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一名患有磨牙切牙矿化不全的儿科患者的治疗选择:一例临床病例报告

Therapeutic Alternatives in a Pediatric Patient With Molar Incisor Hypomineralization: A Clinical Case Report.

作者信息

de la Cruz-Fabián Karla D, Robles-Bermeo Norma-Leticia, Lovera-Rojas Nayeli, Medina-Solís Carlo E

机构信息

Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" School of Dentistry, Autonomous University of State of Mexico, Toluca, MEX.

Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, MEX.

出版信息

Cureus. 2025 Jul 23;17(7):e88606. doi: 10.7759/cureus.88606. eCollection 2025 Jul.

Abstract

A notable increase in the incidence of molar incisor hypomineralization (MIH) has been observed in recent years. This trend may be attributed to a combination of factors, including increased public awareness, improved diagnostic techniques, and a greater emphasis on early childhood oral health. Clinically, MIH initially presents as white-to-brown opacities without enamel loss, progressing to post-eruptive breakdown in severe cases, often accompanied by hypersensitivity and atypical caries that may lead to pulp involvement. MIH treatment requires a correct clinical assessment of the tooth as the first step toward selecting a therapy that will ensure long-term success for the patient. The choice of dental materials is a decision that the clinician must make based on scientific evidence, the manufacturer's instructions, and the patient's general condition. The purpose of this case report was to present the clinical results of a 15-month follow-up of different therapy options in an 11-year-old male patient with MIH. The symptoms reported by the patient included hypersensitivity to hot and cold stimuli in the upper first permanent molars (FPMs) and tissue rupture in the lower FPM, which interfered with his eating function. The use of biomaterials, application of infiltrative resin (Icon®, DMG, Hamburg, Germany), preformed bands, topical applications of fluoride, as well as changes in oral hygiene habits and diet, were employed as therapeutics. The main contribution of this clinical case is that preserving the integrity of three molars with MIH in the same oral environment posed the greatest challenge to rehabilitation. However, with an individualized treatment plan, the evolution can be successful.

摘要

近年来,磨牙症伴切牙矿化不全(MIH)的发病率显著上升。这种趋势可能归因于多种因素的综合作用,包括公众意识的提高、诊断技术的改进以及对儿童早期口腔健康的更多关注。临床上,MIH最初表现为白色至棕色的牙釉质不透明,无牙釉质丧失,严重病例在牙齿萌出后会出现破损,常伴有过敏和非典型龋齿,可能导致牙髓受累。MIH治疗需要对牙齿进行正确的临床评估,这是选择确保患者长期成功治疗方案的第一步。牙科材料的选择是临床医生必须根据科学证据、制造商的说明以及患者的一般情况做出的决定。本病例报告的目的是展示一名11岁男性MIH患者采用不同治疗方案进行15个月随访的临床结果。患者报告的症状包括上颌第一恒磨牙(FPM)对冷热刺激过敏以及下颌FPM的组织破裂,这影响了他的进食功能。治疗方法包括使用生物材料、应用渗透树脂(Icon®,德国汉堡DMG公司)、预成带环、局部应用氟化物,以及改变口腔卫生习惯和饮食。本临床病例的主要贡献在于,在同一口腔环境中保留三颗患有MIH的磨牙的完整性对修复构成了最大挑战。然而,通过个性化的治疗方案,病情发展可以取得成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b799/12373262/2141b5853b97/cureus-0017-00000088606-i01.jpg

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