Department of Morphology and Pediatric Dentistry, Araraquara School of Dentistry, São Paulo State University (Unesp), Araraquara, Brazil.
School of Dentistry, CES University, Medellin, Colombia.
Monogr Oral Sci. 2024;32:147-156. doi: 10.1159/000538884. Epub 2024 Jul 1.
Hypomineralisation defects with demarcated opacities are also observed in the deciduous dentition and have been found to be a predictive factor for hypomineralisation defects in the permanent dentition. Deciduous molar hypomineralisation (DMH) represents a qualitative enamel defect primarily afflicting deciduous second molars, albeit its presence is not limited solely to deciduous second molars, as it can manifest in deciduous canines and first molars. Thus, the presence of demarcated hypomineralisation defects in deciduous teeth could be called as deciduous teeth hypomineralisation. Clinically, these defects are characterized by demarcated opacities, posteruptive enamel breakdown, atypical caries lesions, and atypical restorations. The accurate diagnosis of DMH continues to present a clinical challenge, and the reported prevalence of this defect exhibits notable variability across different countries. Its precise etiology remains elusive; however, there is a prevailing suspicion that events occurring during the prenatal, perinatal, or early postnatal periods, particularly those unfolding during the perinatal phase, are intricately linked to DMH development. Factors such as delivery complications, neonatal complications, prematurity, and low birth weight have been associated with DMH. Notably, there exists a possibility that, the more health-related events occur during this critical period, the greater the likelihood of a child presenting with this enamel defect. Nevertheless, the establishment of these associations warrants further investigation through prospective studies. Acquiring knowledge regarding the factors associated with this defect holds paramount importance for effective diagnosis, guidance for families with affected children, and the formulation of strategies to mitigate the incidence of these contributory factors.
发育期釉质不全伴界限明显的混浊也可见于乳牙，并已被发现是恒牙发育期釉质不全的预测因素。乳牙釉质发育不全（DMH）代表一种主要影响乳牙第二磨牙的定性釉质缺陷，尽管其存在不仅限于乳牙第二磨牙，因为它也可能在乳牙前磨牙和第一磨牙中表现出来。因此，乳牙出现界限明显的釉质发育不全缺陷可称为乳牙釉质发育不全。临床上，这些缺陷的特征是界限明显的混浊、萌出后釉质破裂、非典型龋损和非典型修复。DMH 的准确诊断仍然是一个临床挑战，并且不同国家报道的这种缺陷的患病率存在显著差异。其确切病因仍不清楚；然而，人们普遍怀疑，产前、围产期或新生儿早期发生的事件，特别是围产期发生的事件，与 DMH 的发展密切相关。分娩并发症、新生儿并发症、早产和低出生体重等因素与 DMH 有关。值得注意的是，在这个关键时期发生的与健康相关的事件越多，孩子出现这种釉质缺陷的可能性就越大。然而，需要通过前瞻性研究进一步证实这些关联。了解与这种缺陷相关的因素对于有效诊断、为受影响儿童的家庭提供指导以及制定减轻这些促成因素发生率的策略至关重要。
