Postępowanie lecznicze w ciężkiej hipomineralizacji szkliwa – opis przypadku

*Sara Shamsa, Dorota Olczak-Kowalczyk

Summary
Enamel hypomineralization characterized by white, creamy or brown opacity requires an early diagnosis and implementation of preventive and therapeutic procedures in view of high risk of caries and tooth wear. Otherwise it results in hard tissue destruction which requires prosthetic and surgical treatment. The aim of this study is to present the treatment management of enamel hypomineralizaton complications in a 15-year-old female patient.
A 15-year-old patient who was referred to the Department of Pediatric Dentistry, Medical University of Warsaw presented with many white enamel opacities, multisurfaced cavities affecting all permanent teeth, incorrect restorations, malocclusion, gingivitis and unsatisfactory oral hygiene. As the patient was disqualified from orthodontic treatment because of incompliance and difficulties in behaviour management, poor oral hygiene and teeth condition, it was decided to proceed with restorative and prosthetic treatment. At first, desirable dental attitude was established and caries risk reduced by means of prophylaxis and performance of temporary restorations using glass-ionomer cements. In subsequent stages an endodontic treatment of upper and lower incisors was performed and followed by restoration with individual cast gold posts and full ceramic zirconia-based crowns. Glass-ionomer restorations were then replaced with composite resin. The improvement of oral hygiene and patient’s compliance as well as increasing interest in dental esthetics was obtained.
Destruction of hypomineralised teeth associated with inappropriate prophylaxis and therapeutic procedures has an adverse psychological influence on young patients, thus requires implementation of treatment improving dental esthetics.

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