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Hipomineralização molar : diagnóstico e tratamento
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A Hipomineralização Molar (HM) é um defeito no desenvolvimento do esmalte dentário, caracterizado por opacidades demarcadas e hipersensibilidade, com origem sistémica desconhecida (idiopática), afetando principalmente os molares, e frequentemente outros dentes. Descrita em 2001, essa condição resulta de anomalias no desenvolvimento do esmalte e tem uma prevalência estimada de 13,5%, sendo que 36,3% dos casos são moderados a graves. Os incisivos são afetados em 36,6% dos casos, enquanto a hipomineralização dos segundos molares decíduos ocorre em 3,6% das situações. A HM representa um problema significativo de saúde pública, com impactos funcionais, estéticos e psicológicos para os pacientes jovens.
Apesar dos avanços na compreensão dessa patologia, a sua etiologia ainda não está totalmente definida. Fatores multifatoriais, como complicações pré-natais, perinatais e pós-natais, são frequentemente mencionados. Isso destaca a importância de uma abordagem preventiva desde os primeiros sinais clínicos, para limitar as lesões no esmalte e prevenir complicações futuras.
O tratamento da HM é desafiador e deve ser personalizado, considerando a gravidade das lesões, a idade do paciente e os sintomas. As opções incluem medidas não invasivas, como a aplicação de verniz fluoretado, e procedimentos micro invasivos ou invasivos para casos mais graves. A gestão da dor e da ansiedade, comuns nesses pacientes, é essencial, podendo ser necessária anestesia geral ou sedação para garantir conforto, segurança e qualidade durante o tratamento.
A investigação contínua sobre a HM é fundamental para entender suas causas e aprimorar o diagnóstico e as abordagens terapêuticas. A pesquisa em novos materiais bioativos, Medicina Dentária digital e estratégias de sensibilização dos profissionais de saúde é crucial. Assim, a HM exige uma abordagem multidisciplinar que combine investigação, prevenção e inovação terapêutica, visando a deteção precoce e soluções adequadas para a restauração e os cuidados psicossociais.
Molar Hypomineralization (HM) is a defect in the development of tooth enamel, characterized by demarcated opacities and hypersensitivity, with an unknown systemic origin (idiopathic), mainly affecting molars and often other teeth. Described in 2001, this condition results from anomalies in enamel development and has an estimated prevalence of 13.5%, with 36.3% of cases being moderate to severe. The incisors are affected in 36.6% of cases, while hypomineralization of the primary second molars occurs in 3.6% of cases. HM represents a significant public health problem, with functional, aesthetic and psychological impacts for young patients. Despite advances in understanding this pathology, its etiology is still not completely defined. Multifactorial factors, such as prenatal, perinatal and postnatal complications, are often mentioned. This highlights the importance of a preventive approach from the earliest clinical signs, to limit enamel lesions and prevent future complications. The treatment of HM is challenging and must be personalized, considering the severity of the lesions, the age of the patient and the symptoms. Options include noninvasive measures, such as the application of fluoride varnish, and micro-invasive or invasive procedures for more severe cases. Pain and anxiety management, common in these patients, is essential, and general anesthesia or sedation may be required to ensure comfort, safety and quality during treatment. Ongoing research into HM is fundamental to understanding its causes and improving diagnosis and therapeutic approaches. Research into new bioactive materials, digital dentistry and strategies to raise awareness among healthcare professionals is crucial. Thus, HM requires a multidisciplinary approach that combines research, prevention and therapeutic innovation, aimed at early detection and appropriate solutions for restoration and psychosocial care.
Molar Hypomineralization (HM) is a defect in the development of tooth enamel, characterized by demarcated opacities and hypersensitivity, with an unknown systemic origin (idiopathic), mainly affecting molars and often other teeth. Described in 2001, this condition results from anomalies in enamel development and has an estimated prevalence of 13.5%, with 36.3% of cases being moderate to severe. The incisors are affected in 36.6% of cases, while hypomineralization of the primary second molars occurs in 3.6% of cases. HM represents a significant public health problem, with functional, aesthetic and psychological impacts for young patients. Despite advances in understanding this pathology, its etiology is still not completely defined. Multifactorial factors, such as prenatal, perinatal and postnatal complications, are often mentioned. This highlights the importance of a preventive approach from the earliest clinical signs, to limit enamel lesions and prevent future complications. The treatment of HM is challenging and must be personalized, considering the severity of the lesions, the age of the patient and the symptoms. Options include noninvasive measures, such as the application of fluoride varnish, and micro-invasive or invasive procedures for more severe cases. Pain and anxiety management, common in these patients, is essential, and general anesthesia or sedation may be required to ensure comfort, safety and quality during treatment. Ongoing research into HM is fundamental to understanding its causes and improving diagnosis and therapeutic approaches. Research into new bioactive materials, digital dentistry and strategies to raise awareness among healthcare professionals is crucial. Thus, HM requires a multidisciplinary approach that combines research, prevention and therapeutic innovation, aimed at early detection and appropriate solutions for restoration and psychosocial care.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Hipomineralização incisivo-molar Prevenção Etiologia multifatorial Tratamento personalizado