based on PDDE index, the evaluator scored developmental defects of enamel by classifying them as enamel hypomineralization and hypoplasia. The PDDE scores in the extremely preterm and extremely low birth weight groups were significantly higher than those in other groups. Furthermore, PDDE scores of premature babies with bronchopulmonary dysplasia, rickets, intraventricular hemorrhage, or necrotizing colitis were significantly higher than those in the control group. In addition, more than 50 days of endotracheal intubation and more than 20 days of parenteral nutrition were associated with significantly higher PDDE scores than those in the control group and were risk factors for developmental defects of enamel. This study provides basic information for identifying risk factors for developmental defects of enamel in premature babies.

Prenatal exposure to persistent organic pollutants and molar-incisor hypomineralization among 12-year-old children in the French mother-child cohort PELAGIE

BackgroundExceptional episodes of exposure to high levels of persistent organic pollutants have already been associated with developmental defects of enamel among children, but knowledge is still scarce concerning the contribution of background levels of environmental contamination. MethodsChildren of the French PELAGIE mother-child cohort were followed from birth, with collection of medical data and cord blood samples that were used to measure polychlorinated biphenyls (PCBs), organochlorine pesticides (OCs), and perfluorinated alkyl substances (PFASs). At 12 years of age, molar-incisor hypomineralization (MIH) and other enamel defects (EDs) were recorded for 498 children. Associations were studied using logistic regression models adjusted for potential prenatal confounders. ResultsAn increasing log-concentration of β-HCH was associated with a reduced risk of MIH and EDs (OR = 0.55; 95% CI, 0.32–0.95, and OR = 0.65; 95% CI, 0.43–0.98, respectively). Among girls, intermediate levels of p,p’-DDE were associated with a reduced risk of MIH. Among boys, we observed an increased risk of EDs in association with intermediate levels of PCB 138, PCB 153, PCB 187, and an increased risk of MIH with intermediate levels of PFOA and PFOS. ConclusionsTwo OCs were associated with a reduced risk of dental defects, whereas the associations between PCBs and PFASs and EDs or MIH were generally close to null or sex-specific, with an increased risk of dental defects in boys. These results suggest that POPs could impact amelogenesis. Replication of this study is required and the possible underlying mechanisms need to be explored.

In vivo real-time assessment of developmental defects in enamel of anti-Act1 mice using optical coherence tomography

The purpose of this study was to explore the feasibility of using optical coherence tomography (OCT) for real-time and quantitative monitoring of enamel development in gene-edited enamel defect mice. NF-κB activator 1, known as Act1, is associated with many inflammatory diseases. The antisense oligonucleotide of Act1 was inserted after the CD68 gene promoter, which would cover the start region of the Act1 gene and inhibit its transcription. Anti-Act1 mice, gene-edited mice, were successfully constructed and demonstrated amelogenesis imperfecta by scanning electron microscope (SEM) and energy dispersive X-ray (EDX) spectroscopy. Wild-type (WT) mice were used as the control group in this study. WT mice and anti-Act1 mice at 3 weeks old were examined by OCT every week and killed at eight weeks old. Their mandibular bones were dissected and examined by OCT, micro-computed tomography (micro-CT), and SEM. OCT images showed that the outer layer of enamel of anti-Act1 mice was obviously thinner than that of WT mice but no difference in total thickness. When assessing enamel thickness, there was a significant normal linear correlation between these methods. OCT could scan the imperfect developed enamel noninvasively and quickly, providing images of the enamel layers of mouse incisors.

The Prevalence of Developmental Enamel Defects in Israeli Children and Its Association with Perinatal Conditions: A Cross-Sectional Study.

