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Amelogénese imperfeita: odontopediatria em foco

Authors: Silva, Thierry Zão;

Amelogénese imperfeita: odontopediatria em foco

Abstract

A amelogénese imperfeita é definida como sendo um complexo grupo de defeitos do esmalte, de tipo hereditário, não associado a doenças sistémicas, que atinge ambas as dentições, decídua e definitiva. Trata-se de um defeito raro de mineralização do esmalte com uma incidência de 1:14000. A amelogénese imperfeita pode caracterizar-se pela hipoplasia do esmalte e/ou hipomaturação ou hipocalcificação. Fenotipicamente, a amelogénese imperfeita é dividida em quatro grupos: hipoplásico, hipomaturo, hipocalcificado e hipomaturo-hipoplásico. O tipo hipoplásico ocorre em 60 a 73% dos casos afectados, principalmente, no sexo feminino, enquanto o tipo hipomaturo afecta 20 à 40% dos casos e é mais comum no sexo masculino. Aproximadamente 7% dos indivíduos afectados têm a variante hipocalcificada. Witkop 1988, defende que existem quinze subtipos de amelogénese imperfeita com base nos fenótipos e padrões de hereditariedade. Segundo a literatura, os pacientes com amelogénese imperfeita, independentemente do subtipo presente, apresentam complicações orais semelhantes: sensibilidade dentária, estética dentária comprometida e diminuição da dimensão vertical de oclusão. Outras anomalias dentárias associadas com a amelogénese imperfeita são: impactação múltipla de dentes, ausência congénita dentária, mordida aberta e taurodontismo. A amelogénese imperfeita é conhecida como uma anomalia isolada ou como uma característica de certas síndromes, tais como: tricodento-ósseo, Morquio, Kohlschütter, epidermólise bulhosa distrófica, entre outros. A nível odontopediátrico, é importante conhecer toda a história passada e presente da criança, bem como todos os tratamentos efectuados até então. A compreensão e colaboração no tratamento da amelogénese imperfeita por parte dos pais é particularmente relevante, pois verifica-se que a criança é afectada também psicologicamente. Restabelecer estética e capacidade funcional, sobretudo ao nível da mastigação e fala são pontos a considerar. As opções de tratamento variam, consideravelmente, dependendo de vários factores tais como a idade do paciente, as condições sócio-económicas, a condição periodontal, a perda de estrutura dentária, a severidade da doença e, o mais importante, a cooperação do paciente. O Médico Dentista deve considerar o prognóstico de tratamento a longo prazo. Uma intervenção consciente e cooperante permitirá ao paciente o retorno à alegria de sorrir. Amelogenesis Imperfecta is defined as a complex group of enamel hereditary defects, not associated with systemic diseases, affecting both dentitions, deciduous and permanent. It is a rare defect of enamel mineralization with an incidence of 1:14000. Amelogenesis Imperfecta can be characterized by enamel hipoplasia and/or hypomaturation hypocalcification ou existing teeth. Phenotypically, the amelogenesis imperfect is divided into four groups: hypoplastic, hypomature, hipocalcified and hypomature-hypoplastic. The hypoplastic type occurs in 60 to 73% of affected cases, particularty in females, whereas type hypomature affects 20 to 40% of all cases and is more common in males. Approximately 7% of affected individuals express the hypocalcified variant. Witkop 1988, suggests fifteen subtypes of amelogenesis imperfecta on the basis of phenotypes and inheritance patterns. According to the literature, patients with amelogenesis imperfecta, regardless subtype express similar, oral complications: teeth sensitivity, poor dental aesthetics, and decreased vertical dimension of occlusion. Other dental anomalies associated with amelogenesis imperfecta, but not limited to, are: multiple impaction of teeth, congenital absence of teeth, open bite and taurodontism. Amelogenesis imperfecta is known as an isolated anomaly or as a characteristic of certain syndromes, such as bone-tricodento, Morquio, Kohlschutter, dystrophic epidermolysis bullous, among others. Consedering pediatric dentistry, it is important to know the whole history of the child, all treatments carried out so far. This comprehension and parent´s cooperation in this type of treatment is very relevant and important in order to help children mainly affected at psychological level. Restoring aesthetic and functional capacity chewing and speech are another point to consider. Treatment options vary considerably depending on several factors such as patient age, socioeconomic conditions, periodontal condition, loss of tooth structure, severity of the disease and, most importantly, patient cooperation. The dentist should consider the prognosis for long-term treatment. A conscious intervention and cooperative patient will return to the joy of smiling.

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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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