Mandetta Amanda Rafaelly Honório, Bortoletto Carolina Carvalho, Sobral Ana Paula Taboada, Gimenez Thais, Ribeiro Caroline Diniz Pagani Vieira, Motta Lara Jansiski, Horliana Anna Carolina Ratto Tempestini, Mesquita-Ferrari Raquel Agnelli, Prates Renato Araujo, Deana Alessandro Melo, Duran Cinthya Cosme Gutierrez, Cordeiro Rita de Cássia Loiola, Fernandes Kristianne Porta Santos, Dos Santos-Pinto Lourdes Aparecida Martins, Bussadori Sandra Kalil
Biophotonics Medicine Postgraduate Program, Universidade Nove de Julho, São Paulo, Brazil.
School of Dentistry, Universidade Metropolitana de Santos, Santos, Brazil.
Transl Pediatr. 2025 Feb 28;14(2):311-321. doi: 10.21037/tp-24-480. Epub 2025 Feb 25.
Molar incisor hypomineralization (MIH) is a complex developmental enamel defect influenced by various factors, including genetic predisposition. This condition primarily affects the first permanent molars and, in some instances, the permanent incisors. In this case series, we examined the clinical effects of antimicrobial photodynamic therapy (aPDT) and deproteinization with Papacárie on teeth with MIH and carious lesions, focusing on decontamination, hypersensitivity control, and restoration longevity with the use of minimally invasive techniques.
Seven permanent first molars from children aged 7 to 10 years, with carious dentin lesions and post-eruptive fractures, which required restorative clinical treatment, were selected. Selective chemical-mechanical removal of carious tissue and deproteinization were performed using Papacárie, followed by aPDT. A laser device was used, which emitted red light (wavelength: 660 nm, 100 mW, 6 J per spot, 3,571 mW/cm, 214 J/cm, 60 seconds). The teeth were then restored with a combined method involving resin-modified glass ionomer cement and bulk-fill composite resin. Microbiological analysis was conducted, along with the assessment of hypersensitivity using the Visual Analog Scale (VAS) and Schiff Cold Air Sensitivity Scale (SCASS) scales, and the evaluation of the longevity of restorations according to the criteria of the United States Public Health Service (USPHS). Clinical evaluations were performed after 48 hours, 3 months, and 6 months.
aPDT proved to be promising treatment for decontamination and hypersensitivity control in molars with hypomineralization and dentinal caries. Moreover, deproteinization with Papacárie offers a promising, minimally invasive approach for enhancing restoration longevity.
磨牙症性切牙釉质矿化不全（MIH）是一种受多种因素影响的复杂发育性釉质缺陷，包括遗传易感性。这种情况主要影响第一恒磨牙，在某些情况下也会影响恒切牙。在本病例系列中，我们研究了抗菌光动力疗法（aPDT）和使用Papacárie进行脱蛋白处理对患有MIH和龋损牙齿的临床效果，重点关注去污、过敏控制以及使用微创技术的修复体寿命。
选取了7名7至10岁儿童的7颗恒第一磨牙，这些牙齿患有龋坏牙本质病变和萌出后骨折，需要进行修复性临床治疗。使用Papacárie进行龋坏组织的选择性化学机械去除和脱蛋白处理，随后进行aPDT。使用了一种发射红光的激光设备（波长：660 nm，100 mW，每点6 J，3571 mW/cm，214 J/cm，60秒）。然后用树脂改性玻璃离子水门汀和大块充填复合树脂的联合方法对牙齿进行修复。进行了微生物学分析，同时使用视觉模拟量表（VAS）和席夫冷空气敏感量表（SCASS）评估过敏情况，并根据美国公共卫生服务（USPHS）标准评估修复体的寿命。在48小时、3个月和6个月后进行临床评估。
aPDT被证明是治疗矿化不全和牙本质龋磨牙去污和过敏控制的有前景的方法。此外，使用Papacárie进行脱蛋白处理为提高修复体寿命提供了一种有前景的微创方法。