Molar incisor hypomineralization (MIH) and deciduous molar hypomineralization (DMH) affect the first permanent molars and second primary molars, respectively, causing a greater dental treatment burden and worse oral health quality of life among affected children. We assessed the prevalence and risk factors of MIH and DMH among 1209 children aged 3-13 years who attended a university dental clinic in Israel in 2019-2020. Clinical examinations were conducted to assess the presence of DMH and MIH. Potential etiological factors of MIH and DMH, including demographics, the mother's perinatal health, and the child's medical history during the first three years of life, were retrieved using a questionnaire. To examine the associations between the demographic and clinical variables and the prevalence of MIH and DMH, continuous variables were tested using the Kruskal-Wallis test with Bonferroni corrections. Categorical variables were analyzed by chi-squared test. Multivariate logistic regression was conducted to evaluate which of the significant variables found in the univariate analysis could predict a diagnosis of both MIH and DMH. The prevalence of MIH and DMH was 10.3% and 6.0%, respectively. Age ≥ 5 years, taking medications during pregnancy and severe lesions were associated with a greater risk for a diagnosis of DMH + MIH. Multivariate logistic regression with adjustment for age showed that the severity of hypomineralization was positively and significantly associated with a diagnosis of MIH + DMH with an odds ratio of 4.18 (95% confidence interval 1.26-17.16), p = 0.03. MIH should be diagnosed and monitored in young children to prevent further deterioration. Moreover, a preventive and restorative program for MIH should be established.

Fifty years of progress in paediatric dentistry

Progress in paediatric dentistry over the last half a century has been evident across all areas of the speciality. This article highlights significant changes in the diagnosis, prevention and management of dental caries, traumatic dental injuries, developmental enamel defects, tooth erosion, dental fear and anxiety and safeguarding children. The dedication of clinicians and researchers along with advances in material science and technology have supported this progress. We discuss the importance of working with those both within and outside of the specialty in order to collaborate to improve children’s oral health. There have been significant strides in the provision of child-centred holistic care and research. Reviewing the advancements made over this period has set a high precedent for making further progress within paediatric dentistry over the next 50 years. CPD/Clinical Relevance: Knowledge of key advances in the field of paediatric dentistry will facilitate good diagnosis and treatment of younger patients.

Epigenetics in developmental defects of enamel:A scoping review.

The significant role of epigenetics has been revealed in normal enamel formation process and occurrence of developmental defects. This presented literature is aiming at summarizing the regulatory function of epigenetics in physiological amelogenesis process and reviewing the epigenetic mechanisms in occurrence of developmental defects of enamel (DDE), so as to provide biological foundation evidence to support early predication and clinical management of DDE. An extensive literature review was conducted using electronic databases MEDLINE (through PubMed), Web of Science and EMBASE up to November 30,2022. Studies about epigenetic effects on enamel tissue or cells associated with amelogenesis, including in vivo studies using humans or animal models, and in vitro studies, are selected. 22 studies were included. Epigenetic factors or effects specifically activate or silence certain genes, which may regulate related biological activites including cell proliferation, cell differentiation, enamel secretion and mineralization during the process of amelogenesis. Once the status of epigenetic modification is altered, the quantity and quality of enamel may both be disturbed, which can finally result in DDE. Epigenetics plays a noteworthy role of regulating the amelogenesis process and DDE potentially by altering the expression level of genes related to enamel formation, providing a new perspective of early predication and clinical management of DDE.

Developmental enamel defects and their relationship with caries in adolescents aged 18 years

Randomly selected 1,611 individuals aged 18 years formed a nationally representative sample from all provinces of Poland. Developmental defects of the enamel (DDE) and caries were assessed using the modified DDE index, molar incisor hypomineralisation (MIH) Treatment Need Index (MIH-TNI), FDI and WHO criteria by 22 trained and calibrated dentists. T-test was used for comparing group means. A simple and multiple logistic regression tests were used to assess the relationship between DDE and caries severity expressed as DMFT (p < 0.05). The prevalence of DDE was 13.7%. Demarcated opacities (DEO) were the most frequent (9.65%); 4% had diffuse opacities (DIO) and 1.5% had hypoplasia. MIH was diagnosed in 0.6% patients. The prevalence of caries was 93.2%, with mean DMFT of 6.50 ± 4.22. The DMFT value was 7.52 ± 4.77 in the group of patients with demarcated opacities (DEO); 7.85 ± 4.74 with diffuse opacities (DIO) and 7.56 ± 4.57 with enamel hypoplasia, respectively. There was a significant relationship between caries severity and DDE (p < 0.001), DEO (p = 0.001) and DIO (p = 0.038), and between DDE and DMFT index (p < 0.001). The results obtained in the study proved the significant relationship between DDE and DMFT in 18-year-olds, the assessment of which was the aim of the study.

Incorporating cancer survivorship care in dental education.

Incorporating cancer survivorship care in dental education.

Postępowanie kliniczne w amelogenesis imperfecta w wieku rozwojowym – przypadki kliniczne

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.