Hipomineralização molar-inciso: avaliação longitudinal em crianças de 6 a 9 anos
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Data
2012-01-23
Autores
Fragelli, Camila Maria Bullio [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os objetivos deste estudo foram: observar a evolução clínica dos pacientes com HMI, para estabelecer a relação entre a sua severidade com fatores socioeconômicos, índice CPO-D e a presença de DDE, avaliar a evolução clínica do dente afetado por HMI, para estabelecer a relação com a presença de cárie, necessidade de tratamento e a ocorrência de perdas estruturais. Foram acompanhados 49 pacientes com HMI com idade entre 6 e 9 anos, totalizando 588 molares e incisivos com e sem alterações, que receberam tratamento preventivo e proteção com CIV quando indicados. As coletas de dados foram realizadas ao longo de 1 ano, com intervalos de 6 meses por meio de exame clínico, moldagem e fotografias. Um questionário semi-estruturado foi respondido pelas mães a fim de identificar a renda familiar, a escolaridade dos responsáveis e a fonte de água consumida. A análise descritiva, o teste Exato de Fisher, Qui-quadrado, McNemar e análise de sobrevida pelo método Kaplan-Meier foram usados para demonstrar os resultados encontrados. Houve uma associação significante entre o agravamento da HMI e o aumento do CPO-D. O nível sócio-econômico do paciente e a presença de DDE na dentição decídua não foram fatores relacionados à severidade. As fraturas pós-eruptivas ocorreram em 7 dos dentes afetados por manchas de HMI. Das restaurações acompanhadas, 16 apresentaram fratura, ocorridas todas nos primeiros molares permanentes. A presença de HMI apresentou estreita relação com a necessidade de tratamento e com o índice CPO-D. Com a grande possibilidade da estrutura afetada por HMI se manter hígida, 95% para manchas e 77% para restaurações atípicas, não se justifica a remoção, por completo ou prematuramente, da área afetada
The goals of this study were to evaluate the clinic prognostic of patients with molar-incisor-hypomineralization (MIH), to establish the relation between its severity with socioeconomic background factors, DMTF index and the presence of dental enamel defects (DED), evaluate the clinical progress of the tooth affected by that injury, to establish the relation with the presence of dental decay, treatment needs and the occurrence of structural lost. The sample was constituted by 49 patients with HMI aging from 6 to 9 years old. This sample presented 588 molars and incisors teeth with and without abnormalities, which received preventive treatment and protection with conventional glass ionomer cement (GIC) when indicated. The data were collected along of one year with one period of 6 month of interval to clinical exam, impressions and intrabucal photographs. A semi-structured questionnaire was answered by the main guardians aimed to identify the family income, level of schooling and the source of water intake. The descriptive analysis, Fisher Exact test, Quis-square, McNemar and the Kaplan-Meier method (survive analysis) were performed. As results, there was a significant association between the MIH progression with the increase of DMTF index. The patient socioeconomic status and the presence of DED in the primary dentition were not the main factors related to severity. There were 7 post eruptive fractures in the group with MIH spots. Of all restored teeth, 16 first permanent molars presented fractures. The presence of MIH showed a close relation with the need of treatment and with the DMTF index. The results showed a high index of success of this treatment in maintain the sound structure of the teeth affected by HMI with 95% related to spots and 77% to atypical restorations procedures. Thus, remove the affected structure completely or prematurely is not a justified clinical decision
The goals of this study were to evaluate the clinic prognostic of patients with molar-incisor-hypomineralization (MIH), to establish the relation between its severity with socioeconomic background factors, DMTF index and the presence of dental enamel defects (DED), evaluate the clinical progress of the tooth affected by that injury, to establish the relation with the presence of dental decay, treatment needs and the occurrence of structural lost. The sample was constituted by 49 patients with HMI aging from 6 to 9 years old. This sample presented 588 molars and incisors teeth with and without abnormalities, which received preventive treatment and protection with conventional glass ionomer cement (GIC) when indicated. The data were collected along of one year with one period of 6 month of interval to clinical exam, impressions and intrabucal photographs. A semi-structured questionnaire was answered by the main guardians aimed to identify the family income, level of schooling and the source of water intake. The descriptive analysis, Fisher Exact test, Quis-square, McNemar and the Kaplan-Meier method (survive analysis) were performed. As results, there was a significant association between the MIH progression with the increase of DMTF index. The patient socioeconomic status and the presence of DED in the primary dentition were not the main factors related to severity. There were 7 post eruptive fractures in the group with MIH spots. Of all restored teeth, 16 first permanent molars presented fractures. The presence of MIH showed a close relation with the need of treatment and with the DMTF index. The results showed a high index of success of this treatment in maintain the sound structure of the teeth affected by HMI with 95% related to spots and 77% to atypical restorations procedures. Thus, remove the affected structure completely or prematurely is not a justified clinical decision
Descrição
Palavras-chave
Desmineralização do dente, Tooth desmineralization
Como citar
FRAGELLI, Camila Maria Bullio. Hipomineralização molar-inciso: avaliação longitudinal em crianças de 6 a 9 anos. 2012. 78 f. Dissertação (Mestrado) - Universidade Estadual Paulista, Faculdade de Odontologia de Araraquara, 2012.