臼齒與門牙礦化不全症治療：病例報告

Treatment of Molar-Incisor Hypomineralization: A Case Report

王威迪(Wei-Ti Wang) ； 黃慧瑜(Huei-Yu Huang) ； 陳瓊芬(Chiung-Fen Chen)

《臺灣兒童牙醫學雜誌》 19卷4期 (2019/12) Pp. 149-154

https://doi.org/10.6319/TJPD.201912_19(4).0003

摘要

臼齒與門牙礦化不全症（Molar-Incisor Hypomineralization）之臨床表徵為個案恆第一大臼齒和恆門齒因牙釉質礦化不全產生變色或是多孔性變化，由於牙釉質礦化不全使得齲齒率比一般人高出2－4倍，且可能因牙釉質崩落使牙本質暴露進而造成牙齒敏感，治療選擇需根據患齒嚴重程度給予適當的治療計畫。本篇目的為敘述一位8歲患有臼齒與門牙礦化不全症之女孩，其四顆恆第一大臼齒因牙釉質礦化不全造成嚴重牙釉質崩落，且因牙齒敏感造成個案潔牙困難及不願意接受治療使得齲齒進展快速。治療計畫為在全身麻醉下進行全口重建，將四顆恆第一大臼齒施作間接覆髓後以不鏽鋼牙冠復形，18個月追蹤回診時，個案口腔衛生有明顯改善，且放射線影像可見牙根皆持續生長成熟。

關鍵字

臼齒與門牙礦化不全症 ； 牙釉質礦化不全 ； 間接覆髓處理

並列摘要

Molar-Incisor Hypomineralization (MIH) is defined as hypomineralization of one to four permanent first molars that frequently associated with affected incisors. The clinical features of MIH include brown or yellowish discoloration, soft and porous enamel. Caries rate of MIH is 2-4 times higher than normal teeth because enamel tends to break down causing hypersensivity. Therefore, patient may refuse to receive dental treatment and experience difficult brushing. It is essential to diagnose and intervene early based on severity of MIH. This case report was to present an 8-year-old girl with severe MIH, rapid enamel break down and deep caries at all first permanent molars. The patient refused to brush teeth and receive dental treatment due to tooth hypersensitivity. The decision was made to perform full mouth dental rehabilitation under general anesthesia included all first permanent molars were treated with indirect pulp treatment then restored with stainless steel crown. At 18-months follow up, no clinical symptom and sign were noted at all permanent first molars and no pathological change at radiography. The patient's oral hygiene was improved as well. The radiographic finding shown continued root formation of all permanent first molars.

並列關鍵字

Molar-Incisor Hypomineralization ； enamel hypomineralization ； indirect pulp capping