A amelogénese imperfeita constitui uma anomalia de desenvolvimento do esmalte, de carácter hereditário. A sua prevalência é de , podendo o esmalte. Amelogenesis imperfecta (AI) is a congenital disorder that presents with a rare abnormal formation of the enamel or external layer of the crown of teeth. 19 jul. O objetivo deste artigo foi apresentar uma revisão de literatura sobre tratamento restaurador conservador na amelogênese imperfeita.
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The aim of this paper was to describe a clinical case of immediate dental desensitization using a self-etch adhesive system in an adolescent patient diagnosed with amelogenesis imperfecta AI. AI was associated with severe tooth sensitivity, treated by the application of a universal adhesive system for desensitization of the teeth affected by AI.
Reduction of tooth sensitivity was assessed using a visual analog scale during all reevaluations. The technique was effective for reducing tooth sensitivity. Amelobenese was concluded that the adhesive system for imperfeiat desensitization had an immediate effect and maintained its effectiveness during a month follow-up period.
Amelogenesis imperfecta AI is a hereditary anomaly of the enamel, which affects both dentitions and amelogenwse cause tooth sensitivity, loss of vertical dimension, enamel deficiencies, pulp calcification, failed tooth eruption, impaction of permanent teeth and aesthetic commitment 12. Xmelogenese synthesis or amelogenesis occurs by the activity of ameloblasts after dentin formation 3. Historically, Qmelogenese has been known and studied sincebut only in it was classified separately inperfeita dentinogenesis imperfecta and considered to possibly affect both deciduous and permanent teeth 45.
AI can be classified according to phenotype and clinical aspect as follows: Type I or hypoplastic, involves problems in enamel secretion; Type II or hypomature, related to enamel maturation; Type III or hypocalcified, involves mineralization and Type IV, hypoplastic, hypomature and taurodontic 6.
These teeth present different levels of color alteration, presenting dark brown color, increase of roughness and susceptibility to attrition, which results in the reduction of vertical dimension 457. Oral hygiene is often unsatisfactory owing to the irregularity of the tooth surface and sensitivity, contributing to a greater susceptibility to staining 8.
According to the literature, the main sequelae in these patients, regardless of AI classification, are intense tooth sensitivity, poor aesthetics, risk of dental caries and decreased vertical dimension 9 Thereby, different treatment strategies are available, according to the degree of damage, including the use of all types of glass ionomer cements, stainless steel crowns, amalgam restorations, adhesive restorations, metaloceramic crown, prefabricated resin veneer amelogenewe multiple extractions requiring an overdenture 7111213 This paper reports a amelogensee of a simple and useful protocol for immediate reduction of amepogenese sensitivity in a young patient with AI by using a self-etch adhesive system.
The patient authorized publication of this case and written informed consent was obtained from this his parents. The main complaint reported by the patient was extreme sensitivity of the posterior teeth, especially with drinks and cold food.
The patient was subjected to clinical and radiographic examinations and received orientation amdlogenese oral hygiene and treatment of sensitivity with fluoride.
During anamnesis, his mother did not know if anyone else in the family had the same problem and reported that the son was diagnosed with attention-deficit hyperactivity disorder. An intraoral examination revealed teeth with alterations in size and shape, yellow-brown imperfeia Fig. Clinical examination revealed the presence of generalized bacterial plaque on the surface of the teeth. A complete periapical radiographic examination was ordered, which revealed absence of enamel in some places.
Study models were made ijperfeita complement the clinical examination. For the anterior teeth, was planned a future rehabilitation with direct veneers using composite resin for aesthetic recovery. Desensitization was not recommended because the patient did not report pain in the region. However, in the posterior teeth, the patient reported pain when ingesting cold or citrus foods and imperfeiita level 8 on the visual analogue scale to classify tooth sensitivity asmild, moderate or severe, after application of an air jet at a distance of 10 cm, for about 2 s.
Thus, immediate desensitization using self-etching adhesives was proposed. In the preventive and early stages were performed dental prophylaxis, removal of dental calculus, topical fluoride application, oral hygiene instruction and sealing of the posterior teeth with adhesive.
Paul, MN, USA was performed after careful prophylaxis with pumice and water, followed by relative isolation of the regions that would be subjected to the clinical protocol. At the buccal, lingual or palatal and occlusal faces Figs. The first was actively applied with a microbrush for 20 s, without curing. On imerfeita proximal faceadhesive was applied with a dental floss after the same steps described for the other faces Figs.
However, before curing, polyester matrices were placed in order to prevent adhesion to the adjacent teeth and ensure polishing of these surfaces. After 7 days, 1 month, 2 months and 1 year of adhesive application, the patient was re-evaluated, and an adhesive layer was still covering tooth surfaces.
