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Publication
Caso clínico: amelogénese imperfeita
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Authors
Advisor(s)
Abstract(s)
A amelogénese imperfeita (AI) é uma doença hereditária que causa defeitos no desenvolvimento do esmalte, e esta pode ser do tipo: hipomineralizado, hipomaturado ou hipoplástico.
Este caso clínico tem como objectivo o tratamento de uma criança com amelogénese
imperfeita (AI), mordida aberta anterior, infeção periapical do dente 21 (com ápex aberto)
e raquitismo.
Este fará uma análise da paciente no seu todo, não se focando meramente nos seus
defeitos de esmalte, mas correlacionando-os com a má oclusão da doente e com o
raquitismo.
O plano de tratamento realizado está correlacionado com vários factores como a idade
da paciente, o seu nível socioeconómico, o tipo e a gravidade da AI, bem como, com a
situação intra-oral no momento do tratamento, razão pela qual várias vezes durante o
decorrer deste se realizaram consultas de reavaliação e novo plano de tratamento.
Tratou-se de uma abordagem multidisciplinar que envolveu as áreas de Odontopediatria e Ortodontia, encontrando-se o seu tratamento ainda a decorrer.
Numa primeira fase, foi realizado o tratamento endodôntico do 21, com o intuito inical
de realizar a revascularização do dente. Contudo devido a um período de ausência de
cerca de 18 meses, verificou-se que não existiam as condições necessárias para a
realização da revascularização. Optou-se pela realização de uma barreira apical de
Mineral Trioxyde Aggregate (MTA) e o preenchimento canalar com Gutta Percha
injectável.
De seguida foi colocado à doente um aparelho funcional do tipo Myobrace® e feita a
proteção do remanescente dentário com restaurações a resina composta.
Mais tarde após nova avaliação do tratamento ortodôntico foi decidido realizar a
extração dos 2º molares superiores e 3º molares inferiores, e depois das extrações
realizadas foi colocado um expansor maxilar do tipo Mcnamara, estando de momento
nesta fase.
Amelogenesis Imperfecta (AI) is a hereditary disease that causes defects in the developing enamel, and it’s types are: Hypocalcified, Hypomature our Hypoplastic. This clinical case has the objective of treating a child with amelogenesis imperfecta (AI), anterior open bite, periapical infection of tooth 21 (with open apex) and rickets. This work will do an analyses of the patient as a whole, not focusing merely in her enamel defects, but correlating them to the malocclusion and rickets. The treatment plan is correlated with several factors, as the patient age, socioeconomic level, type and severity of the AI, as well as, the intra-oral situation at the time of treatment, reason why several changes in the treatment plan had to be done over time. This was a multidisciplinary treatment, that involved the areas of Pediatrics and Orthodontics, and the treatment is still on going. At first the root canal treatment of tooth 21 was performed, with the objective of doing the revascularization of the tooth. But because the patient was absent for a period of 18 months, no longer we had the necessary conditions for the realization of a revascularization. And then opted for an apical barrier of Mineral Trioxyde Aggregate (MTA) and the filling with injectable Gutta Percha. After this the patient was treated with functional braces (Myobrace®), and the remaining tooth structure as protected with direct composite restorations. Later in a new evaluation by the orthodontics department it was decided to perform the extraction of the 2º upper molars and 3º inferior molars, after these extractions were completed, the patient performed maxillary expansion with Mcnamara type expander, and at this moment is still undergoing maxillary expansion.
Amelogenesis Imperfecta (AI) is a hereditary disease that causes defects in the developing enamel, and it’s types are: Hypocalcified, Hypomature our Hypoplastic. This clinical case has the objective of treating a child with amelogenesis imperfecta (AI), anterior open bite, periapical infection of tooth 21 (with open apex) and rickets. This work will do an analyses of the patient as a whole, not focusing merely in her enamel defects, but correlating them to the malocclusion and rickets. The treatment plan is correlated with several factors, as the patient age, socioeconomic level, type and severity of the AI, as well as, the intra-oral situation at the time of treatment, reason why several changes in the treatment plan had to be done over time. This was a multidisciplinary treatment, that involved the areas of Pediatrics and Orthodontics, and the treatment is still on going. At first the root canal treatment of tooth 21 was performed, with the objective of doing the revascularization of the tooth. But because the patient was absent for a period of 18 months, no longer we had the necessary conditions for the realization of a revascularization. And then opted for an apical barrier of Mineral Trioxyde Aggregate (MTA) and the filling with injectable Gutta Percha. After this the patient was treated with functional braces (Myobrace®), and the remaining tooth structure as protected with direct composite restorations. Later in a new evaluation by the orthodontics department it was decided to perform the extraction of the 2º upper molars and 3º inferior molars, after these extractions were completed, the patient performed maxillary expansion with Mcnamara type expander, and at this moment is still undergoing maxillary expansion.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Amelogénese imperfeita Mordida aberta anterior Adesão Diagnóstico