Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirao Preto, Brazil.
Monogr Oral Sci. 2024;32:157-165. doi: 10.1159/000538886. Epub 2024 Jul 1.
Tooth hypersensitivity is a common symptom in molar incisor hypomineralisation (MIH) patients and can affect children's quality of life. During daily routine, children with MIH often report sensitivity to various thermal and mechanical stimuli, and difficulty in achieving effective analgesia is a common issue becoming a challenge for dentists. Research has focused on the possible pathophysiological mechanisms behind this phenomenon, which, in turn, have not been determined. Even with the apparently intact enamel of MIH-teeth, the porosity of the hypomineralised enamel acts as an open door for the invasion of oral microorganisms, which reach the dentinal tubules, and stimulate subclinical inflammatory reactions in the pulp. Tissue inflammation may, in turn, lead to morphological and cytochemical changes within sensory neurons, resulting in sensitization of these nerve fibers. This phenomenon is complex, and the treatment modalities focus on inflammation management followed by tubule obliteration by using different materials and technologies. In conclusion, this chapter reviews the concept and etiology of hypersensitivity in teeth with MIH and summarizes the clinical management according to the best evidence available.
牙本质过敏是低矿化磨牙症（MIH）患者的常见症状，会影响儿童的生活质量。在日常生活中，患有 MIH 的儿童常报告对各种热和机械刺激敏感，难以达到有效镇痛是牙医面临的常见挑战。研究集中在这种现象背后可能的病理生理机制上，但尚未确定。即使 MIH 牙齿的牙釉质表面看起来完整，矿化不足的牙釉质的多孔性也像一扇敞开的门，让口腔微生物进入，到达牙本质小管，并刺激牙髓中的亚临床炎症反应。组织炎症反过来可能导致感觉神经元内的形态和细胞化学变化，导致这些神经纤维敏化。这个现象很复杂，治疗方法主要集中在炎症管理上，然后使用不同的材料和技术封闭牙本质小管。综上所述，本章回顾了 MIH 牙齿过敏的概念和病因，并根据现有最佳证据总结了临床管理。