The patient reported that he was consuming food and cold drinks without tooth sensitivity. Before application of the amelogensse system, he had already been using desensitizing toothpaste, although he could not eat cold food because of the high sensitivity. The patient showed improvement in hygiene and considerable reduction of gingival inflammation.
The patient is currently under observation and direct composite restorations are planned to provide better aesthetics and function. AI is a hereditary anomaly of the enamel, which affects both dentitions and may cause many unfavorable conditions such as tooth sensitivity, loss imperfsita vertical dimension, enamel deficiencies, failed tooth eruption, impaction of amelogennese teeth, aesthetic commitment and anterior open bite 12 The ammelogenese of these cases is related to many factors, including age, damage severity, aesthetics, socioeconomic status, psychosocial aspects, and functional and social demands 1416ameelogenese The literature presents different treatments that use all types of glass ionomer cements, stainless steel crowns, amalgam restorations, adhesive restorations, metal-ceramic crowns, prefabricated resin veneer, and multiple extractions requiring an overdenture 7, The main treatment goals are to preserve maximum tooth structure, restore masticatory functions and aesthetics, and eliminate tooth sensitivity 713 However, the authors of this systematic review failed to identify the best intervention.
Thus, without a high-quality evidence, the authors planned the treatment in stages according to priority. Normally, the dentist should first reduce or eliminate tooth sensitivity, improve aesthetics and provide oral hygiene orientation.
The dentist should then eliminate the loss of vertical dimension and finally complete the rehabilitation 712 – 14 Fluoride is important to AI patients because of their high risk of caries and it may reduce a little ameligenese the hypersensitivity and impereita this effect when associated with the occlusion of the dentin tubules Bonding agents are used to obliterate dentin tubules by reducing or eliminating tooth sensitivity 11 Another positive effect of the protocol ameelogenese the improvement of the patient’s oral care because he no longer felt pain during tooth brushing.
The bond strength in dentin AI is significantly lower than that in normal dentin because of the hypermineralized sclerotic tissues. These sclerotic areas are probably more resistant im;erfeita demineralization by amelogenrse etching, impairment or prevention of resin infiltration.
Extending the etching time showed no significant difference and the hypermineralized impetfeita was dissolved by acid. However, over-etching of the underlying mineralized dentin may occur; thus, resin monomers would not penetrate the full depth of the demineralized dentin, producing a porous, non-resinous, infiltrated zone The universal adhesives showed equivalent bonding quality to that of dentin regardless of etching mode amelogwnese In AI enamel, this adhesive system without previous etching provided a bond strength similar to that of etch-and-rinse adhesive systems The choice of this protocol was based on sensitivity control and reduced clinical time, because the patient had attention-deficit hyperactivity disorder and had no loss of vertical dimension.
The use of a universal adhesive eliminated the etch, rinse and dry phases, and showed relevant results in terms of bond strength 2021thereby obliterating the dentin tubules, and reducing amrlogenese eliminating tooth sensitivity 11 Thus, based on the present clinical case, it may be concluded that the sealing of the exposed dentin on teeth affected by AI by a universal self-etch adhesive system effectively reduced or eliminated tooth sensitivity immediately and maintained this effect during the month follow-up period.
Further clinical studies are required, but the technique seems promising, as it greatly improved the patient’s quality of life. It had an immediate effect, was effective and was a simple clinical option. Review and case report. N Z Dent J ; Genes and related proteins involved in amelogenesis imperfecta.
Stomatos – Amelogenese imperfecta em uma criança com paralisia cerebral
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Influence of different etching mode on bond strength and fatigue strength to dentin using universal adhesive systems. Microtensile bond strength to enamel affected by hypoplastic amelogenesis imperfecta. J Adhes Dent ; This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Services on Demand Journal. Abstract The aim of this paper was to describe a clinical case of immediate dental desensitization using a self-etch adhesive system in an adolescent patient diagnosed with amelogenesis imperfecta AI.
Introduction Amelogenesis imperfecta AI is a hereditary anomaly of the enamel, which affects both dentitions ameloegnese may cause tooth sensitivity, loss of vertical dimension, enamel deficiencies, pulp calcification, failed tooth eruption, impaction of permanent teeth and aesthetic commitment 12. amelogenewe
Case Report The patient authorized publication of this case and written informed consent was obtained imperfeiha this his parents. Results After 7 days, 1 month, 2 months and 1 year of adhesive application, the patient was re-evaluated, and an adhesive layer was still covering tooth surfaces.