Tratamento estético e funcional para hipomineralização molar-incisivo: relato de caso clínico

Abstract

INTRODUCTION: Molar-incisor hypomineralization (MIH) corresponds to a developmental defect of enamel that affects between one and four first permanent molars, often associated with changes in permanent incisors. The etiology of MIH is not fully understood, but it is believed that both genetic and environmental factors may be involved. Teeth affected by MIH can present aesthetic changes, loss of tooth structure, caries lesions and dentin hypersensitivity and can represent a challenge for dentists, due to the higher percentage of failures in restorative treatment. Thus, the early diagnosis of teeth affected by MIH will promote the adequate management, minimizing the resulting damage. OBJECTIVE: To report the clinical case of a child diagnosed with MIH and to present aspects of dental treatment related to this condition. CASE REPORT: Pediatric male patient, leucoderma, ten years old, with the main complaint of “decayed tooth” and without reports of complications or health problems during the child’s pregnancy, as well as in thr first three years of life. In the intraoral clinical examination, demarcated opacities were observed in teeth 16, 11 and 21. The patient was diagnosed with mild to moderate MIH. Dental treatment consisted of instituting measures to control caries risk factors, with oral hygiene motivation and guidance, dietary guidelines, topical fluoride applications and periodic professional monitoring and follow-up. Restoration repair of tooth 16 was carried out in composite resin, in addition to the preparation with wear on teeth 11 and 21 for restorations in composite resin for aesthetic purposes. In all composite resin restorations performed, a deproteinization technique was used with the application of 2.5% sodium hypochlorite. FINAL CONSIDERATIONS: Studies with case reports can contribute to better knowledge about the diagnosis and the dental management of MIH. The early diagnosis of individuals with MIH should be carried out to adopt preventive and interceptive measures in order to control, minimize and treat possible sequelae.